With a formation reminiscent of football's "flying wedge" -- but with stakes of life or death -- federal officials envision phalanxes of law enforcement officers protecting paramedics so they may more quickly reach the wounded in active shooter situations.
Working with FEMA guidelines released three months ago, the Los Angeles Fire Department expects training of paramedics to work with police in "rescue task forces" to begin next month, according to LA Fire Department Battalion Chief Steve Ruda.
"Now we will be training all of of our firefighters in the Los Angeles Fire Department as first responders to be able to do that," Ruda said.
Shielded by armed officers, the medical responders would wear body armor and helmets and carry lightweight packs with supplies geared mainly to staunch bleeding and stabilize trauma patients long enough to be moved to a safer area for further care.
The FEMA guidelines are intended for departments nationwide.
Some have already begun training.
All 1,000 personnel in the Orange County Fire Authority have completed the training, though are yet to deploy it in a real emergency, said Capt. Steve Concialdi.
Impetus to push forward stemmed from a horrific attack inside a Seal Beach Beauty Salon in 2011, shots fired by a single gunman claiming eight lives.
Since the attack at Columbine High School in 1999, more than 250 Americans have been killed in active shooter/mass casualty situations, according to FEMA statistics.
Even as law enforcement has been expected to aggressively pursue active shooters, the traditional protocol has called for medical responders to stage at a safe distance in a so called "cold zone," awaiting word it is safe to approach.
That era is ending.
"The thinking now is we're going in with force protection," Concialdi said.
The motivation is to get to the wounded and bleeding, for whom a matter of a few minutes can mean life or death.
"If we can stop bleeding and save lives, that's what we'll do," Concialdi said.
The new methods were tested last month during a training drill in Anaheim.
Under the scenario, a hospital was invaded by an "active shooter." During the drill, clusters of paramedics and law enforcement entered the building to search for victims.
Currently, Los Angeles has a small number of "tactical paramedics" who have been trained to work with LAPD SWAT officers.
Paramedics were present nearly six years ago when SWAT responded to a Winnetka home with an active shooter who had shot family members.
Two members of the SWAT team were shot as they made entry.
Paramedics went in with officers to rescue the officers. Officer James Veenstra suffered severed damage to his jaw but survived.
The wounds to Randal Simmons were fatal. Last month, the Los Angeles Fire Department was still operating on the longstanding protocol when gunfire erupted at Los Angeles International Airport inside Terminal Three.
A gunman had opened fire on TSA personnel near the entrance and then the screening area, and had continued deeper into the building.
Paramedics reached the greater terminal area within minutes, but held back from approaching Terminal Three until advised that the shooter was down and under control.
"The LAX incident really was a paradigm shift for us," Fire Dept. Medical Director Mark Eckstein, told the Los Angeles Times.
Some wondered whether it might have been possible to save TSA Officer Gerardo Hernandez had paramedics reached him sooner.
However, the autopsy determined his wounds were so severe that death came within two to five minutes, before paramedics would have reached him even if they had gone straight into the terminal.
But belief other lives can be saved is the motivation for the new emergency medical directive.
At the same time, there is a growing trend to provide law enforcement officers with training and portable medical kits to staunch bleeding.
"It's important for our deputies to be trained to treat gunshot wounds," said Lt. Jeff Hallock of the Orange County Sheriff's Department.
Hallock said the training was put to use recently in South Orange County when a deputy suffered a stab wound, and another deputy was able to staunch the bleeding until paramedics arrived.