If your department is like most volunteer or combination departments in the U.S., you struggle to maintain the staffing needed to provide the adequate level of service to your community. The numbers are clear. The National Fire Protection Association reports that in 1984 there were 897,750 volunteer firefighters, and that in 2013 there were 786, 150. This is a 12 percent decrease. In that same time period, call volume has tripled, largely due to increased medical emergency calls.

Why are we having problems recruiting new members? There are a lot of factors, including increased demands on people’s time, increased training requirements, and geographical shifts as people move away from smaller communities for job opportunities...

Friday, Nov 13, 2015. It’s 2130 h when the Assistance Publique-Hôpitaux de Paris (APHP) is alerted to the explosions that have just occurred at the Stade de France, a stadium in Saint-Denis just outside Paris. Within 20 min, there are shootings at four sites and three bloody explosions in the capital. At 2140 h, a massacre takes place and hundreds of people are held hostage for 3 h in Bataclan concert hall.

The emergency medical services (service d’aide médicale d’urgence, SAMU) are immediately mobilised and the crisis cell at the APHP is opened. The APHP crisis unit is able to coordinate 40 hospitals, the biggest entity in Europe with a total of 100 000 health professionals, a capacity of 22 000 beds, and 200 operating rooms. It is very quickly confirmed that the attacks are multiple and that the situation is highly scalable and progressing dangerously. These facts led to a first decision: the activation of the “White Plan” (by the APHP Director General) at 2234 h—mobilising all hospitals, recalling staff, and releasing beds to cope with a large influx of wounded people. The concept of the White Plan was developed 20 years ago, but this is the first time that the plan has been activated....