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Nearly four years ago, emergency personnel聽responding聽to the confronted a chaotic and bloody聽scene聽much like the one first responders encountered early Sunday morning, when they聽sped to the aid of victims at a聽nightclub massacre in Orlando, Fla.

The that horrifying night in 2012 led to changes in procedures not only for Aurora’s emergency personnel, but for first responders across the country.

A report after聽the shooting found that a tangle of parked police cars, curbs and panicked moviegoers trying to reach the injured.聽Aurora police officers transported victims to hospitals in police cars, taking initiative that probably saved many lives, according to the report.

He noted that video of the response to the Orlando massacre聽showed officers placing聽wounded people in a聽pickup truck.

“That was the most important lesson, evacuate the wounded as quickly as possible by whatever means,” said Oates, who now heads the Miami Beach (Fla.) Police Department. “It looks like officers in Orlando practiced that.”

Twelve people were killed and聽70 injured in July 2012, when James Holmes started shooting at聽the Century 16 movie theater during a premiere of “The Dark Knight Rises.”

Until early Sunday, when a gunman killed at least 50 people and wounded at least 53 others at Pulse聽nightclub in Orlando, Holmes’ attack caused聽the聽largest number of casualties during a mass聽shooting in the United States.

“The department has made a lot of changes in response to these types of incidents,” said Sean Dolan, Aurora Fire Department spokesman.聽“Some of the things we’ve learned as far as communication with the police department, with dispatchers and coordination with the agencies involved have been adopted nationwide.”

Police now pay closer attention to their vehicles, to assure they don’t slow down medical care聽for victims, Dolan said.

“They have their vehicles staffed to be moved when we approach,” Dolan said.

Aurora brought in聽victims’ advocates from neighboring jurisdictions to work with victims and their families so one advocate was assigned to each family, Oates said.

Among other things, the advocates acted as liaisons between the media and the聽families.聽Reporters would contact the advocates, who would then ask family members if they were willing to be interviewed. “The press respected that. It took the burden off the families,” Oates said.

Today, Aurora police and fire departments share space in the聽Aurora Public Safety Training Center, which opened in January and allows officers and firefighters to train together, Aurora Police Chief Nick Metz said.

“That allows us to train together more often,” Metz said. “It is really rare to see major city police departments and fire departments sharing training facilities.”

Significant improvements have been made to radio communications equipment connecting emergency responders, Metz said, and Aurora has beefed up its SWAT teams.

After repeated mass shootings, law enforcement agencies have become more sophisticated in handling the incidents, Oates said.聽But gun laws remain loose.

“Pain and anguish continues, and nothing changes about guns in this country. You are still talking about a guy with an assault weapon walking into a nightclub,” he said.

“I don’t see any need for anyone to have an assault rifle.”