Right after the attack at Columbine High School, law enforcement agencies nationwide began developing and delivering training on new response protocols for active shooter events. One of the things that was included in those early curriculums was recognizing that as officers responded to the sound of shots, they would have to ignore and pass by the injured, dead or dying victims. Following on that protocol was usually a plan for clearing paramedics and other emergency medical personnel to enter the scene and begin treating the wounded. Those plans varied from jurisdiction to jurisdiction and depended on the risk level accepted by the medical personnel (or the risk level the command staff was willing to expose them to).
Just as we know, based on historical data, that the faster we neutralize the attacker the more lives we save through reduction of victim access (to the shooter), the same applies to saving the wounded. The faster we can get emergency care started, the more lives we can save. With gunshot wounds to the extremities, exsanguination (blood loss) is the primary cause of death. Those deaths are easily preventable with proper application of a tourniquet, but it has to be done pretty quick after the wound is created, and that’s just one example of how timely medical attention can save lives.
When it comes to neutralizing the threat through the delivery of lethal force, the debate will continue to rage about gun control and there will be the on-going challenge of identifying the “good guys” and separating them out from the “bad guys.” What is easily agreed upon is that once the threat has been neutralized, or even just kept restricted from a particular area, emergency medical assistance can be started immediately. The challenges that exist for such circumstances to be created are twofold: first, we have to embrace the potential for all citizens to deliver medical assistance, and second, we have to support the possibility with training and equipment.
In that regard, what would be required?
On the training side, it would mean supporting training in advanced first-aid and trauma care. In general, most law enforcement agencies face a challenge in getting enough training budget to meet minimum requirements much less providing training to citizens in their community. That recognized, if your agency has any type of “community outreach” or even crime prevention budget, it could be used to provide such training. We largely depend (if not exclusively depend) on our fire and emergency medical public safety entities to provide such training, but we also have our own instructions in the law enforcement training staff. Why not offer the training if you have the staff, time and budget to do so?
Let’s accept this one outlook: the more properly trained and willing good guys we have on any active killer scene, the better position we’re in for recovery and mitigation after the threat is neutralized. Ideally, it’s best to have two care providers for each injured or wounded individual. It’s a rare occasion that we have that much manpower in uniform, but there are almost always citizens standing around either ogling the scene or waiting to be released. Some of them inevitably ask, “What can I do to help?” If they have been trained and certified for emergency medical care, at whatever level, they can help treat the wounded and prepare them for evacuation to a triage facility or hospital.
In a perfect world, we could train everyone to be paramedics or EMTs, but that takes a lot of time and budget. Typical EMT training is a college semester long or months part time through volunteer firehouse membership. One commercial entity this author is familiar with, the Commonwealth Criminal Justice Academy in Fredericksburg, Virginia, offers an EMT program online with the requirement to go to their facility to be tested after you’ve completed the course. (More information available HERE.)
Our other challenge, even if we can get people trained and willing to help on any type of mass basis, is making sure there are the necessary materials available to deliver treatment. We can’t reasonably expect every citizen to walk around with a trauma kit, although it’s highly recommended that every legally armed citizen have a basic minimal trauma kit near at hand, so we’ll have to plan to preplace trauma care equipment. Tourniquets, pressure bandages, hemostatic agents, nitrile gloves and micro-masks for delivering CPR – these are all items that can be put into kits and stocked around public buildings. For every fire extinguisher you see, there should be another “Break glass in case of emergency” cabinet with a stocked trauma kit inside. Several manufacturers of trauma care materials also sell mass attack response packages equipped for basic trauma treatment of a dozen people or more.
