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Could you save a life in a mass shooting?

Stop the Bleed teaches bystanders how to help in mass casualty events

JACKSONVILLE, Fla. – In light of Sunday night's deadly mass shooting in Las Vegas and stories of victims being saved by properly applied tourniquets, many have expressed interest in learning the life-saving skill.

But experts with UF Health in Jacksonville said a tourniquet used in the wrong way could actually cause more harm than good.

Doctors said the best thing to do is find a rag or anything, like a shirt, and apply pressure to the wound and just keep holding it until help arrives.

“We would recommend direct pressure, because these improvised or self-made tourniquets can cause damage to the skin and to the nerve, and more importantly it’s not going to control the bleeding,” said Chad McIntyre, manager of TraumaOne Flight Services for UF Health.

After the Sandy Hook Elementary School shooting in 2012, the American College of Surgeons met with emergency medical response organizations, the National Security Council and other public safety officials and published the Hartford Consensus, a report on improving survival rates from active shooter events.

Their findings showed half of the students involved lost their lives due to controllable bleeding after being struck by gunfire to their arms and legs. If bystanders had known proper bleeding control methods, the students could have survived until paramedics arrived, the group found.

Those findings led the group to conclude turning civilian bystanders into first responders is essential to saving lives.

“The most important thing is to make sure that you are safe. We do not need more victims,” McIntyre said. “Once you determine that you are safe, obviously we need immediate responders. The first responders -- EMTs, paramedics, firefighters -- are coming, but we need what is called an immediate responder that is going to be the people that are at the scene that can help a loved one or themselves.”

The group's recommendations became the basis for the nationwide Stop the Bleed campaign, which aims to teach bleeding control techniques to the public and decrease preventable deaths during mass casualty events.

“It only takes minutes for someone to bleed to the point that they’re not going to survive, especially if you hit one of the major arteries in your leg or your arm,” said David Ebler, MD, medical director of TraumaOne at UF Health Jacksonville.

Chance of survival improves significantly when someone can apply Stop the Bleed techniques, UF officials said.

“It could go from somebody bleeding to death in minutes to having up to two hours before they need intervention by a trauma surgeon,” Ebler said.

The Stop the Bleed course takes an hour to complete. A trainer guides the class through two evidence-based methods of bleeding control: placing a tourniquet on an extremity and packing a wound with gauze with both hands. 

Participants learn directly from EMT first responders, faculty trauma surgeons and surgery residents, and spend time practicing on anatomical models with stab and gunshot injuries.

While the course is a byproduct of active shooter scenarios, it could also save lives in other traumatic scenarios.

“This knowledge can be used in any traumatic situation -- if a guy outside cutting tree limbs or building something using a saw cuts his arm, or in motor vehicle crashes,” said James Montgomery, EMT-P, outreach coordinator for TraumaOne.

The focus of the course is to make participants feel capable of taking action in an emergency situation, and it seems to be working, UF officials said.

“A lot of people don’t necessarily think there’s something they can do,” Montgomery said. “Some of the feedback we’re getting is that if they were ever to be in a situation, regardless of if it’s a more common traumatic event or an active shooter event, they’re more confident in knowing what to do and how to do it.”

On Feb. 17, hospital CEO Russ Armistead, Ebler and Montgomery honored Terrance Hightower of the Jacksonville Sheriff’s Office with a plaque for using a tourniquet to save a teenage victim during the First Wednesday Art Walk shooting in downtown Jacksonville. Hightower's use of Stop the Bleed methods is a reminder that tragedy happens unexpectedly, and a bystander’s response can be the difference between life and death, UF officials said.

“‘Mass shooting’ and ‘active shooter’ weren’t in our vocabulary a decade ago, but now they are. With minimal equipment, if any, you can make a difference,” Ebler said.

The Stop the Bleed initiative is working to provide bleeding control supplies, including a CAT tourniquet, to each person who takes the course. They hope to train and equip 1,000 members of the public by the end of 2017.

If you or your organization would like to host a 60-minute Stop the Bleed training session, contact James Montgomery at 904-244-8515 or James.Montgomery2@jax.ufl.edu.


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