Civilian Gun Shot Wound First Aid During a Mass Shooting

Surprisingly, many Active Shooter response protocols don’t outline first aid recommendations for civilians who may be in position to help gunshot wound victims during or after a mass shooting.    In fact, some protocols go so far as to recommend that citizens flee the situation without offering first aid.

But if you are following US Department of Homeland Security Active Shooter protocols which include hiding out from the shooter, you may be sheltering in the vicinity of a gunshot wound victim who is hemorrhaging. Emergency medical responders may be delayed for an hour or more. And you know that stopping the bleeding is one of the first steps necessary for saving a life.

In that case, many experts are beginning to believe that “in mass shootings and terror attacks, perhaps civilians could be their own first responders.”    (“Fighting Terrorism with Tourniquets” , The Atlantic, 11/20/2015).

“In Mass Shootings and Terror Attacks, perhaps civilians could be their own first responders..”

The number of mass shootings* in the US is growing:  in 2015, the United States suffered three hundred and thirty incidents according to the Mass Shooting data list published by the not-for-profit group Gun Violence ArchiveYour first-aid training for gunshot wounds could be more important someday than you ever imagined.

Here are highlights from the updated 2015 American Heart Association and Red Cross first-aid guidelines for treating open chest wounds and bleeding control.  These should be included in your CPR and First Aid certification preparation classes.

Open Chest Wound Updates:

New recommendations from the American Heart Association website warn first-aid responders to avoid using an air or water tight bandage to stop the bleeding.    “We recommend against the application of an occlusive dressing or device by first aid providers for individuals with an open chest wound.”

The warning extends to using non-occlusive gauze bandages.  Blood-soaked bandages can become a partial or full barrier to air flow depending on saturation and should be monitored closely.

Bleeding Control Updates

Applying direct pressure without or without gauze is still a best practice for restricting bleeding and tourniquets are recommended in many situations.  

  • Pressure points and extremity elevation are no longer recommended. Instead, using direct pressure with or without gauze is considered best practice. 
  • First aid providers are advised to consider using a tourniquet if other means have not stopped the severe external limb bleeding.
  • Tourniquets are also recommended as a first-line response such as “during a mass casualty incident, with a person who has multi system trauma, in an unsafe environment, or with a wound that cannot be accessed.”

If your first aid training center provided you with access to a mobile phone app like the one from the American Health and Safety Institute, all the new guidelines situations should be included in the online refresher scenario modules delivered quarterly.

Of course, anyone pursuing certification should ask the training center if the curriculum follows 2015 AHA and Red Cross Updates.    If you’d like to review the 2015 updates yourself, here is a link to a very handy  web interactive tool for updates to First Aid guidelines.

The Beating Heart Center is approved by the American Heart Association and the American Health Safety Institute as a CPR/AED and First Aid Training Center.  The Beating Heart Center is also approved for CPR & First Aid Training by the Emergency Management Service Authority (EMSA), which oversees licensing for day care employees and bus drivers in the state of California.

Resources: U.S. Department of Justice, Federal Bureau of Investigation, a Study of Active Shooter Incidents in the United States Between 2000 and 2013. American Heart Association and Red Cross First Aid Guidelines Mass Shooting *defined as 4 more people being injured or killed.