CAP Talk

General Discussion => The Lobby => Topic started by: Stonewall on February 05, 2013, 01:49:19 AM

Title: A Cadet in an Active-Shooter Incident
Post by: Stonewall on February 05, 2013, 01:49:19 AM
Awesome article on the subject of Active Shooter over on CadetStuff (http://www.cadetstuff.org/a-cadet-in-an-active-shooter-incident/).

I highly recommend reading and sharing with your squadrons!
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Pylon on February 05, 2013, 02:12:51 AM
+1.  Share this resource with cadets.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: That Anonymous Guy on February 05, 2013, 02:33:56 AM
Good read, interesting. Scary that we have to think about it but compared to most kids in my school I am better trained to deal with an event such as a mass shooting, even with something as simple as making the 911 call. Has a CAP cadet ever been caught in an active shooter situation?
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Stonewall on February 05, 2013, 02:37:13 AM
Quote from: NY Wing King on February 05, 2013, 02:33:56 AM
Has a CAP cadet ever been caught in an active shooter situation?

Sort of, here (http://legacy.utsandiego.com/news/metro/santana/20010309-9999_1m9gordon.html).  He was no longer in CAP at the time, but still.

Oh, and NY Wing King...share this article with your fellow cadets.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: That Anonymous Guy on February 05, 2013, 02:40:33 AM
[darn]...
The first article raised a good question though. I think school first aid kits should have QuikClot
Title: Re: A Cadet in an Active-Shooter Incident
Post by: coudano on February 05, 2013, 02:49:25 AM
Quote from: NY Wing King on February 05, 2013, 02:40:33 AM
[darn]...
The first article raised a good question though. I think school first aid kits should have QuikClot

Well, only if you are properly trained in how to use it...
Title: Re: A Cadet in an Active-Shooter Incident
Post by: JayT on February 05, 2013, 03:02:40 AM
Quote from: NY Wing King on February 05, 2013, 02:40:33 AM
[darn]...
The first article raised a good question though. I think school first aid kits should have QuikClot

Have you ever used Quikclot?
Title: Re: A Cadet in an Active-Shooter Incident
Post by: That Anonymous Guy on February 05, 2013, 03:11:17 AM
Quote from: JayT on February 05, 2013, 03:02:40 AM
Quote from: NY Wing King on February 05, 2013, 02:40:33 AM
[darn]...
The first article raised a good question though. I think school first aid kits should have QuikClot

Have you ever used Quikclot?
No but I read a book where they used it. Is it really that complicated?
Title: Re: A Cadet in an Active-Shooter Incident
Post by: SJFedor on February 05, 2013, 03:13:16 AM
Quote from: NY Wing King on February 05, 2013, 02:40:33 AM
[darn]...
The first article raised a good question though. I think school first aid kits should have QuikClot

Disagree. There's a reason why the vast majority of EMS services out there don't carry the stuff. Mainly the first generation of the stuff had a huge heat release while it did it's magic, has a big risk of entering the body's circulation and causing an embolism (read: stroke, MI, PE) and it's a PITA for the surgeons to deal with once the patient gets to definitive care. It also does NOTHING for penetrating trauma, at least to the torso (ballistic wounds, stabbings, etc.) unless it's a "blowout" type wound. It's moreso designed for big gashes (chainsaws, IED's, etc). There's also a couple contraindications for the application and use of it.

An ABD pad and direct pressure, or an improvised tourniquet, will do wonders more for that patient than you trying to read the instructions on a hemostatic agent and trying to apply it.

While some of the article is good, sound advice, some if it isn't so great. TCCC and PHTLS, for instance, goes into things like IV initiation, fluid resuscitation, needle chest decompression, airway management, and a few other things, none of which is readily available in a first aid kid in the civilian world. So, while the "cool factor" is there, it's just not practical for the civilian lay rescuer. Basic first aid w/ the addition of a tourniquet is about as far as the civilian world needs to take it. Remember, most of these products are designed with the battlefield in mind, and with a significant delay in transport to definitive care. Unless you're in BFE, once you say "active shooter", the calvary is on the way, won't take long to secure the scene, and triage/transport commences of the wounded. You're not trying to keep them alive for the first 2 hours, just the first 10min or so.

And while blood loss is a big concern, and increases risk of mortality in penetrating trauma, other than the occasional shot to an extremity which manages to transect an artery, you're not going to have an awful lot of bleeding. It's the damage and bleeding internally that causes the majority of deaths, like tension pneumothorax, pericardial tamponade, large vessel transection, or internal hemmorage from hitting vascular organs, like the liver, kidneys, or spleen, which the ONLY treatment for is bright lights and cold steel (an OR and surgeon).
Title: Re: A Cadet in an Active-Shooter Incident
Post by: SJFedor on February 05, 2013, 03:16:31 AM
And BTW, this is coming from someone who has worked in two large metropolitan 911 services, and has seen and treated a LOT of shootings/stabbings. Watch the First 48 sometime when they're showing episodes from Louisville, occasionally you'll see me or one of my cohorts running around in the background.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: That Anonymous Guy on February 05, 2013, 03:25:00 AM
Quote from: SJFedor on February 05, 2013, 03:16:31 AM
And BTW, this is coming from someone who has worked in two large metropolitan 911 services, and has seen and treated a LOT of shootings/stabbings. Watch the First 48 sometime when they're showing episodes from Louisville, occasionally you'll see me or one of my cohorts running around in the background.
I stand corrected, since they stated that it's carried by every infantryman I assumed it was good for gunshot wounds although you stated that it in fact is not. In regards to actively trying to neutralize the shooter (I'm NOT advocating this), there were two teens at the camp in Norway who attacked the shooter with rocks and sticks and then saw their friend get killed so don't do that unless he's in the classroom(last resort). Question for the senior members, do you agree with the author when he said that cadets had a duty in a situation like this? Do you believe they could make a difference?
Title: Re: A Cadet in an Active-Shooter Incident
Post by: SJFedor on February 05, 2013, 03:34:10 AM
Quote from: NY Wing King on February 05, 2013, 03:25:00 AM
Quote from: SJFedor on February 05, 2013, 03:16:31 AM
And BTW, this is coming from someone who has worked in two large metropolitan 911 services, and has seen and treated a LOT of shootings/stabbings. Watch the First 48 sometime when they're showing episodes from Louisville, occasionally you'll see me or one of my cohorts running around in the background.
I stand corrected, since they stated that it's carried by every infantryman I assumed it was good for gunshot wounds although you stated that it in fact is not. In regards to actively trying to neutralize the shooter (I'm NOT advocating this), there were two teens at the camp in Norway who attacked the shooter with rocks and sticks and then saw their friend get killed so don't do that unless he's in the classroom(last resort). Question for the senior members, do you agree with the author when he said that cadets had a duty in a situation like this? Do you believe they could make a difference?

It's good for uncontrolled arterial extremity wounds, and even then, it's usually not used until AFTER the tourniquet has failed, which is a big rarity, unless the wound is just too high up for a tourniquet to be applied. Central wounds (torso, neck, head) are no-go's, because this product is designed to actually occlude the vessel itself. Since we can't really get to the vessel affected in a central wound (unless they're just blown apart, or you're McGyver, either way, minimal chance of survival) it's not all that useful.

And it's decently expensive and only has a shelf life of ~3 years. Whereas a CAT (combat application tourniquet) is good for essentially forever, is cheaper, and is your 2nd line standard of care (after direct pressure)
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Huey Driver on February 05, 2013, 03:59:49 AM
Whenever my school has a bomb or gun threat (multiple times per year), I always bring a condensed first aid kit specifically with bleeding control items, gauze and pads, etc, among some other stuff. If there's an increased risk, why not make myself ready in the unlikely event that something could occur? I've thought about the stuff mentioned in that article many times.

No, I'm not paranoid either. Just vigilant.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Eclipse on February 05, 2013, 04:06:22 AM
When I saw the article come across the RSS, the first thing I thought of was Naugle, so no surprise he wrote it - he's published those
types of articles on CS before, and I believe they have some training for this at the CSS school.

I understand it, especially for our cadets, the best ones who probably would be looked to for leadership in these situations, and are
most likely to have a clearer head, but...

My second though was, is this the new !@#$% normal?  Because I sure don't want it to be.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Private Investigator on February 05, 2013, 06:05:39 AM
Excellent for a Safety Brief.

I'll pass it along   :clap:
Title: Re: A Cadet in an Active-Shooter Incident
Post by: ♠SARKID♠ on February 05, 2013, 07:59:23 AM
This
RUN. HIDE. FIGHT. Surviving an Active Shooter Event - English (http://www.youtube.com/watch?v=5VcSwejU2D0#ws)

And this
Last Resort ACTIVE SHOOTER SURVIVAL Measures by Alon Stivi (http://www.youtube.com/watch?v=r2tIeRUbRHw#)
Title: Re: A Cadet in an Active-Shooter Incident
Post by: That Anonymous Guy on February 05, 2013, 12:04:32 PM
Quote from: JerseyCadet on February 05, 2013, 03:59:49 AM
Whenever my school has a bomb or gun threat (multiple times per year), I always bring a condensed first aid kit specifically with bleeding control items, gauze and pads, etc, among some other stuff. If there's an increased risk, why not make myself ready in the unlikely event that something could occur? I've thought about the stuff mentioned in that article many times.

No, I'm not paranoid either. Just vigilant.
A bomb or gun threat lasting multiple days? If my school has a bomb threat we shut down and evacuate.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: JayT on February 05, 2013, 02:00:50 PM
Quote from: SJFedor on February 05, 2013, 03:13:16 AM
Quote from: NY Wing King on February 05, 2013, 02:40:33 AM
[darn]...
The first article raised a good question though. I think school first aid kits should have QuikClot

Disagree. There's a reason why the vast majority of EMS services out there don't carry the stuff. Mainly the first generation of the stuff had a huge heat release while it did it's magic, has a big risk of entering the body's circulation and causing an embolism (read: stroke, MI, PE) and it's a PITA for the surgeons to deal with once the patient gets to definitive care. It also does NOTHING for penetrating trauma, at least to the torso (ballistic wounds, stabbings, etc.) unless it's a "blowout" type wound. It's moreso designed for big gashes (chainsaws, IED's, etc). There's also a couple contraindications for the application and use of it.

An ABD pad and direct pressure, or an improvised tourniquet, will do wonders more for that patient than you trying to read the instructions on a hemostatic agent and trying to apply it.

While some of the article is good, sound advice, some if it isn't so great. TCCC and PHTLS, for instance, goes into things like IV initiation, fluid resuscitation, needle chest decompression, airway management, and a few other things, none of which is readily available in a first aid kid in the civilian world. So, while the "cool factor" is there, it's just not practical for the civilian lay rescuer. Basic first aid w/ the addition of a tourniquet is about as far as the civilian world needs to take it. Remember, most of these products are designed with the battlefield in mind, and with a significant delay in transport to definitive care. Unless you're in BFE, once you say "active shooter", the calvary is on the way, won't take long to secure the scene, and triage/transport commences of the wounded. You're not trying to keep them alive for the first 2 hours, just the first 10min or so.



I agree that a cadet has no need what so ever for TCCC or PHTLS (Thank you NAEMT for the sweet, sweet CME credit).

I'm curious what style of Quikclot your service is using through? Ours either comes packaged as an impregnated 4x4 or as a beanbag style pouch. I've been arguing for the Z-Fold style with is to TCCC guideline. We never carried the powder. I've used it a few times and except in one case of a surgical wound opening on a patient on coumadin, it's worked well.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Stonewall on February 05, 2013, 03:28:57 PM
There are critics in everything, from applying lifesaving first aid to how to fire your rifle.  This is not a bad thing and I highly encourage debate and challenging others' opinions and practices.  While I may not agree 100% with every aspect of the article, I do think its overall message is what's important. 

I take from it one important bit of advice – be a part of the solution.  Seek first aid training, or specifically, advanced first aid training.  Call it TCCC, or whatever, the fact is you can never have too much knowledge or tools in your toolbox.  TCCC does NOT cover IVs, BTW.  Combat Life Saver (CLS), did, then they stopped; then they taught it again, then they stopped...  I'm not sure what they're doing now, but it was a controversial topic so they kept going back and forth on whether or not IVs should be taught.  At the end of the day, I would not discourage anyone from sitting in on a TCCC or CLS program, solely because you CAN gain something from it.  Who cares if they cover IVs or QuickClot.  If it's not something you can/want/choose to carry in your kit (likely can't afford it), that's your prerogative, and I agree with that 100%.

I don't think the author is saying "cadets must carry QuickClot", I think the point is the more prepared you are, through training and the availability of relevant equipment, beyond band aids and aspirin, the better off you'll be.

The author is in the military and the military still puts QuickClot (gauze) in the Individual First Aid Kits (IFAKs) that are issued to EVERYONE deploying overseas.  Additionally, two CATs are issued.  And it is widely taught that CATs save lives and you can apply one and not always lose a limb, contrary to what used to be taught pre-GWOT.  This is why most combat units, including mine, require a CAT be affixed to a specific location on your IBA or in a specific pocket on your uniform (usually a sleeve or pant pocket).

I absolutely applaud and respect the feedback and insight from our EMS professionals completely, but there is more to the article than the necessity or applicability of TCCC or QuickClot.  To the readers, please don't neglect the overall message of the article, because I still find it a valuable piece we can all learn from.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: abdsp51 on February 05, 2013, 05:26:12 PM
Most SOPs in regards to active shooters are to get out of the building or hide and is taught that you only engage as a last resort.  With this being said it is far better for cadets and children in general to try and get out of the building or hide.  Document what you see and hear and try to get the word out to LE.  Being a good solid witness is better than trying to play hero.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Stonewall on February 05, 2013, 05:44:35 PM
Quote from: abdsp51 on February 05, 2013, 05:26:12 PM
Most SOPs in regards to active shooters are to get out of the building or hide and is taught that you only engage as a last resort.  With this being said it is far better for cadets and children in general to try and get out of the building or hide.  Document what you see and hear and try to get the word out to LE.  Being a good solid witness is better than trying to play hero.

SOPs?  The article isn't talking about a police response to active shooters, it discusses what to do in the event an active shooter, or other "mass violence" incident as a victim, as well as making preparations for such an event (i.e. first aid training; being prepared).

The article makes it clear that only as a last resort.  In fact, here's the quote "I want to be abundantly clear here: this does not mean I think you should take a weapon to school, and it doesn't mean I think you should be in a rush to take a bullet for your country and classmates."  And then there's "I am not talking about fighting the bad guy."  So I think the author made the point abundantly clear NOT TO PLAY HERO.  However, if put into a position where there is no way out, you may (as unlikely as it is) have to take some sort of action. 

Most people have not seen the video footage of Eric Harris and Dylan Klebold chasing students throughout Columbine...with the AUDIO.  In one (of many) scenes, the shooters taunt their fellow students as they retreat under a desk.  The kids are begging for mercy...it is gut wrenching.  And I think the author genuinely wants reader to know that if it comes between dying and surviving, then fight to survive.  Don't put yourself in that situation willingly, but if it comes down to it, DON'T GIVE UP!  NEVER QUIT!  Use a fire extinguisher, a pencil, that 5 lbs algerba book...you never know, but fight, fight, fight....AS A LAST RESORT, when there is no other option.  Think UA Flight 93.  They died fighting and they saved more lives by doing so.  If they would have sat there and let the terrorists do their thing, more than the 40 passengers onboard.

That's what I think the author is saying here.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Huey Driver on February 05, 2013, 08:46:56 PM
Quote from: abdsp51 on February 05, 2013, 05:26:12 PM
Most SOPs in regards to active shooters are to get out of the building or hide and is taught that you only engage as a last resort.  With this being said it is far better for cadets and children in general to try and get out of the building or hide.  Document what you see and hear and try to get the word out to LE.  Being a good solid witness is better than trying to play hero.

Our school's SOP is for everyone to stay inside, in a locked classroom in a less exposed corner with the lights out. We all say though that if there were a real incident, we'd all run out if that was a viable option. That would really screw over accountability, but there'd be a higher chance of survival.

Edit: We have only one floor. There's also plenty of exits. So running is just situational for my school.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Майор Хаткевич on February 05, 2013, 08:50:01 PM
Quote from: JerseyCadet on February 05, 2013, 08:46:56 PM
Quote from: abdsp51 on February 05, 2013, 05:26:12 PM
Most SOPs in regards to active shooters are to get out of the building or hide and is taught that you only engage as a last resort.  With this being said it is far better for cadets and children in general to try and get out of the building or hide.  Document what you see and hear and try to get the word out to LE.  Being a good solid witness is better than trying to play hero.

Our school's SOP is for everyone to stay inside, in a locked classroom in a less exposed corner with the lights out. We all say though that if there were a real incident, we'd all run out if that was a viable option. That would really screw over accountability, but there'd be a higher chance of survival.

Not quite true...

If you're on the 2nd/3rd floor of your school, you want to take chances in the hallways? Most schools have reinforced glass next to their doors, and chances are, most shooters will not try to break into a locked room. Your chances of surviving by running are ONLY viable if you're already in the open, and can't quite get anywhere else.

That said, I've always thought that if I am in a "trapped" position, and a shooter does enter the room, my odds are better if I charge the shooter than sitting under a desk kissing my ass goodbye. In fact, the second video posted above was quite interesting in that regard.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Huey Driver on February 05, 2013, 08:53:30 PM
Quote from: usafaux2004 on February 05, 2013, 08:50:01 PM
Quote from: JerseyCadet on February 05, 2013, 08:46:56 PM
Quote from: abdsp51 on February 05, 2013, 05:26:12 PM
Most SOPs in regards to active shooters are to get out of the building or hide and is taught that you only engage as a last resort.  With this being said it is far better for cadets and children in general to try and get out of the building or hide.  Document what you see and hear and try to get the word out to LE.  Being a good solid witness is better than trying to play hero.

Our school's SOP is for everyone to stay inside, in a locked classroom in a less exposed corner with the lights out. We all say though that if there were a real incident, we'd all run out if that was a viable option. That would really screw over accountability, but there'd be a higher chance of survival.

Not quite true...

If you're on the 2nd/3rd floor of your school, you want to take chances in the hallways? Most schools have reinforced glass next to their doors, and chances are, most shooters will not try to break into a locked room. Your chances of surviving by running are ONLY viable if you're already in the open, and can't quite get anywhere else.

That said, I've always thought that if I am in a "trapped" position, and a shooter does enter the room, my odds are better if I charge the shooter than sitting under a desk kissing my ass goodbye. In fact, the second video posted above was quite interesting in that regard.

See my edit. But I definitely agree with you on your last point.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Eclipse on February 05, 2013, 09:33:37 PM
Quote from: usafaux2004 on February 05, 2013, 08:50:01 PM
That said, I've always thought that if I am in a "trapped" position, and a shooter does enter the room, my odds are better if I charge the shooter than sitting under a desk kissing my ass goodbye. In fact, the second video posted above was quite interesting in that regard.

I'd agree - trained police officers can empty a whole clip and never hit someone, let alone a school shooter.

But easily said, and not so easily done.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Майор Хаткевич on February 05, 2013, 10:10:00 PM
Quote from: Eclipse on February 05, 2013, 09:33:37 PM
Quote from: usafaux2004 on February 05, 2013, 08:50:01 PM
That said, I've always thought that if I am in a "trapped" position, and a shooter does enter the room, my odds are better if I charge the shooter than sitting under a desk kissing my ass goodbye. In fact, the second video posted above was quite interesting in that regard.

I'd agree - trained police officers can empty a whole clip and never hit someone, let alone a school shooter.

But easily said, and not so easily done.

No doubt. Having never been in a situation like that, I don't know If I could act or would freezeup. No one knows until it happens.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: NIN on February 06, 2013, 02:52:46 AM
Guys, while he doesn't post here, CadetStuff's resident warlord and thinker wanted me to thank you guys for the spirited discussion here and offer this:

QuoteI was impressed with the thoughtful peer review of the CadetStuff article.  I meant it when I invited better ideas. 

While I am agnostic as to which hemorrhage control method one chooses to use, based on his or her level and scope of training, I think hemorrhage control is an important skill and capability.  I think it is optimistic to expect EMS to enter a mass violence incident on a tight timeline. 

I was particularly concerned with SJFedor's statement that: "Unless you're in BFE, once you say "active shooter", the calvary [sic] is on the way, won't take long to secure the scene, and triage/transport commences of the wounded. You're not trying to keep them alive for the first 2 hours, just the first 10min or so."  Sir, the data does not support your assertion. Look at the timelines at Columbine and Virginia Tech... it DID take hours, and one teacher in Columbine bled to death over the course of those hours, under the care of students at that. 

I have no particular affection for Quikclot, but I know that most school and office first aid kits are essentially boxes of band-aids and are not set up for trauma, I also know, as you pointed it out, that the problems with clotting agents have been mostly resolved.  My assertion on the first aid stuff in the article is that people should get the most training they can in trauma-related first aid, and equip accordingly. If that wasn't clear, hopefully this will serve to make it clear.

And just to add some more clarity, on SJFedor's point that: "An ABD pad and direct pressure, or an improvised tourniquet, will do wonders more for that patient than you trying to read the instructions on a hemostatic agent and trying to apply it."  If you can't follow the -cartoon- instructions on the back of a Quikclot package, I don't want you applying an improvised tourniquet on me... it will probably end up around my neck. -JamesN
Title: Re: A Cadet in an Active-Shooter Incident
Post by: EMT-83 on February 06, 2013, 03:17:51 AM
As a direct result of Columbine, police response to active shooters has changed. Where the old line of thinking was to secure the perimeter, current practice is to immediately enter the building and engage the shooter.

Not sure if the timeline quoted for emergency care at Columbine is still valid.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Eclipse on February 06, 2013, 03:38:10 AM
Quote from: EMT-83 on February 06, 2013, 03:17:51 AM
As a direct result of Columbine, police response to active shooters has changed. Where the old line of thinking was to secure the perimeter, current practice is to immediately enter the building and engage the shooter.

I worked for a municipality during that time, the municipal building was an old high school and the backside on both floors still maintained the
classrooms (as offices and workspaces) and typical locker-lined hallways.

More then once I walked into signs indicating the area was off-limits as PDs from the area practiced these scenarios.  Full gear, with dummy weapons.
Still scary, especially when you're not expecting it.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: abdsp51 on February 06, 2013, 03:41:15 AM
Sir,

There have been many many active shooters spanning the last years.  I was simply saying that a cadet or anyone should not necessarily engage a shooter unless it was a last resort. 
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Майор Хаткевич on February 06, 2013, 07:17:17 AM
Quote from: EMT-83 on February 06, 2013, 03:17:51 AM
As a direct result of Columbine, police response to active shooters has changed. Where the old line of thinking was to secure the perimeter, current practice is to immediately enter the building and engage the shooter.

Not sure if the timeline quoted for emergency care at Columbine is still valid.

Don't know, the response times still seem to be in the HOURS, not minutes.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Thom on February 06, 2013, 01:53:06 PM
Quote from: usafaux2004 on February 06, 2013, 07:17:17 AM
Quote from: EMT-83 on February 06, 2013, 03:17:51 AM
As a direct result of Columbine, police response to active shooters has changed. Where the old line of thinking was to secure the perimeter, current practice is to immediately enter the building and engage the shooter.

Not sure if the timeline quoted for emergency care at Columbine is still valid.

Don't know, the response times still seem to be in the HOURS, not minutes.

I'll wade in with a few items...

1. Response Times Vary - Yes, protocol is now 'move to engage' with active shooters. However, EMS response may still be delayed until a scene is locked down. For a less 'Walter Mitty' scenario, here in Louisiana we have Hurricanes which completely disrupt the normal EMS response times, and produce lots of traumatic injuries. After you get Basic First Aid training, look for Wilderness First Aid training, which often addresses more traumatic injuries, and longer timelines until professionally trained and equipped folks are able to take over care of the injured.

2. Response to Active Shooters Varies/ICS - I highly recommend listening to the Aurora, CO Fire Dispatch recording(as opposed to LE) which is online. It goes on for more than 30 minutes, and painfully shows how long some folks were left lying in the theater before EMS/FD finally reached them. Also of note, this is a great ICS learning tool, as you can hear over the radio as they spool the ICS structure up and back down during the incident in response to the growing and changing incident details. Prime ICS demonstration material, it also illustrates some of the unavoidable overhead that comes along with ICS.

3. Quickclot - After trying various hemostatic agents over the years, the US Military has mostly settled on QuickClot Gauze, which is a cotton gauze (just like most regular krinkle gauze) that is impregnated with bits of powdered hemostatic agent. You apply it to a wound exactly the same as you would regular gauze. Note that this is wound packing gauze, not the roller gauze used to wrap someone up and hold a dressing in place. This stuff gets wadded up and shoved in the wound, or laid on top and then covered with something else, either roller gauze or an elastic bandage. Using this format means that users need essentially zero additional training on hemostatic agents, they just use it like the regular gauze they are already trained on. Also note that this version works just as well on a gash caused by the corner of a van door (CAP likelihood %20) as on a penetrating GSW (CAP likelihood 0.0001%).

4. Tourniquets - Over the last 12 years the US Military medical community has vastly increased our knowledge base around the use of tourniquets. We now know that properly applied tourniquets are safe and effective, and the old fears of losing limbs are limited to very long applications times, longer than 8 hours. In fact, a tourniquet is now the FIRST reaction to many injuries. To further drive home the safety of tourniquets, it is now SOP for many folks to apply tourniquets to themselves and their teammates on a regular basis during training. Some civilian EMS protocols are now including tourniquet use in the Pre-Hospital environment, and I fully expect them to be a standard First Aid training task again within the next 10 years. Tourniquets Save Lives, there just really is no argument any more.


Thom
Title: Re: A Cadet in an Active-Shooter Incident
Post by: isuhawkeye on February 06, 2013, 03:26:30 PM
^^^ Agreed

I had a fairly detailed post written, but I will defer to Thom

As to medical kits several groups are putting toghter initial action medical kits geared to all levels from civilian through combat medic.  These kits include bulky dressings, tourniquates and other simple treatments for traumatic injury. 

ITS Tactical
http://www.itstactical.com/medcom/medical/edc-trauma-kit-now-available-for-your-back-pocket/ (http://www.itstactical.com/medcom/medical/edc-trauma-kit-now-available-for-your-back-pocket/)

Dark Angel Medical
http://darkangelmedical.com/Home.php (http://darkangelmedical.com/Home.php)
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Stonewall on February 06, 2013, 03:38:30 PM
Quote from: Thom on February 06, 2013, 01:53:06 PMTo further drive home the safety of tourniquets, it is now SOP for many folks to apply tourniquets to themselves and their teammates on a regular basis during training. Some civilian EMS protocols are now including tourniquet use in the Pre-Hospital environment, and I fully expect them to be a standard First Aid training task again within the next 10 years. Tourniquets Save Lives, there just really is no argument any more.

Excellent post, Thom!  Good points, especially noting how units/departments are requiring their people to apply a CAT to themself. 

Following contact in Afghanistan where 2 of our troops required CATs applied (by others), we added self-application to our training requirements.  In September of 2012 we conducted an 80 hour (1 week) intense program that culminated into an overnight (24 hour) "Rite of Passage" filled with unexpected scenarios based on real experiences in combat.  One situation called for our Defenders to apply CATs to themself.  Not in perfect weather conditions, under the sun, but at 0300 after 5 miles into the much longer mission, with fatigue, a combat scenario, and 50+ pounds of gear on, were they evaluated applying a CAT.

Title: Re: A Cadet in an Active-Shooter Incident
Post by: Stonewall on February 06, 2013, 03:48:12 PM
Quote from: isuhawkeye on February 06, 2013, 03:26:30 PMAs to medical kits several groups are putting toghter initial action medical kits geared to all levels from civilian through combat medic.  These kits include bulky dressings, tourniquates and other simple treatments for traumatic injury. 

Too bad the PJ I learned that from in 1995 didn't market that back then  8)

I was invited to a SOCOM demo on Bolling AFB back in 1995 and found interest in the PJ's trauma kit.  He had these small, vacuum sealed, mini-kits wtih exactly what you said in them, minus QuickClot.  In one pouch, he fit like 5 of them.  I asked and he said they're for "mass casualty" situations where he can't tend to everyone at once and there are limited supplies available.  He said he would throw those to other capable people to help address the wounds.

Interesting. 
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Flying Pig on February 06, 2013, 05:38:15 PM
^sadly, in 1995 if a guy like that tried to market that to the civilian world, there would not have been any market for it.  My how times have changed in a little over 10 years.    I would venture to guess that LE would have even thought it was extreme.   I remember getting our first gunshot trauma kits in our patrol cars in early 2000.  And that only happened because we had an officer shot and no body had any trauma gear readily accessible. 
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Stonewall on February 06, 2013, 07:40:08 PM
Local news for me:

Gun found in teen's car in high school visitor parking lot. (//http://)

Quote from: Local NewsAccording to the police report, Clark (18 y/o) told police he has issues with a couple of students at the school and that a couple of students want to fight him.

Clark told police he always carries a gun and knife on him. He said he got the gun from his grandfather.

A witness told police she was going to fight someone over two music groups, one of which Clark was a part of, and Clark was going to record the fight. She said Clark told her he was going to bring his gun to school to resolve an issue had had with a student according to the report.

So this guy originally went to the school "to pick up a friend for breakfast" (students leave school to go eat breakfast?), and decided to arm himself with a knife and gun because some kids at the school always want to fight him?  Interesting.  Of course we'll never know for sure, but it looks like a potential shooting incident at another school was thwarted by someone who "saw something and said something" to the School Resource Officer.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: NIN on February 07, 2013, 06:48:34 PM
All you guys going on about Quikclot & tourniquets....

This morning, I somehow nicked my earlobe while shaving (not sure what I was doing, its a good inch away from my face) and I was convinced after 20 minutes that there was a good possibility I was going to bleed out. :)

Direct pressure? Yeah, forget it.  Plus, I was trying to get dressed for work without bleeding on my dress shirt.  The bath tissue I was using to put the pressure on was literally soaked with blood. If you'd look in my bathroom trash, from the blood soaked tissue in there you'd probably believe that someone lost a finger.

So I start rooting around for bandaids or something.  Where do I go? Yeah, my IFAK.  Those slide-zipper ziplocs are difficult to operate one handed, BTW.  While I'm rooting, I'm thinking about this disussion thread.  "Hmmm, you know, this might be just the case for Quikclot. Where is that?" 

I thought about a tourniquet, but it would have had to go around the neck, and something tells me that is the wrong application.

Took 20+ minutes for it to stop bleeding. Lesson learned: I need a trauma kit in my bathroom cabinet if I'm gonna be that clumsy with sharp objects.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Stonewall on February 07, 2013, 07:23:22 PM
Quote from: NIN on February 07, 2013, 06:48:34 PMWhere do I go? Yeah, my IFAK.

Where did you get that IFAK?  8)
Title: Re: A Cadet in an Active-Shooter Incident
Post by: NIN on February 07, 2013, 08:05:05 PM
Quote from: Stonewall on February 07, 2013, 07:23:22 PM
Quote from: NIN on February 07, 2013, 06:48:34 PMWhere do I go? Yeah, my IFAK.

Where did you get that IFAK?  8)

Came sailing out of the sky one day...
Title: Re: A Cadet in an Active-Shooter Incident
Post by: bosshawk on February 08, 2013, 12:17:46 AM
Many years ago, I had a similar problem.  Bought and used an electric razor: problem solved.  Couldn't use a safety razor now if I wanted to: might lose too much blood.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: RRLE on February 08, 2013, 04:54:41 AM
Quote from: NIN on February 07, 2013, 06:48:34 PMLesson learned: I need a trauma kit in my bathroom cabinet if I'm gonna be that clumsy with sharp objects.

I know I'm going to date myself with this. There was a better day when (Real) Men had such a "trauma kit" in the bathroom. It was designed for just such emergency care. It was easy to operate. All you did was remove it from its case, assuming you left it in its case. Then you wet it and applied it. It worked fairly well for over a century. It is fairly low tech.

It is a styptic pencil.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: a2capt on February 08, 2013, 07:25:02 AM
A similar local story here:
Quote from: UT San DiegoCARLSBAD — The shipment of gunshot survival kits had arrived the night before, and Lt. Terry Stayer claimed the first pack for herself the next morning. She tucked the little vacuum-sealed baggie in the pocket of her ballistic vest, and then spent the next few hours distributing the rest to the roughly 75 other police officers in Haltom City, Texas.

By the end of the day, that tiny first-aid kit, developed by a retired cop who lives in Carlsbad, would be credited with helping to save an officer's life.
http://www.utsandiego.com/news/2013/feb/06/carlsbad-officer-survival-solutions-halton-city/
Title: Re: A Cadet in an Active-Shooter Incident
Post by: cap235629 on February 08, 2013, 07:51:09 AM
has anyone ever heard of a stypic pencil??????
Title: Re: A Cadet in an Active-Shooter Incident
Post by: SarDragon on February 08, 2013, 08:15:33 AM
Quote from: cap235629 on February 08, 2013, 07:51:09 AM
has anyone ever heard of a stypic pencil? ??? ??

Sure. Got one in the bathroom. It's basically alum and a binder. Put in on a shaving cut, and it stops it right up. Boxing trainers use similar stuff.

http://en.wikipedia.org/wiki/Styptic#Styptics (http://en.wikipedia.org/wiki/Styptic#Styptics)
Title: Re: A Cadet in an Active-Shooter Incident
Post by: NIN on February 09, 2013, 05:31:26 AM
Quote from: RRLE on February 08, 2013, 04:54:41 AM
It is a styptic pencil.

The last styptic pencil I had was probably 20 years ago. Seriously.

I occasionally nick myself. Like, maybe once every six months.  If I was really prone to cutting myself, I might get one.

But this, man, talk about an arterial gusher on my earlobe. Crikey.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: SarDragon on February 09, 2013, 09:24:35 AM
Mine has got to be at least 15 years olde. Instead of wetting it under the faucet, I wet a Q-tip, and run it around on the flat end, and then apply to the cut. Gives a more precise application, and doesn't waste it washing it down the drain. Same basic technique used on boxers.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Stonewall on February 09, 2013, 12:55:13 PM
Biggest thread hijack in CAP Talk history; from active shooter to septic pencils for shaving nicks.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Flying Pig on February 09, 2013, 04:57:43 PM
Quote from: Stonewall on February 09, 2013, 12:55:13 PM
Biggest thread hijack in CAP Talk history; from active shooter to septic pencils for shaving nicks.

But are septic pencils authorized in AF blues? >:D
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Luis R. Ramos on February 10, 2013, 03:26:36 PM
Stone and Flying:

Are you being sarcastic or is that a typo?

::)

From Styptic to Septic is a looong stretch!

:P

Septic means "infected" or similar.

Flyer
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Luis R. Ramos on February 10, 2013, 03:29:45 PM
RRLE and SAR-

Where did you get yours? Whenever I have tried getting one, no one knows! I have tried Walgreens, Rite Aid, and similar. No dice!

I have been forced to put tiny pieces of toilet paper on the nicks. Works somewhat, part of the time. It is a time-waster as well.

I remember the styptic pencil worked but it had a side. It stung!

Flyer
Title: Re: A Cadet in an Active-Shooter Incident
Post by: cm42 on February 10, 2013, 03:58:34 PM
Somewhere, something said that chap stick can work for sealing up nicks in a pinch.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: SarDragon on February 10, 2013, 09:17:15 PM
Quote from: flyer333555 on February 10, 2013, 03:29:45 PM
RRLE and SAR-

Where did you get yours? Whenever I have tried getting one, no one knows! I have tried Walgreens, Rite Aid, and similar. No dice!

I have been forced to put tiny pieces of toilet paper on the nicks. Works somewhat, part of the time. It is a time-waster as well.

I remember the styptic pencil worked but it had a side. It stung!

Flyer

Like I said, mine is ancient. I think I got it at the Exchange.. They last forever, especially if you only shave once a week.  :angel:

Look in the shaving gear section of the drug store. Try a grocery store that sells that stuff, too.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Extremepredjudice on February 10, 2013, 09:25:44 PM
I got mine at walmart.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: Pylon on February 10, 2013, 09:36:29 PM
Not to derail this thread even more, but I've had the same styptic pencil for probably 5 years or more and it's still got 95% of its original product.  One styptic pencil will probably last you half of your adult life.  Amazon it.  It's worth it, stinging or not.


Quote from: NIN on February 07, 2013, 08:05:05 PM
Quote from: Stonewall on February 07, 2013, 07:23:22 PM
Where did you get that IFAK?  8)
Came sailing out of the sky one day...
Gear adrift is a gift!
Title: Re: A Cadet in an Active-Shooter Incident
Post by: RRLE on February 10, 2013, 10:00:19 PM
Quote from: flyer333555 on February 10, 2013, 03:29:45 PM
RRLE and SAR-

Where did you get yours? Whenever I have tried getting one, no one knows!

Mine is at least 30 years old and is at least 3/4 of its original size. If you don't drop and break it, they seem to last forever. It also helps if you don't have to use it a lot.  :)

Title: Re: A Cadet in an Active-Shooter Incident
Post by: NIN on February 10, 2013, 11:01:51 PM
Quote from: Pylon on February 10, 2013, 09:36:29 PM
Gear adrift is a gift!

Factual statement.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: That Anonymous Guy on February 11, 2013, 12:55:13 AM
How do we unhijack this thread?
Title: Re: A Cadet in an Active-Shooter Incident
Post by: PHall on February 11, 2013, 03:26:20 AM
Quote from: NY Wing King on February 11, 2013, 12:55:13 AM
How do we unhijack this thread?

We don't.  You just roll with it.
Title: Re: A Cadet in an Active-Shooter Incident
Post by: That Anonymous Guy on February 11, 2013, 04:56:06 AM
Quote from: PHall on February 11, 2013, 03:26:20 AM
Quote from: NY Wing King on February 11, 2013, 12:55:13 AM
How do we unhijack this thread?

We don't.  You just roll with it.
Yes Sir!
Title: Re: A Cadet in an Active-Shooter Incident
Post by: bosshawk on February 11, 2013, 07:05:09 AM
Hang on, it will turn into a uniform discussion.