A Cadet in an Active-Shooter Incident

[Stonewall]

Awesome article on the subject of Active Shooter over on CadetStuff.

I highly recommend reading and sharing with your squadrons!

[Pylon]

+1.  Share this resource with cadets.

[That Anonymous Guy]

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?

[Stonewall]

Has a CAP cadet ever been caught in an active shooter situation?

Sort of, here.  He was no longer in CAP at the time, but still.

Oh, and NY Wing King...share this article with your fellow cadets.

[That Anonymous Guy]

[darn]...
The first article raised a good question though. I think school first aid kits should have QuikClot

[coudano]

[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...

[JayT]

[darn]...
The first article raised a good question though. I think school first aid kits should have QuikClot

Have you ever used Quikclot?

[That Anonymous Guy]

[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?

[SJFedor]

[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).

[SJFedor]

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.

[That Anonymous Guy]

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?

[SJFedor]

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)

[Huey Driver]

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.

[Eclipse]

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.

[Private Investigator]

Excellent for a Safety Brief.

I'll pass it along   :clap:

[♠SARKID♠]

This
RUN. HIDE. FIGHT. Surviving an Active Shooter Event - English

And this
Last Resort ACTIVE SHOOTER SURVIVAL Measures by Alon Stivi

[That Anonymous Guy]

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.

[JayT]

[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.

[Stonewall]

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.

[abdsp51]

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.