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How to save lives when an active shooter strikes

This month, children and young adults will return to their schools and universities from summer recess. It’s sad that we must prepare and train for active shooters and mass murderers in our schools, but unfortunately that’s the world we live in and this has become standard operating procedures for SWAT teams across this country. One mass murder was already attempted at a California high school.

So, are you prepared to deal with a life-threatening injury to another officer or an innocent victim if medical personnel isn't available? What if you’re in a combat environment, such as an active shooter incident, and your team leader takes a .223 round to the chest and suffers from tension pneumothorax? Do you have the training and equipment to save your team leader's life?

In 1997, LAPD officers responded to an active shooter incident in North Hollywood. Three civilians and nine officers were shot. The incident lasted 39 minutes and in the end, seven civilians and eleven officers were shot and injured. The suspects shot 1100 rounds from fully automatic AK-47’s, fully automatic Bushmaster .223’s and a .308 H&K semi auto. Besides having a trouble neutralizing the threats, officers were unable to get EMTs to the injured officers and citizens.

In this situation, most EMTs won’t deploy to render aid in an unsecure environment. Even if this situation occurs during a SWAT operation then a single TEMS operator won’t be able to handle the situation alone. What if the injured officers are cut off from TEMS personnel for some time?

The answer to this problem is tactical combat care training. This training isn’t new to the military, and all SWAT officers and uniformed officers can benefit from this valuable training.

The basics of tactical combat care training
The single most contributing cause of officer deaths is gunshot trauma. That being said, research indicates that most gunshot trauma victims have five minutes to be stabilized from life-threatening injuries. After the first five minutes, your chances of survival significantly decrease. That’s when tactical combat care training can save your life.

EMTs have been trained for years on the concept of the “golden hour,” however research from military combat indicates that most shooting victims with life-threatening injuries die within the first five minutes. Research also indicates that if a shooting victim is alive when EMTs arrive, he or she will most likely survive.

Tactical combat care training is designed to provide skills so that officers may may render life-saving aid while remaining in the fight. This training will not turn officers into medics, but it may allow an officer to stabilize an injured cop until medics arrive.

Tactical combat care will also train the officer to assess the situation and the victim needing aid. For example, 99% of penetrating gun shot wounds to the head are fatal. So, if an officer is an active shooter situation and he locates a civilian victim with a penetrating gunshot wound to the head, he may assess the tactical situation and make a logical determination if he should risk exposure to gunfire and aid the victim or not. Remember, an officer’s primary duty is to stop criminal behavior; their second duty is to render aid.

Approaching a victim in a tactical formation is another vital component of this training. Although most SWAT teams train for this procedure, uniformed officers are typically at a disadvantage and will find this training very useful. There are many other important nuances in the initial phase of assessment and approach training those officers will be taught to recognize and deal with.

Basic first aid training is another component, and will refresh the officer’s basic first aid training in areas like airway and breathing treatment as well as hemorrhage and shock treatment. These topics will be taught in greater detail than what officers might typically receive, but it will include performing the skills in a combat environment.

Learning how to prevent life-threatening injuries
The most significant component of this training will include life-saving skills that are not basic first aid, but instead techniques used by medical personnel that may be necessary to save your victims' lives in a combat situation where emergency aid isn’t available.

For example, officers will learn how to keep an airway open, which is critical to survival. One tool that officers will be trained to use is the Nasopharyngeal Airway tube. This flexible tube can maintain an open airway in a victim until medical personnel arrive so you can stay in the fight.

Tension pneumothorax is another life-threatening injury officers should be trained to deal with. Tension pneumothorax is a condition that occurs when a bullet or shrapnel penetrates a lung. The air from the lung enters the chest cavity and fills the space between the ribs and the lung. When this happens the lung no longer has the space needed to inflate the lung. Therefore, the lung may collapse and the heart can be shifted, causing blood flow to stop to the heart. Performing a chest decompression with a BD Angiocath Autogard Catheter can stop tension pneumothorax from occurring and provide immediate relief.

Massive blood loss is another life-threatening injury that can be prevented. Officers should be trained in the use of a blood-clotting agent like the CELOX Hemostat and the use of a tourniquet such as the CAT tourniquet. Although tourniquets can cause the loss of a limb, losing a limb is better than losing your life. Training in tourniquet application during a combat environment is a critical component in the combat care training. Modern tourniquets make the process simple.

The warrior spirit
Finally, the last component is the warrior mindset and how it applies to the officer’s survival during combat. I like to teach that the way to warrior supremacy is through preparation and training; the way to failure and defeat is through arrogance and indifference. Preparing the warrior spirit begins with confidence, confidence is built through training.

“In peace prepare for war, in war prepare for peace. The art of war is of vital importance to the state. It is matter of life and death, a road either to safety or to ruin. Hence under no circumstances can it be neglected” — Sun Tzu

When the time comes, get your mind right, engage the warrior spirit, and stay in the fight. Tactical combat casualty training is an obvious asset to the warrior spirit.

Here are some items that I carry and train SWAT officers to utilize in emergency operations. Although these items may be a name brand, other variations are available. Also, if you purchased these items individually it would cost you less than $80. Obviously, bulk orders and shopping for low prices can cut the cost to less than $50 per officer. Most fire departments, paramedics and hospitals carry these items and you might be able to get them at no cost. Place these items in your tactical vest or back pack and have them available to you when you need them.

1) Asherman Chest Seal
2) Nasopharyngeal Airway Tube
3) BD Angiocath Autogard Catheter
4) CAT Tourniquet
5) CELOX Hemostat

As you prepare your SWAT operators for active shooter and mass murder incidents, prepare them by providing them the opportunity for tactical combat care training. Once you train your SWAT operators, encourage them to train fellow uniformed warriors as well.

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