We've talked about what you can do in the event of an Active Shooter event, but what about after? There will be wounded. Perhaps seriously wounded. Do you know what to do?

Triage, CPR, Bleeding Control. These are the first things to consider after the threat is over and while awaiting EMS. Bystander intervention will make the difference between life and death.

After the recent deadly shooting at Umpqua Community College in Oregon, know this is a real and present danger. This has been a growing concern for both Medical Organizations and the Government (as we discussed in Building National Resilience through Bystander Action.)

If Bystanders do not take a more active role, many will die unnecessarily. Have a bleeding control kit handy, know what to do, take action - save lives.

An active shooter is an individual actively engaged in killing or attempting to kill people in a confined and other populated area. In most cases, active shooters use firearms and there is no pattern or method to their selection of victims


From the September 2015 American College of Surgeons Compendium on Strategies to Enhance Survival in Active Shooter and Intentional Mass Casualty Events: See Something, So Something -- Improving Survival.

“Never doubt that a small group of thoughtful, committed citizens can change
the world. Indeed, it’s the only thing that ever has.”
—Margaret Mead

Image of Trauma and First Responder kits See Trauma and First Responder kits

Three levels of responders
There are different levels of responders in an intentional mass-casualty or active shooter event:

  1. Immediate responders: The individuals who are present at the scene who can immediately control bleeding with their hands and equipment that may be available
  2. Professional first responders: Prehospital responders at the scene who have the appropriate equipment and training
  3. Trauma professionals: Health care professionals in hospitals with all of the necessary equipment and skill to provide definitive care Immediate responders

One goal of the Hartford Consensus III is to empower the public to provide emergency care. During intentional mass-casualty events, those of wounding have often proven invaluable in responding to the initial hemorrhage control needs of the wounded.

Traditionally thought of as “bystanders,” these immediate responders should not be considered passive observers and can provide effective lifesaving first-line treatment.
Immediate responders contribute to a victim’s survival by performing critical external hemorrhage control at the point of wounding and prior to the arrival of traditional first responders. Immediate responders contribute to what is the critical step in eliminating preventable prehospital death: the control of external hemorrhage.