October 8, 2013
Mass shootings such as those at the Washington Navy Yard, the Kenya mall and the Aurora movie theater don't seem to be going away. It would be a mistake to think something similar couldn't happen locally.
Here are some suggestions on what you could do medically if you were involved in such a tragedy.
Before doing anything in an emergency, make sure you're safe. This is essential. If you see someone get shot, only go to the aid of that victim if the shooter has been neutralized or is not present at the scene. No matter how much you want to help, you must stay out of the line of fire.
Once you're safe, decide who to help first. It could be minutes to hours before the first responders arrive. Until then, if there are multiple victims, consider triaging. Spend time assisting the ones you realistically can help.
It seems cruel, but if you spend all of your time on victims who can't be saved, others who could be saved might bleed out.
Although there are multiple injuries you can treat, two obvious ones come to mind.
The first is bleeding. If you see obvious bleeding, stop it by putting pressure directly on the wound. For instance, you could pack your shirt into and around the wound and tie it firmly in place - but not too firm lest you accidently make a tourniquet. However, if direct pressure doesn't work, you might need to make a tourniquet. For directions, search for "tourniquet" at gazette.com and read my column on the subject.
The second is a sucking chest wound. Thus can happen when a bullet punctures the chest cavity where the lung resides. When the victim tries to breathe, air might enter the chest cavity through the wound, pressing the lung aside.
Placing something as common as a credit card or driver's license over the wound can save a life. The body fluids from the injury will hold the card in place. When the person inhales, the card will get sucked up against the skin so air can't enter the wound. When the person exhales, any excess air in the chest wall can cause enough pressure to lift the card slightly and allow the air to escape.
Finally, make a mental note of who's in the worst condition. The fate of victims with severe internal bleeding can depend on how quickly they get to a medical facility. So what you can do is try to assess ahead of time which victims seem to be the worst and direct the emergency personnel to them first.
Having a full understanding of how to assess severity - and what you can do in any trauma situation - requires more than reading this column. I strongly suggest you consider taking a hands-on course. Check with local hospitals or the Red Cross to see what's available.
Family doctor James Hubbard teaches how to survive during disasters or any time you can't get expert medical help at TheSurvivalDoctor.com.