Active Violent Incidents (AVI) are defined as high threat incidents where a person or persons are actively engaged in killing or wounding civilians at the time of first responder activation. Examples include the Boston Marathon bombing, Pulse Nightclub shooting, and Las Vegas shooting.
Penetrating trauma is the primary mechanism of injury in AVI (i.e. blast projectile or ballistic injuries). Generally, hemorrhage is the leading cause of potentially preventable death in trauma. And, as trauma is the leading cause of death for Americans aged 1-48 years, preparedness for AVIs can result in improved day-to-day community resilience.
The time to initial life saving intervention, time to stabilizing professional trauma care, and time to definitive care affect trauma-related mortality. As bystanders are nearly always the first on scene after a traumatic incident, a trained and empowered citizenry is critical to improving trauma survival.
What YOU can DO
Intervening to save a life is not without risk and is a deeply personal decision. Generally, Good Samaritan laws protect non-professional first responders who are acting in good faith to assist a fellow citizen. If you encounter an individual with a traumatic injury, take a moment to ensure your own safety and activate the first responder system (i.e. call 911 in the US). Then, “Be the Help” until help arrives.
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1. Control massive external bleeding with direct pressure, pressure dressing or tourniquet (if extremity injury).
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2. Open the airway.
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3. Improve breathing by covering any holes in the chest and allowing the individual to assume a position of comfort; do not force the person to lay down!
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4. Keep the individual warm and in a comfortable position.
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5. Provide psychological support.
Individuals with penetrating trauma to the chest and abdomen require immediate emergency medicine and trauma evaluation. Decisions to transport traumatically injured individuals in a private vehicle or non-medical vehicle should consider at least the type of injury, the ability to provide care en route, the current situational threat, EMS response times, and distance to the hospital or trauma center.
For More Information
Committee for Tactical Emergency Casualty Care
FEMA’s You are The Help Until Help Arrives Program
https://www.ready.gov/until-help-arrives
Stop the Bleed Campaign