Active Shooter: A Tourniquet Won’t Save You?

You don’t understand active shooter events.  It’s not your fault, most people who’s job it is to study these incidents are still learning.  Due to their increasing occurrence, there has been an explosion of research.  This has revealed some new medical data, that will likely have drastic impacts on how law enforcement, and everyday citizens will need to deal with them.  Keep reading to learn some key statistics on active shooter events, and learn how to handle them better.

I think the fundamental problem with active shooter events, hence forth called ASE’s, is that people are treating them like combat and, trying to adapt their responses to that notion.

This is the wrong way to think about this.  ASE’s are not combat.  Yes, there are some commonalties between the two, but that’s like saying that a forest fire is the same as a kitchen grease fire.  Sure they both are fire, but your response, and the scale, will be drastically different.

Before we get into these key differences, and why they matter, we first need to define the problem by looking into what researchers say about ASE’s.

Definition 

ASE’s are defined by the Dept. of Homeland Security as…”an individual actively engaged in killing or attempting to kill people in a confined and populated area; in most cases, active shooters use firearms(s) [sic] and there is no pattern or method to their selection of victims.”

You can see that that the big difference between this and general murder is the difference in victim selection.  Murder is often a crime of passion, with the victim being selected for specific reasons.

Active shooters don’t care who the victim is in particular.  They might care what type of person they are i.e children, religious affiliation, co workers, but they aren’t shooting the guy who screwed them out of money for example.

Locations 

These types of events are most commonly found in businesses, educational facilities, and least often in public outdoor venues.  They also seem to be increasing in frequency.


Businesses: 37%

Educational Facilities: 34%

Outdoors/Public Venues: 17%

source


 

Weapons 

The vast majority of weapons were pistols, with rifles being the next favorite, and shotguns being used least.  I think there are a few reasons for this.  First pistols are easily concealable, and allow you to get closer to your target area without drawing undue attention, thus compromising your plan.

I mean, how many people are going to call the police if I walk from a mall parking lot to the front door dressed like Arnold from commando.


Pistols : 60%

Rifle: 27%

Shotgun: 10%

Other: 3%

Multiple Weapons: 41%

source


 

If you like this kind of article, and want more sent directly to you, put your email in on the right, and join the team.  If you don’t, I bet it’s because you’re too busy shopping for fanny packs.  Does this match my eyes? 

Details of an ASE

These types of event are actually pretty well scripted in some aspects.  Often times the shooter kills themselves, or the Police do.  Here is a nifty chart that shows you pretty clearly how this actually happens.

The numbers on each block indicate how many ASE’s ended in this method between the year 2000-2010.  I think the thing that surprised me the most, is how many of these ended with the victims actually stopping the attacker.

I just want to point out that, if after reading this article, you stop an active shooter, I get at least 80% of the credit, and you’ll owe me $7 out of your wallet.  Just kidding, but seriously.

Victims 

This is the key area where most researchers and experts on ASE’s seem to be missing the boat.  Many of the trainers and people that study them are fundamentally assuming that this is basically urban combat that is occuring in the US.  This isn’t true.

The average number of people shot in these events is 4, with 2 of them dying (source).  Crucially, this is a much different casualty rate than you would normally see in combat from gun shot wounds.

Last year a study came out in the Journal of Trauma and Acute Care Surgery, that looked at post mortem, and autopsy data for victims of ASE’s. They came up with some surprising results.

Progress, Clinic, Medical, Care For, Disease, To Wonder

They gathered data on 139 fatalities which occurred over a 10 year period, and concluded that the vast majority of wounds were not survivable.  Here they are in their own words.

“-Overall, 58% of victims had gunshots to the head and chest, and only 20% had extremity wounds. The probable site of fatal wounding was the head or chest in 77% of cases. Only 7% of victims had potentially survivable wounds. The most common site of potentially survivable injury was the chest (89%). No head injury was potentially survivable. There were no deaths due to exsanguination from an extremity. “

This is really upends our current thinking about casualty care for ASE’s.  Law enforcement and concerned civilians are taught that they need tourniquets, and that these will save lives.  These researchers have pointed out that in none of these cases would a tourniquet have saved anyone’s life!

Before you go crazy with the hate emails, I’m not saying you should not carry, and be proficient with a tourniquet, because it is still a great tool and it might save someone’s life, but it just isn’t as likely as we once thought.

I do recommend that you have access to a trauma kit, either near by, or in a vehicle.  Something like this kit from Phokus Research Group (Amazon Affiliate Link).

The Doctors that crunched these numbers noted that each victim had 2.7 bullet wounds on average.  These wounds were often times in the chest and head area, which limited their survivability.

In the military this is different, because of the prevalence of explosives as a weapon, and hard ceramic armor, which protects the head and trunk.  If you protect these vital areas, then by definition the extremities are more likely to be injured, which means a tourniquet will be invaluable, especially in IED wounds.

This brings us around to our original thesis.  ASE’s are not combat.  Last time I checked there weren’t squads of combatants going at it in Las Vegas, just one stupid asshole, with his rifles.

A Better Response to ASE’s 

Even though these are increasing in frequency, you still are very unlikely to be involved in one, but that doesn’t mean we shouldn’t know how to handle them.

For joe civilian the mantra Run, Hide, Fight is still a good one.  The circumstances will dictate exactly what you can do, and should do in these situations.

This video does an excellent job of showing you that there are no hard and fast rules.  Hiding may work, but it sure won’t if you’re found.

For LEO’s I think we need to shift our thinking.  Priority number one will still be to stop the threat, but I think more emphasis needs to be placed on evacuating casualties quickly, even at the expense of moving them through uncleared portions of a structure.

Currently what happens is, police will get a call for an active shooter, get a lot of conflicting descriptions from justifiably scared witnesses, and they will respond to neutralize the threat.

At that point they will then clear the area and make sure there are no other threats, which often times get reported due conflicting accounts.  Meanwhile casualties are not being treated, because EMS will not come into a “hot” scene.  This isn’t Blackhawk Down, they just don’t do that.

I think we need to take a page out of the military’s play book and start doing some concurrent actions.  Once the main threat is neutralized, aid and litter teams need to be formed by officers and civilians to evacuate the wounded as soon as possible.  There can be no waiting around to be sure everything is cleared.

U S Air Force, Casualties, Plane, Treating, Medics

That does not mean that we just go off half cocked and forget about safety.  Other teams of officers will continue to clear the structure, and search for secondary devices like IEDs, or other shooters, that might be playing victim.

For those that are not first responders, it’s imperative that you be your own hero.  If you are injured you need to treat yourself, and you need to help others as you are able.

If you are legally armed and you make the decision to try and end the threat yourself, you need to be smart about it, and wait for your opportunity.  You cannot afford to miss, or otherwise launch bullets around people.  Otherwise you are no better than the criminal.

You might have to wait for your opportunity, much like you would if you were a victim of a robbery.  Read this article for the specifics on what makes self defense firearms use successful.

The last thing I’ll say for civilians who attempt to defeat the shooter, is that you need to put your firearm away as soon as you are able.  There is a real risk that you will be shot by the police.

If you are given commands, or even tackled please do not resist, and just follow them.  Listen to them now, and I promise they will talk to you once they’ve secured the scene.

Conclusion 

So far we’ve given tons of advice and considerations for these events, but I haven’t even spoken about the number one tip.  Pay attention! Stop starring at your phone!  Situational awareness is worth much more than going to the best schools, and having the best training, so don’t give that advantage up.

Let us know what you think about the article.  Leave your thoughts or comments below.

 

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