Saving Lives after a mass shooting

Let’s be honest, I have been writing this blog to help you prepare for an active shooter. I have covered many issues up to this point, including what medical supplies will be needed, but today’s blog post deals specifically with preparing for a mass casualty incident. Tomorrow, I will cover where you can get training if you do not already have people trained to respond.

As I described yesterday, if an active shooter gets past your defenses, it will probably take 10-20 minutes before the first ambulance will arrive. Your house of worship should put together the needed items that may save lives when there may be multiple injuries. These will likely save lives if an active shooting takes place in your church.

While we do not want to think about it, we need to ask ourselves how we could save more than one or two people after an active shooter finishes their cowardly act. We likely will have bleeding, shock, and major confusion. Some people may be sitting, staring into space, not even knowing they are injured. Some may even walk around in a daze, or they may start helping others, not even knowing they are injured. There will probably be a lot of crying and/or moaning. We will see blood, smell gunpowder, and we may hear ringing in our ears from the gunshots. We may even see an arterial bleed, where blood is shooting out of an arm or a leg (see this video [caution, graphic images]. How do we manage these injuries? What supplies do we need? What can we do?

Believe it or not, there are some basic supplies that can be obtained from the  local retail store. These items could make a huge difference. Let’s start off with something that is super-cheap and extremely effective; sanitary napkins. Sanitary napkins can be used to absorb blood, and to help in the clotting process until professional help arrives at the church. Remember, if it bleeds, cover it! You may have to add some heavy pressure, depending on how bad it is bleeding, but sanitary napkins are great for stopping bleeding.

You should also consider purchasing (white) towels at the local retail store. These towels can also be used to cover bleeding which will assist in clotting the blood. If you feel led, purchase multiple size, including kitchen towels, face towels, and bath towels. Choose an appropriate amount that equals about half of your congregation. If at all possible, get them in a color that bleach will not affect it if added to the wash.

You may might want to purchase a supply of Coban, Ace bandages, or similar types of wraps. When tending to arm and leg injuries, the sanitary pads, or the towels might be able to be held in place by this type of wrap, thereby freeing up a person that can help someone else while monitoring the person with the wrap on.

We also want to make sure we do not forget blankets. People will be in shock. They will need their feet elevated, and they will need a blanket to help regulate their body temperature. The blanket does not need to be extra heavy, or even thick, but it does need to be thick enough to help the body to regulate its temperature.

While not typically something you can get at the local store, you should consider tourniquets. You can purchase proper medical tourniquets, or you can purchase materials that can be used as a makeshift tourniquet. If a makeshift tourniquet, the material should (whenever possible) be at least an 1-1/2 wide, and made of strong durable material that won’t break. It should applied to provide steady pressure above the wound. If needed, a belt will work, however a commercial tourniquet would be better, because they are designed to cause minimal damage. It is important to note that whenever a tourniquet is put on, that you should mark the victims forehead with a clearly visible “T” so that first responder’s know that there is a tourniquet applied somewhere on that persons body. It is best marked with a permanent marker (if possible) so that it will not wipe off if a half-alert patient rubs their forehead. Contrary to the way we were taught years ago, they now suggest that the tourniquet should not be loosened (to allow blood flow) for at least two hours.

When you get these supplies, you will need to keep them clean, but ready to use at the same time. I personally suggest that items such as the towels and blankets should be put through the washer and dryer to remove any contaminants that they may have picked up during manufacturing, transportation, or sitting on the store shelves. If they won’t bleed color, use some bleach in the wash as well as the laundry soap. When they are completely dry, seal them in bags so that contaminants are less likely to absorbed into the linens. A clear bag is best, so you can see what is in each bag when seconds count.

Tomorrow, I will discuss places that you can get basic to advanced first aid training. Until then, may God keep you safe, … Mark

Medical supplies needed

When an active shooter comes into your church, most people think that the police, fire department, and ambulances will arrive in just a few seconds. That assumption would, in most instances, be wrong. Depending on which statistics you read, the arrival of police will take 8-10 minutes. Fire and ambulances will not arrive until the police have secured the church. Securing the church means removing, or neutralizing, the threat.

From the first day of training, firefighters and EMT’s are taught that the should not enter a situation (such as an active shooter) until the scene is safe. In their practical test for their license, they will fail to become an EMT if they do not ask “Is the scene is safe?”. While I hate to burst peoples bubble when it comes to response times, this means that the church will likely be on their own for 10-20 minutes. Of course, some of this will depend on how rural or urban the geographical area is, whether they rely on local law enforcement (city police) or county law enforcement, and how much funding is provided to law enforcement in that area. More funding typically means more officers are available to respond, while smaller budgets mean fewer officers are available to respond.

In order to be better prepared, the church should implement a medical response team, and keep supplies on hand. You could purchase one or more ready-made trauma bags (such as this) for your medical response team, or you could build your own. Most medically trained personnel should know what supplies are needed, however I have included this basic list to make it a little easier for you:

  • 10-12 pairs of Nitrile gloves
  • 1 pair of trauma shears
  • 1 pair of bandage scissors
  • 1 Stethoscope
  • 1 blood pressure cuff
  • 1 disposable penlight
  • 1 splinter forceps
  • 1 quick reading ear or forehead thermometer
  • 1-2 C-Collar, adjustable, adult size
  • 1-2 C-Collar, adjustable child size
  • 2-4 pair of safety goggles
  • 1-2 CPR  barrier devices
  • 1 Alcohol Hand Sanitizer
  • 60-80 Adhesive bandages
  • 10-15 butterfly bandages
  • 10 -15 2″x2″ gauze pads
  • 20-30 4″x4″ gauze pads
  • 5 -10 5 x 9 gauze dressings
  • 2 trauma dressings  (10″x30″)
  • 4-8 gauze rolls (3″ wide)
  • 4-6 triangular bandages
  • 2-4 elastic bandages (2″ wide)
  • 2-3 Mylar Survival Blanket
    1-4 rolls of 1″ wide plastic medical tape
  • 1-4 rolls of 2″ wide porous medical tape
  • 1-4 roll of 2″ wide cloth medical tape
  • 3-4 roll of self-adhesive Wrap (Coban)
  • 10-12 triple antibiotic ointments
  • 4-6 instant cold packs, large
  • 2 eyewash solutions, 4 oz.
  • 15 antiseptic wipes
  • 20 alcohol preps
  • 2 resealable plastic bags
  • 2-4 red bio-hazard bags
  • 2 Ink Pens
  • 2 permanent markers

Another item that you may want to consider in your house of worship is an Automatic External Defibrillator (AED).  Should someone have a heart attack, an AED combined with CPR may be the only hope of reviving someone before brain damage or permanent death happens. These can be a little pricey for smaller churches ($1,000-$2,500), but you have to ask yourself, what is a life worth? I am assuming that if you are in a church, you know where you are going when you die, but you don’t want to rush that process when you can provide a longer life. While the picture shows a Phillips brand, they are not the only brand available, so do some shopping before purchasing an AED. Some important considerations include battery life, maintenance requirements, and ease of use. You will also need to determine if you want to be prepared for an adult that may need this, or if you want to have the capability of helping a child as well.

Tomorrow, we will talk about other, (non-medical) supplies that you might want to have on hand. Until then, … Mark

Medical emergencies

Last week, I touched on the mitigation of medical emergencies. This is an important factor whether you someone is having a heart attack, or if an active shooter got past you defenses. Having a medical response team is an important part of being prepared, no matter what the emergency.

Nearly every church in the United States has some type of first responder that attends their church. I know in my small country church, with a weekly total of congregants of less than 60 per week, we have several first responders, or former first responders/medical staff. Even though two of them moved away (a CNA and a firefighter), we still have a former respiratory therapist (with ER experience), a nurse, and a former firefighter/EMT. We also have an EMT-I that occasionally attends. If needed, we also have multiple veterans from the Vietnam and Cold War era who have had some basic medical training. If you think about it, these veterans could be very helpful in the aftermath of an active shooter in church.

Every church should, at the very least, consider forming a medical response team. This team should be created not only to respond to active shooters, but nearly every type of emergencies. These are the members that will be able to stabilize someone that has fallen, to help someone that has suffered a stroke, and even do CPR, potentially saving their life.  They might be the one that might be able to save a child that was hit by a car, or the elderly person who has fallen down the stairs.

When looking for people within the congregation that might be suitable for an medical response team, there are a handful of individuals who would likely be willing to help in this capacity. They include:

  • Nurses
  • Medical doctors
  • EMT’s and Paramedics
  • DOT Medical first responder’s
  • Firefighter
  • Law enforcement officers
  • Former military medics
  • Anyone trained in medicine
  • People trained to American Red Cross first aid standards
  • People trained in CPR and AED’s
  • Trained veterans

There may also be others that are also trained in first aid who might be able to help in an emergency, such as Boys Scouts, Girl Scouts, work safety teams, and more. These people are already somewhat trained in what to do in a medical emergency. Because they already have the knowledge of what to do, why not utilize them to keep Gods flock healthy and safe.

Beyond responding to a medical emergency, this medical response team could also be used to  identify early medical problems. I know of several churches that use nurse volunteers to do blood pressure checks, and who give church goers advice on what to ask their doctor when they next visit them.

Tomorrow, I will discuss some basic tools and/or supplies that should be collected to help make the medical response team more effective. Until tomorrow, may God bless you, … Mark