Medical Examiner

More and More Americans Are Learning Basic First Aid for Gunshot Wounds

In the wake of several mass shootings, learning how to stanch bleeding is becoming increasing popular.

A volunteer poses with a tourniquet on his arm in Bordeaux, western France, on July 30, 2016, during a Red Cross workshop on first aid after the different attacks that struck France.
A volunteer poses with a tourniquet on his arm in Bordeaux, France, on July 30, 2016, during a Red Cross first aid workshop.

Thibaud Moritz/Getty Images

I frequently exchange parenting advice with my sister, an emergency room physician whose kids are younger than mine. My advice tends to be pretty straightforward, like how to help your kids transition to a new school or just the occasional kid-friendly recipe. Hers, given her profession, tends to be a little more intense. Recently, she offered this useful guidance: If someone’s been shot in the leg, use the heel of your hand to slow the bleeding by pressing down on the femoral artery located in the middle of the crease at the top of the thigh. If the bleeding doesn’t slow or is pulsing, use a T-shirt or other piece of clothing to tie a tourniquet as close to the top of the thigh as possible.

Against the backdrop of ongoing mass shootings, being prepared for such a worst-case scenario seems increasingly prudent. It appears I’m not alone in thinking so: From Bismarck, North Dakota, to San Diego, ordinary citizens are now signing up for classes to learn how they, too, can maximize their chances for survival by learning skills such as how to stanch blood loss after a mass shooting. In Georgia, all public schools are receiving “Stop the Bleed” kits so they’ll have what they need while they wait for professional first responders to arrive. And last month in Washington, D.C., nearly 40 members of Congress were trained in bleeding control techniques. The training they received is modeled on life-saving techniques first honed on the battlefield but now being promoted for civilian use in schools, churches, shopping malls, and other everyday venues.

These sorts of lessons have been gathering steam for years. In the wake of the Sandy Hook shootings in December 2012, the American College of Surgeons pulled together first-response experts from law enforcement, the medical community, and the military. Their recommendations, known as the Hartford Consensus, stemmed from the realization that injuries from mass shootings are similar to those found in combat. The resulting five-point response plan was based in part on military trauma guidelines and led to the “Stop the Bleed” campaign, launched by the White House in 2015, to “encourage bystanders to become trained, equipped, and empowered to help in a bleeding emergency before professional help arrives.”

Mass tragedies often yield lessons that can be applied the next time around. Five months before Sandy Hook, the movie theater shootings in Aurora, Colorado, showed the need for better coordination between responding police and firefighters. It also underscored that getting victims to the hospital as quickly as possible, rather than waiting for ambulances, saves lives.

In 2007, the mass shooting at Virginia Tech in Blacksburg, Virginia, led to improvements in campus safety, including requirements for emergency message systems and physical changes such as better door locks. And perhaps the seminal event that changed how we think about and respond to mass shootings was the 1999 tragedy at Columbine High School, which led to regular school lockdown drills and changed how police respond to active shooters. (Instead of waiting for specialized backup to arrive, responding officers now enter the building immediately to try to stop the carnage.)

If you consider the chronology of these examples, it’s apparent that our reactions are skewing toward figuring out how to survive mass shootings rather than prevent them. Mass shootings such as the recent tragedy in Las Vegas are often what spur ordinary citizens to enroll in “Stop the Bleed” classes. In just the last two years, more than 70,000 Americans have taken the courses, according to the American College of Surgeons. In fact, a 2015 telephone poll of 1,000 respondents found that 82 percent of those who said they were physically able to take a course like this were interested in doing so.

Being prepared is pragmatic: According to the Gun Violence Archive, there have been 323 mass shootings (which they define as four or more people shot or killed, not counting the shooter) so far this year, including two just last week. Even my sister, despite all of her training, found herself searching online for bulletproof backpack inserts for her kids. Last year, the PTSA at my son’s high school, which was put on lockdown during the 2015 San Bernardino mass shooting, purchased body bags and triage center supplies to use in the event of a similar tragedy on school grounds.

It’s hard to know where the line is between prudent preparation and diminishing returns. Learning to tourniquet a bullet wound might make you feel safe. It could also make you feel anxious or diminish the reserves you have to fight gun violence in other ways. As the Hartford Consensus noted, “Active shooter/mass casualty events are a reality in modern American life.” What’s worse is that they’re an accepted reality.