Part of being prepared to deal with a mass shooting — and hopefully surviving it and helping others to survive it — is knowing what you will face once the shooting stops. When the gunfire finally ceases and the haze of adrenaline and terror begins to subside, the work has really just begun. If you are uninjured, or injured and still able to render aid to others, you must kick into first-responder mode and make it your mission to save lives. After all, you might have a while before medical professionals get to the injured, and your actions can save lives that might otherwise be lost.


Mass Shooting Wounds

The injuries resulting from these assaults are likely to be penetrating gunshot wounds to virtually any part of the body. These wounds can result in hemorrhage (bleeding) from the extremities (arms and legs), the junction where extremities and head meet the torso (neck, groin, armpit, etc), or the torso itself. This hemorrhaging can be controlled or uncontrolled. Uncontrolled hemorrhage can obviously kill you if not brought under control quickly

There may also be wounds to the central nervous system (brain and spinal cord), which may or may not be immediately fatal, as well as catastrophic wounds to vital organs such as the heart, which can also be immediately fatal. Finally, one may encounter wounds to the face or neck that could compromise the airway, making a person unable to adequately breathe. 

If you are on scene and no longer in imminent danger of being killed yourself, your first course of action is to triage the victims around you. Triage is a sorting out of who is potentially savable and who is not. If a victim has no pulse, is not breathing, and is not conscious, you must leave them and focus on a victim you can save. Look for those with uncontrolled, pulsing, or spurting bleeds in the extremities. Such bleeding can be stopped with a tourniquet. If a commercial one is not available, an improvised tourniquet will do.

A bleeding artery in an extremity, such as the femoral artery high in the leg, can kill a person in as quickly as three minutes if not brought under control. Do your best to tighten a tourniquet around such an extremity between the wound and the heart, and make that bleeding stop with whatever force it takes.

If the victim is bleeding in the junctional areas or in the torso, you can try to apply direct pressure to the wound if you do not have a hemostatic dressing immediately available to pack inside the wound. If you can see and clamp off a bleeding vessel, this pressure might be applied with your fingers, or you might have to put your knee or both hands on the wound and place as much pressure as possible on it. Again, use whatever force is necessary to stop the bleeding.