STONE: How would you respond during a mass casualty?

Mass casualty events happen with little to no warning and in virtually any setting imaginable. They come in many forms, ranging from mass shootings to motor vehicle crashes and natural disasters to building collapses.

A mass casualty event is defined by any instance in which emergency medical services personnel and/or equipment are overwhelmed by the number and severity of casualties at that event.

This doesn’t always mean a mass casualty event involves a large number of injured people. An example could be a two person response crew arriving to a scene involving only three severely wounded individuals. The skills and training may be there, but the resources … both the humans providing treatment and the equipment they need to do so … are outnumbered.

Knowing even highly trained emergency medical personnel can become overwhelmed, it’s a safe assumption the average layperson wouldn’t know where to begin if faced with reacting to a mass casualty event. Ask yourself, if you walked into a situation where 3 … 2… or even 1 person lay on the ground, bleeding profusely, would you know what to do to improve their chance of surviving? It’s a safe bet most would not, which helped spur the launch of a White House campaign over 3 years ago known as “Stop the Bleed.” “Stop the Bleed” is a call to action in helping cultivate grassroots efforts that encourage bystanders to become trained, equipped, and empowered to help in a bleeding emergency before professional help arrives.

No matter how quickly emergency medical personnel arrive to a scene, it’s often bystanders who are first to respond to an event. Trauma related injuries, which are among the more common types in mass casualty situations, may often involve bleeding from one or multiple sources from the body. Depending on the severity of the bleeding, a person can die from blood loss within 5 minutes. Therefore, rapid detection and stopping the source of bleeding can literally mean the difference between someone living and dying. While this may seem overwhelming and something you cannot do, trust in yourself and note that taking just a few simple actions can help save lives.

Should you find yourself in the midst of a mass casualty event, first make sure you and those around you are moved to safety, if necessary. Next, call or have someone call 9-1-1 immediately so you know additional help is on its way. If there is a need to stop an active bleed, there are 3 specific actions you can take until help arrives.

The first is applying direct pressure, with your hands, from where the bleeding is coming from. This means exposing the area to confirm where the bleeding is coming from and applying firm, steady pressure over the site with both hands (if possible). The second method that may have to be used is applying a dressing and pressing it against the exposed bleeding area.

If bandages are not readily available, clothing may have to be utilized by being placed over the wound to apply firm, steady pressure. Thirdly, if bleeding doesn’t stop from the previous two methods, a tourniquet will need to be applied. Like bandages, medical-grade tourniquets may not be on hand.

While commercially made tourniquets are far more effective and recommended, in real-world applications improvising with what resources are available may be the only option. Tourniquets can be made with a variety of common materials. Choose a material such as a belt, long strip of cloth (such as a t-shirt), shoelaces, backpack straps, or even a bra. You’ll also need something to provide adequate torsion in order to generate enough compression to achieve blood flow restriction.

These can include any short, strong, and straight item such as a stick, metal rod, flashlight, or even a wrapped up knife. Wrap the tourniquet around the limb, two inches closer to the body from the wound site. One important note is to make sure you do not apply it directly over a joint. Once applied, use the remaining tourniquet material to tie onto your torsion device and then begin turning it slowly until blood flow is stopped. Once it stops, tie the tourniquet securely in place.

Above all, the way think about first response and acting quickly in mass casualty situations must change. If you haven’t received first-aid training, consider doing so, regardless of our profession or skill sets. Again, mass casualty events can happen anywhere at any time and you never know when you might be faced with needing to provide life-saving measures to fellow co-workers, students, or complete strangers.

Anyone can save a life and you do not need years of training to be able to do it. Unfortunately, we live a world where this type of training and preparation has become a harsh reality. If you would like more information regarding the “Stop the Bleed” campaign, along with additional information and life-saving tips, you can find it on the web at