By, Patrick Kelley, Captain Ventura County Fire Department, Member of IPSA’s Mentoring Committee

The Hartford Consensus has been the most in depth study about active shooter and mass casualty incidents and the development of best practices. According to the study, there are three levels of responder: (1) immediate responders, (2) professional first responders and (3) trauma care professionals. These traditional roles are no longer enough.

Immediate responders’ role

Within four to six minutes a person can bleed out and die. This is less than national average response times for professional first responders. 

Trauma is now the number one cause of death in Americans under the age of 46, and immediate responders are a vital component of survival after a mass casualty incident. Historically, an immediate responder is a bystander who, at best, would initiate a call to 911, and then sit passively waiting for the first responders to arrive. Fast forward to today, immediate responders are now deemed essential to victim survival in active shooter and mass casualty type incidents. Arguably, the immediate responders are the most critical because they are present when the event happens and can immediately intervene.

Community members are clamoring nationwide for training, but also have legitimate concerns about causing further injury, liability and communicable disease transmission, which is why education and training is so important.

Provide citizen education, training

To ensure preventable deaths do not continue to occur, community members need to know that they represent the immediate responders. The Boston Marathon bombing proved how effective the individual can be if they know rudimentary disaster medicine. Everyone remembers the guy in the cowboy hat that became an instant nationally recognized figure for his efforts.

In 2015, the Obama Administration launched the Stop the Bleed campaign, and DHS now has oversight. Programs endorsed by the campaign teach basic life-saving fundamentals. Bleeding control, airway positioning and activating the 911 system are the common threads throughout theses training programs. All municipalities must learn how to get started and then educate, train and empower their communities about life-saving measures. 

It must be recognized that asking the public to act as a responder and potentially perform life-saving interventions on others will be tremendously stressful. To ensure that they are successful when called to act, public access bleeding control kits are essential. 

The study recommends co-locating these kits next to the Public Access Defibrillators, since most people know that is where to find help in the event of an emergency. As part of the information dissemination, mobile technology applications could also show the location of these kits, much the same as has been done with the AEDs.

An international call to action

You must educate your community members that when a true disaster occurs, the public safety system will be overloaded. It is in these rare instances when everyone who is able will be asked to assist as an immediate responder.

Now, the onus for preparing for and mitigating against disasters falls on local government. Given this, you must be the one to initiate the discussion in order reduce preventable deaths occurring.

Partnerships between local leadership, public safety and the public need to be formed. Once these partnerships are formed, these individuals must sit down at the same table to work through the problem of so many lives being lost to preventable causes and develop actionable solutions. Without these partnerships, a resilient community will never be achievable.

Communities throughout the country need to recognize the value of these spontaneous rescuers, educate them, equip them and account for them in the planning process. As the study suggests, the nation needs to move forward from simply “if you see something, say something” to “if you see something, say something, do something.” The only way to achieve this is through public education, whole-community partnerships, and providing the equipment necessary to be successful. 

About the Author

Patrick Kelley is a Fire Captain assigned to the training section with the Ventura County Fire Department. He also holds a bachelor’s degree in Emergency Management, and is pursuing a Master’s in Emergency Management and Homeland Security. Patrick currently serves on the IPSA’s Mentoring Committee, and if you have any questions you can contact him at patrick.kelley@ventura.org.

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