So now we're going to talk about first aid. Okay? an active shooter situations as often about 11 minutes is the national response time. Okay, one of the things that you need to know is that please generally will not begin first aid until they know that that scene is secure. Absolutely, it takes 11 minutes to get there plus the scene securing can take anywhere from 10 to 20 minutes depending on how large of an area you have to deal with. So the main thing you want to know is how to do field expedient medicine or we refer to it referred to as tactical medicine and tackle medicine.

It's not what a doctor can do, they can do much more, the first thing you want to do is get them to emergency responders. Now, I highly recommend you go through training first, but we're going to give you a couple tips on what you can do at that moment to help save the life of yourself and the people around you. Because minutes do make a difference. So we're going to do is walk through the stuff on how to actually check for wounds. This is assuming the person is either unresponsive or just not complying with you. Okay, so the first thing anytime you do any kind of first aid situation is you assess the scene.

I know this is often disregarded, and a lot of times you don't have the time to do it, but it's very, very important. You can start working on someone else helping someone until you You know that that area is secure. So first thing we're gonna do is assess that scene. Once. That's right, we're going to come up and we're going to check the responses. So Stephens gonna kind of stood in here, I'm gonna back out, and seven, the first thing to do is you're gonna verbally ask for a response to your way, can you hear me?

Okay, so there's mild bumbling going on right now, the reason why we first do verbal is because sometimes we don't want to freak that person out. Okay, so we don't want the person to come to us and they're going to start flailing out. So, first we're going to do is we're going to talk to them verbally, and then we're going to do a rub on the shoulder. From there, if there's still no responses, you have the time to see any visible ones. You can do a knuckle rub on the chest. So we're going to do is place your knuckles extended, I just have a nice rub on the chest foam to see if this causes a lot of pain.

And if he's not responding to this, that means he's probably is probably in pretty bad shape. So we're gonna go ahead and get on with it. examination. First, we're gonna start with the head. We're looking for any bleeding. Okay, we're gonna take our two hands behind the sides of his ears.

And we're being very careful with any bleeding coming out of the IRS knows pretty much anything even outside of class. We just don't want any blood coming out of there. Next, we're gonna move down to the shoulders. Now one of the important things as you're moving down is keep one hand in contact with your subject at all times, because at any point that person can wake up, and at that time they might use when they feel a new hand coming in, touch them. So continuous motion, go from the neck down across the shoulders. When you get to the arms, you're gonna select one arm, you're gonna go up and down all the way from the fingertips and all the way down on the other side crosses our shoulder And you're looking for blood on him and blood on your fingertips.

Once you have that go under both armpits and go down. You're basically going to go down the sides of that body and expedient motion by looking for any signs of bleeding. Same things with the leg is what you do to the arms, you can take one leg, go out one side and down the other side, go all the way down. And remember to look at the two flats, if you can step on glass, anything like that, it could be injuries that are overload from there, you're gonna come up and go up and down the other leg. Now for the cameras were slowing us down to make it a little bit more of an explanation. But really, you're gonna want to do this and about under 10 seconds depending if you don't see a lot in the beginning.

So at this point, you don't see looks okay on the beginning. So what he's going to do is talk up his knees right next to the patients that You're gonna grab one knee, and you're gonna grab one arm across it, he's gonna pull it and rest him on his knee. on there, you're gonna run your hands, you're gonna check the back. Again, we're being mindful of the neck at all times. But at this point, there doesn't seem to be any risk of that injuries. One side looks good.

We're gonna cover about 80% of that. On that side, check the other side as well, throwing them away. Good. So at this point, there's no signs of bleeding. Now, the only time we would take this long is a patient is still breathing, and we're doing a very specific look to what the patient isn't breathing. You gotta want to jump to another step.

So now we're going to do is we're going to assess the situation from a tactical standpoint, during a live shooting active shooter scenario, someone can get shot, stabbed, there could be explosions, there could be shrapnel. So our victim here is played by Stephen Bonner. So the first thing we're gonna do is we're going to assess him to make sure that he's okay. You want to do the ABCs. The first a is airway, you want to make sure that his airway is clear, and then he's breathing properly. Second, you're going to look for bleeding.

Now the victim isn't always going to know their bleeding as crazy as it sounds, a lot of times adrenaline's pumping, and they're actually unaware that they're bleeding out. So you're gonna need to articulate if it's a veinous, if it's an arterial, or whatever the case may be, and the C stands for circulation. So again, you want to make sure that his heart's pumping blood properly in his body. So let's take a look at that and dissect that a little bit more. So first thing we're talking about is airway. Want to make sure that there's no obstructions in the airway.

I'm actually a disabled combat veteran. I was served just over seven years in the Marine Corps. So I've been to Iraq and some different things. So one of the things we're talking about with the airway will be dealing with blasts or wounds to the chest that are actually going to disrupt his breathing can be wounds to the throat, if he had, if he did get shot might get shot in the side, it could break a rib, it could actually collapse in your lungs, which really restricts your breathing, the breathing would be your airway would be blocked, and it felt like there was an elephant sitting on his chest, his windpipe would actually be moved over to one side because that one side of your lung is working harder than the other and it actually pulls your trachea over. So what you want to do is you want to visually inspect his neck right here to make sure that his windpipe is directly lined up underneath chin like it should be if he's struggling breathing, and you can see that he's wheezing and it sounds really heavy and this is starting to move over to one side.

You know that his airway is being obstructed because he has a collapsed lung. Next we're going to talk about bleeding. I myself, I'm a combat veteran, a veteran of RAC analysts have done search and rescue and done wilderness first aid. So I've seen a lot of things I'm bleeding out there from gunshot wounds to the small, right? One thing to know about it, they're always going to be different, and it's going to depend a lot on your patient. First thing you want to do is find out where the bleed is and how severe it is, assuming that they don't have a neck injury, what we're going to do is we're going to turn them first of all versus visually inspect the front.

And you can use your hands if you have gloves, if you have finished tech, your fingers tech behind the neck, check behind the ears. If there's any kind of bleeding coming from the ears, you're probably not going to want to move that person. Okay, it's going to show that there's spinal fluid. There's different ways you can do a test on that using the drop method, stuff like that, but you're not going to want to move them on that. So watch out for bleeding from the face. You're not gonna have a lot of time to assess these situations, you're gonna have to move quick.

So let's go on to the rest of the body, and we're gonna look at the limbs. Now one of the things you should know that gunshot wounds and knife wounds to the lambs are not arterial bleeds, they actually have a pretty decent rate of survivability. Okay, so don't panic on that, you're gonna want to treat it right away using the appropriate method as in putting pressure on the wound or using a tourniquet. But that's gonna have to be up to you when you see and we'll look specifically how to address those things. But moving on, we'll come in, we'll check the back, we're checking the stomach, when watch for the stomach, the stomach, we can divide up into four different sections. Okay, and we'll go into that a little bit later to see what that injury is going to be.

Come down the legs, your first visual assessment looks good. So what I'm going to do, there's a lot of different methods on this, my personal one is to kneel next to them create a little bit of a table, I'm going to have one leg on this knee, and I'm going to cross this and I'm going to pull them throw them towards me. From here. I'm going to check his back, up and down, rolling back and I'll check the other side as well just so I didn't miss anything. Here. You're going to want to hold him you're not going to want to let him go.

Because you want to maintain control the patient at all times. When I bring them back. I can simply talk to him at this point. Okay, is there anything You're bleeding, anything where you can see. And the last thing we're going to talk about is the circulation. Obviously, if his airway has been cleared, and you check for his bleeding, the circulation is the blood pumping within his body, making sure that actually stays in the body, check his eyes, make sure that not dilated is responsive, he's blinking, everything's good from that standpoint.

If at that point, you're seeing no responsiveness from bleeding or breathing, and maybe it's time to start CPR, if you do need to start CPR, obviously aren't going to do is the head up to bat method, you're going to open up the mouth, again, making sure that there's no blockage inside the mouth, his tongue should be coming up forward. If his tongue is rolled back, you stick your finger down in there and pull the tongue out. If there's any obstruction in there which would have obstructed his reading that you can see you're going to want to pull it out you do the scoop method, put your finger in the mouth and scoop it out and make sure that tongue is forward. Once you're at this point, you're going to pinch off the nose. To do mouth to mouth, that cycle is going to be to breast by 30 seconds.

Okay 30 pumps, you can do this by keeping the beat to a song staying alive. There's a lot of other methods out there, I highly suggest to get out there and get CPR certified. On top of that most schools are going to have an ad system available. So get yourself familiar with that. Learn how it's not that complicated. All you got to do is take a class and learn how to do it.

Trust me, if you can save one life, let alone many is very much going to be worth your time. So this time we'll we'll come up to our victim we want to address any bleeding that comes from the head and neck area. Whenever you have some lacerations to the face in the in the head, they tend to bleed a lot more. But the difference is is the lacerations on the neck are more deadly. You have your carotid arteries located on the side of your windpipe, one on this side of one on that side. If those get severed at all and you start to bleed out because it's a main artery, they can die within minutes.

So when you are assessing head traumas, you can look over the face. But when you see the bleeding coming from the arteries, what you want to do is you want to take two fingers and apply pressure directly to that artery, what that's going to do is it's going to keep from the blood coming out of that artery and letting them bleed out. You must maintain constant pressure on this artery, or they will die and you need to stand here and keep this firm until paramedics arrived to assess the scene. While a carotid artery injury is a serious thing, and is not a death sentence, if you do get it severed, you can survive. That's right. There's a very famous case in 1989 were a hockey goalie actually had his carotid artery severed, he applied self care, and he survived.

Yes. So when you're talking about self care, if you do feel an injury to your neck, you're going to reach up and feel your neck. And when you pull your hand away, if you do see that there's blood, you're going to immediately take your two fingers and apply it to your carotid artery while you're holding that when you want to support it with your secondary hand. You're gonna sit there and hold that until a professional medical team arrives to assist you. Now we're going to take a look at what happens if there's a gunshot wound to the arm. At this point, we're not going to go ahead and assume that a tourniquet as needed First, we're going to try and apply a pressure dressing at field expedient one and trying to control that breathing.

So what we're going to do is take any object we can and this point we found a T shirt, and this T shirt assuming that wound is on the bicep, we're going to go ahead and we're going to push down and apply pressure to control that bleeding. You're gonna apply as much pressure as you can. If the wound is still bleeding and you haven't stopped it with this amount of force. Well, we're going to go ahead and do is lay the subject down and keeping that pressure on that bicep, we're going to go ahead and kneel on that arm. We're gonna use our bodyweight to go ahead Go ahead and apply an extreme amount of force. Now this is going to be painful to the person and you don't want to injure them worse, but done correctly.

This is saving the person's life. If this is still not controlling, we're gonna have to move on to a tourniquet. Be aware wary of gravity. So you use some pressure, gravity in your favor. And worst case scenario, a tourniquet so the victim doesn't bleed out while you're waiting for emergency services to come. And we're not equipped.

We're using anything we can. We're waiting for those emergency services. So I'm elevating the arm, getting gravity on my side. I was applying pressure that's not enough. Now I'm gonna go a little above the room and use that shirt to get a nice tourniquet nice and tight. still be mindful graph.

So I still can control the bleeding by using pressure and elevation. So I'm gonna move on to a tourniquet. So I took that same shirt that I was using apply pressure with. It's nice and wet now. So it makes a better tourniquet. You tie one nine, like like so, and find an object to put in between the first night and the second night.

Tie the second night. And now I'm going to twist it off nice and tight like that. And now if he's conscious, he could help me. Hold that tourniquet right there. And I'm going to move on help someone else. Remember in the case that you had to apply a tourniquet make sure you write a T on the victim side along with the time They apply that tourniquet.

So emergency services will no. So what do we do when we do come across someone who's significantly bleeding. Now, let's say our subject right here has severe bleeding in the leg. Now we know that that can be an arterial from oral artery that is bleeding. What we're going to do is we're going to have to go to a tourniquet. Now this isn't going to be applied on small ones.

This is only when there's a severe life threatening bleed. So what we're going to do, because we don't have time to get a med kit, and stuff like that, what we need to do as a field expedient solution. So we're going to use a tourniquet using what we have around us, and we're all wearing belts. Now the first thing you're going to want to think to do is take your belt off and use that but that's not the case. Because why don't you find someone else who has that same problem and you're going to need that. So we're going to do in this case Use our subjects belt.

So Stephen, if you want to go ahead and take that off. Good. Now, if you do have the means to find a tourniquet specifically intended for that use, that's great, but in this time, we don't have that option. So what we're gonna want to do is take this belt, and we're going to surround it around that leg. Now as I'm doing this, I'm checking that there's nothing in the way, okay? There's any cell phones, wallets, anything that's going to block a good solid tourniquet, you're going to want to get that out of the way.

I checked for that, that looks okay. So what we're going to say is the wound is right here. Now generally, what used to be the rule of thumb was you go two inches above any joint. But what happened the last few years, they found out that it's much more effective to just go high and tight. It's a much better success rate. So what we're going to do is we're going to get this belt as high as possible, regardless of where that wound is.

We're going to come up towards the torso as much as we can From there, we're going to go ahead Exactly, and we're going to make a circle around that leg. From this point, it doesn't matter what you use to go ahead and twist it. Alright, it's going to be some kind of firm object. That's going to lock that tourniquet. And now we're only going to simulate it on this because we don't want to end up with an actual medical problem. So once we have that belt wrapped around, when to take a regular stick, good, and that I'll go ahead and actually just put it right even under and we're going to turn it right.

Basically, when I turn and tell you get it as tight as we can get it. Once it's tight, we're going to lock down one of those ends. At that point, you're going to mark the time at which that tourniquet was applied. And let them know that there's severe bleeding he's going to have blood so if you don't have a pen or marker, mark a T on his forehead so that if he's covered up in blankets, the medics are going to know that he has tourniquet and what time it was applied, this is the best way that they'll be able to recover his wounds. Again, most importantly, get ahold of emergency services as fast as possible. Okay, so now we have an open wound on the chest, this will be the same if it's a bullet hole, or debris or a knife wound, what we're going to want to do is apply pressure.

Okay, so we're going to take anything we can maybe kind of cloth fabric, whatever we can find and apply pressure on that. This is a very serious situation, and we're going to need the term x here as fast as possible. Now, obviously a first aid kit is going to be best but we're not always going to have time we want to get pressure on that wound. Just making the still bleeding through that first dressing. We're gonna go ahead and add a second dress. Perfect.

We don't want to keep a lot of pressure on that. Regardless of the discomfort of the victim, we're going to want to first aim at saving his life. At this point, we're going to try and keep them calm, keep them relaxed, and wait for help to realize relax, help is on its way. And remember what I said about gravity if you can, he wants a heart a little bit higher than the one do, you want the heart elevated so you could see better I'm gonna turn Jason around and show you how to elevate that heart a little bit and get gravity on your side. So here I keep that pressure. Now I just tilt my knee underneath, good leverage, compressed back down on the wound.

Okay, so now we're gonna look at a scenario where the victim has a knife and the knife is still in place. Now this can be used for any kind of projectile that goes in To the body, any kind of foreign object, you're going to want to handle the same. Number one, do not remove that without the proper medical attention. Okay, that's not going to be up to you. The number one thing we don't want to do is remove the knife from the subject, and we don't want to move the subject. The reason for this is, as he does any movement tries to set up he can cause further injury.

So what we need to do is keep that person calm, talk to them, tell them to stay for their own benefit, and go ahead and use that T shirt to basically stabilize that knife. You want to keep that knife from doing any further damage. So you can either wrap it if you have tape, it's good to actually secure that item. If you have the person conscious. Go ahead and ask them say can you stabilize this knife for me? Can you help stabilize this knife?

Yes. And don't try to sit up you have an abdominal injury. Okay. Perfect. At that point. We're going to wait for emergency responders to arrive.

We're going to keep that person safe. And we're gonna let the emergency responder know what the injury is. Remember, always talk to your victim, keep them calm, let me know helps on its way Get them to respond and absolutely do not let them fall asleep. Keep them conscious