How Bystanders Can Help Save Lives After a Mass Shooting


If you’ve been disheartened by the number of recent mass shootings involving guns or semi-automatic weapons, you’re not alone. Sadly, mass shootings and other mass-casualty events have become more common in recent years in the United States.

Stop the Bleed training aims to reduce fatalities in mass-casualty events

A new initiative endorsed by the American College of Surgeons, called Stop the Bleed, encourages bystanders to take an active role in saving lives in active shooter or mass-casualty events before emergency crews arrive. The reason: Uncontrolled bleeding is the leading preventable cause of death in trauma situations.

In recent mass-casualty events in Las Vegas and Orlando, uncontrolled bleeding or hemorrhage causes 30 to 40 percent of fatalities.

“If severe bleeding isn’t controlled, people can go into shock or die within five to 10 minutes. In a mass shooting, many lives could be saved if bleeding can be controlled,” says Melissa Thomas, RN, Trauma Program manager at Intermountain Riverton Hospital in Riverton, UT. “When numerous people are injured in succession, no matter how quickly emergency responders arrive, bystanders will always be first on the scene.”

“One-hour Stop the Bleed classes teach basic bleeding control in a way everyone can understand, even if you have no previous medical training,” says Thomas, who is a certified Stop the Bleed instructor.

What do the classes cover?

  • How to identify whether bleeding is life-threatening
  • How to assess whether a trauma first aid kit is available
  • How to properly apply pressure to wounds using hands or clothing
  • How to properly pack a deep wound with clean cloth or bandages and apply pressure
  • How to properly use a tourniquet if available and if bleeding of a limb doesn’t stop with direct pressure
  • First aid: The ABCs of bleeding control
    • Alert - call 911 or have someone else call 911
    • Bleeding - find the injury and assess the bleeding
    • Compress - apply pressure to stop the bleeding
  • How to know if bleeding may be life-threatening:
    • Blood is spurting out of the wound, pooling on the ground, or won’t stop
    • Clothing or bandages are soaked through
    • Part or all of an appendage is missing
    • A bleeding patient is confused or unconscious
  • How to care for arm or leg wounds: Severely bleeding arm or leg wounds are the most frequent cause of preventable death. They can be controlled by direct pressure or a tourniquet. Head, chest and abdominal wounds – point out victims with these types of wounds to emergency crews for rapid transport to a hospital.
  • Compress: How to apply pressure to a wound
    • Wear gloves if available
    • Use two hands if possible
    • If the wound is deep, pack it with clean bandages or clothing, then apply pressure
    • Use firm continuous pressure. Don’t release pressure to check the wound.
  • What’s a tourniquet? A tourniquet is a device that helps stop the flow of blood to a limb and limits blood loss by compressing blood vessels.
  • When and how to use a tourniquet:
    • Use a tourniquet on a limb wound that won’t stop bleeding with direct pressure.
    • Use a pre-manufactured tourniquet if available. The Combat Application Tourniquet is recommended by the American College of Surgeons and is used by the U.S. Army. They’re easy to apply and can be rapidly tightened.
    • If a tourniquet isn’t available, just use direct pressure. Homemade tourniquets are usually less effective.
    • Place a tourniquet two to three inches above the wound.
    • Don’t put a tourniquet directly over joints, bony parts of a limb, or on top of bulky items in a pocket. Tighten the tourniquet until the bleeding stops.
    • If bleeding doesn’t stop, a second tourniquet can be applied above the first tourniquet.
    • Tourniquets are generally OK to be in place for two hours and should be removed by a paramedic or physician.
    • Remind the patient that tourniquets hurt a lot, but can save their life. Pain doesn’t mean it’s put on incorrectly or you should take it off.
    • Note the time the tourniquet was placed on the limb. Write it on the tourniquet if possible.
  • Common mistakes when using a tourniquet:
    • Not putting it on soon enough
    • Not making it tight enough
    • Loosening the tourniquet
    • Removing the tourniquet – only a paramedic or physician should remove
  • Can tourniquets be used on children? Tourniquets can be used on children unless the child is very small or is an infant. For a very small child just use direct pressure to stop bleeding.

If you come in contact with another person’s blood, wash thoroughly with soap and water and notify emergency responders of your exposure.

Stop the Bleed was launched in October 2015 by the Obama administration. The initiative also aims to place trauma first aid kits in areas where large numbers of people gather. The skills taught in the class can also be used in other emergency situations such as car accidents.

How to find a Stop the Bleed class