How can fire chiefs prepare citizens to be MCI responders

First Care training empowers citizens to stop the bleed and transition from hapless bystanders to lifesavers

Updated Sept. 28, 2018

What happened: Oct. 1, 2017, we saw the worst mass fatality shooting spree in this country’s modern history, with  58 people dead and over 500 injured. All the victim of a lone gunman shooting from an elevated hotel room window during a music festival below that attracted over 22,000 country music fans to Las Vegas.

Why it's significant: There are two significant facts. First, a single actor was able to inflict so much carnage in such a relatively short period of time, and that despite what, by all accounts, was an effective a rapid response by first responders, the death toll was horrendous and the casualty count overwhelming.

Training citizens can help save lives when a mass gathering turns violent.
Training citizens can help save lives when a mass gathering turns violent. (AP Photo/John Locher)

Second, is that even with a robust response system like the Las Vegas metro area has, with over 1,400 firefighter-paramedics and -EMTs between Las Vegas FD, Clark County and North Las Vegas Fire Depts., there is no way to quickly and efficiently manage that many casualties during an active shooter incident.

Top takeaways: Here are my top early takeaways from the Las Vegas Shooting incident.

1. Accept inevitability of mass casualty incidents

Communities need stop feeling like this will never happen to them. Mass casualty incidents are not going away, ever. It will happen again and we have to pull our collective heads out of the sand and face the facts that no amount of money or training or equipment will ever be enough to manage these events in time to save all the lives that might be saved.

2. Train citizens in First Care

One answer to reduce casualties is to train our citizens to render aid to themselves, their loved ones and complete strangers that are all unlucky enough to all be at the scene of a similar un-imaginable incident. We must train them to become First Care Providers. We must train citizens to deal with traumatic injuries that have happened right before their eyes.

We have seen it again and again, from the horrors of September 11 to the Boston Marathon to the grounds of the Route 91 Festival, people step up to help. We must train them to be helpers as safely as possible and as effectively as possible. We must preach the efficacy of the tourniquet and the pressure dressing to "Stop the Bleed!"

We have to teach citizens wound packing, how to apply chest seals and how to evacuate victims to a safe area. Training needs to include the importance of public access trauma care kits and carrying your own emergency trauma supplies.

The results of a new paper (included below) show poor proficiency in applying tourniquets in the lay public with only lecture-based training.  The training has to be hands on and performed repeatedly to ensure proficiency under stress.

3. Empower citizen lifesavers

Think of the great work our communities did rolling out CPR and AEDs. Now imagine the lives that can be saved if we use the same directives and the same motivation to save people from traumatic injury, the number one killer of people from age 1 to 43.

In the event of critical bleeding, a person can exsanguinate in as little as three minutes. The best fire and EMS systems in the world can’t respond in time on a good day. Forget about arriving on time on a night like they endured in Las Vegas.

Now is the time for fire chiefs to empower citizens a part of our system instead of hapless bystanders hoping help arrives in time. We need to create force multipliers in our communities who can and will act when these events strike. There is always someone there when tragedy strikes, we must educate and equip them to render first care. Hope is not a plan!

Learn more about First Care

Learn more about empowering your community. Help them realize that whether it’s an active shooter or an F5 hurricane, fire, EMS and law enforcement cannot always get there in time. A truly resilient community is not only one that plans to bounce back after a tragedy; it also knows how to act in the midst of one. Find out more at and visit the Committee for Tactical Emergency Casualty Care’s web page at for guidelines.

TQ Proficiency Study by Ed Praetorian on Scribd

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