This article was written by Sue Pascoe and was first published in Circling the News.

“You’re being shot at. You’ve been hit in the right arm, put on the tourniquet!”

Dutifully, this editor slipped below the table and grabbed the tourniquet and put it on with her left hand.

At the Tactical Emergency Casualty Care for Law Enforcement and First Responders, that scenario was repeated throughout the day. At the end of the course, the editor could pull the tourniquet from the kit and have it in place in less than 20 seconds.

The course was offered by the Ronald Reagan American Legion Post 283 and instructor Jason Ames worked with about 20 people that included residents, private security, the Los Angeles Police Department and Santa Monica Police. He was aided by a former Army Ranger Evan Vilander and a Navy Seal Medic Justin Garza (both are 283 members).

Post commander Jim Cragg said the Legion offered this first aid course (and hopes to offer it again), so that regular citizens, school administrations and store owners will get the training that may save lives if there is a mass casualty event.

This was not a political event, but rather “this is about getting trained, so that if something happens, we can deal with it,” Cragg said.

Instructor Ames said, “This course applies to anyone in a threat situation. This stuff is not secret. The faster the general population understands these skills, the safer everyone is.”

Attendees went through the acronym, T.H.R.E.A.T.

T – Threat means that law enforcement or other person should neutralize or mitigate the threat first.

H – Hemorrhage means one should try to stop massive bleeding.

RE – Rapid Extrication – means move the victim to a safe area.

A – Assess – perform a physical assessment for life threatening injuries

T – Transport – rapid transport needs to be provided to a trauma hospital.

If there are those with numerous injuries, those with massive hemorrhaging should be treated first.

TOURNIQUET:

Attendees learned the proper way to put a on tourniquet, because a massive hemorrhage can cause death in one to three minutes.

A tourniquet needs to be applied if there is severe extremity bleeding or an amputation. The device should be tight, painful, and stop the distal pulse. Once it’s on, only a doctor should remove it.

Bleeding in junctional areas (neck, shoulders and groin) should receive direct pressure with gauze.

PENETRATING WOUNDS:

Penetrating wounds, such as those done with a bullet, need to be identified because it can lead to pneumothorax. Air enters the cavity via the hole and the air pressure (much like a balloon), presses against the heart.

The entrance and exit hole must be found and sealed (with a medical sticker found in kits). If not, death is likely. President Ronald Reagan was shot when a 22-caliber bullet which ricocheted off the limousine and struck him in his left arm pit. It was not noticed until he began to cough up blood.

The bleeding from a wound to the torso “all damage is on the inside,” Ames said.

“The number one preventable cause of death in Vietnam would have been to seal the hole,” Army Ranger, Vilander said. “The exit wound could look like a little dot.”

Once the wound is sealed, the victim should be put in the recovery position on his/her side, with the injured side up.

AIRWAY OPENING:

If a person is injured and one does not suspect spinal trauma, they should be rolled on the side, to allow the mouth to drain and to access airway opening.

All responders should have Narcan in their kits. The first dose is given and then after two minutes, if the person is still not breathing, then a second dose is given. If that does not work responders should breath for the victims – one breath every five seconds.

In general, if one comes upon a person that is taking less than a breath every five seconds, breathing should be supplemented.

INCENDIARY DEVICE BURNS:

In 2020, there were deliberate attacks made on law officials using firebombs, Molotov cocktails, large fireworks and improvised napalm. (Editor’s note: the videos of people who purposely lit police officers on fire, using these devices, was devastating.)

The burns cause the body to “suffocate and drown” at the same time.

There is a fire suppressant, ColdFire Tactical, that can be used in the field. The product is the same technology used on major racetracks for NASCAR, Indy Racing, NHRA and Dirt tracks. It was developed for SWAT, fleet operations, corrections and mobile field force units.

NOW WHAT?

As the day was winding down, attendees were told they were the responding officer at a “mall shooting.” Applying everything attendees had learned; students tried to neutralize the shooters and then attend to victims.

DONE?

No. It was time for more practical applications.

Students were told that had been a mass incident at a preschool. A room was opened in the Legion, and everyone went to the “preschool” and found a “victim,” determined its injury and attended to it.

My victim had a bullet wound in the front, which I promptly sealed. I turned the dummy over and found two additional wounds in the back, which also needed to be sealed.

This editor removed the victim from the area and wrapped it in an emergency blanket to prevent it from going into shock.

EIGHT HOURS LATER:

Eight hours later and after taking a test, this editor came away with an increased appreciation for law enforcement and first responders. It is unlikely that a writer will be called upon to perform any of these life-saving skills, but the knowledge of what these men and women do is inspiring.