Expo Poses: Bang! You`ve Been Shot

"Bang, you're shot! What's important now?" This was the premise of the EMS Expo/Enforcement Expo Southeast session "So You've Been Shot" held last week in Atlanta, Ga.

The session included a video and case study of an officer who survived, as well as a live simulation of an officer providing self-care under fire. The session drew a mixed audience of medical and law enforcement personnel, allowing each side a better understanding of the overall response.

Responders need to be prepared for officer-involved shootings to occur anywhere, said instructor Dennis Valone, Training Coordinator and SWAT Team Leader for the Metro Atlanta Department of Public Safety. Thirty-eight percent of officer-involved shootings occur in areas with low populations, he said. In the last year and a half in Alpharetta, Ga. -- the "Beverly Hills of Atlanta" -- they went from zero to three officer-involved shootings, he said.

Valone, also a former paramedic and tactical medic, said officers need to have some medical knowledge, as EMS will need to stage near the scene until it is safe to enter, he reminded the audience, and officers should aim for quality of life, not just survival.

Valone advised that officers use mental imagery to run through scenarios and develop an instinctive response, because they won't be thinking when the situation occurs. "Making officers go through these things in their minds is a powerful thing," Valone said. "When you do something in your head repeatedly the body will follow."

You've Been Shot

Other than a cranial vault shot, you can survive most wounds if you get focused, get aggressive and eliminate the threat, Valone said. He instructed officers to move to a tactical position, get help on the way, and assess and treat their wounds.

Tactical Positioning

When taking a position of cover, concealment or both, officers need to consider whether help will be able to find them, Valone said. He reminded the audience to consider any option available -- officers have survived by standing behind a pole or lying next to a curb. Valone has his trainees use a fire hydrant in simulation training.

When positioned, check your weapon and do combat breathing to get your heart rate down and clear your tunnel vision, Valone advised officers. His version is to inhale through the nose for four seconds, hold for four, exhale for four, and cycle through this three times.

Calling for help

Give your location, what happened, a threat description and the resources needed, Valone advised. "It's basic stuff, but you have to know it inside and out because you won't be thinking.” Self assessment is to look for any additional holes.

Valone advised officers to repeatedly re-evaluate their position and threat, and "Don't give up until your backup gets there."

Bleeding Out

Session co-presenter Jim Darling, EMS Training Coordinator for the Metro Atlanta Department of Public Safety, discussed hemorrhage control. He presented a visual demonstration of five liters of blood -- the average amount in the human body -- and what it looks like to pour the blood out a half liter at a time. Darling discussed the symptoms that occur depending on the amount of blood lost, and noted, "Anyone with altered mental status, we have to get the guns out of their hands."

Darling reviewed pressure points, pressure dressings, tourniquets and hemostatic agents. He said he would not hesitate to use a tourniquet because officers can usually expect to get to a hospital in a few hours or less. He advises the use of hemostatic agents when a tourniquet is not adequate or not possible for a particular wound area.

"No one should bleed to death from an extremity wound," Darling said.

He advised officers to do simulation training on these medical devices -- learning to self-apply them on each limb, in the dark, when slippery with simulated blood, etc.

Equipment

The instructors said officers or their agencies can put together a kit containing these basic medical items for $20-$40 per person.

Valone says he takes issue with arguments against cost. "People will refuse to spend $20 on a piece of equipment that can save their life but spend $350 on an Xbox and games," he lamented.

"There's no reason not to have a tourniquet. They're inexpensive and they work," Darling added. The officers offered suggestions for where to carry these items, such as pocket, belt, around the leg, or stashed in easy areas of the patrol vehicle.

Valone recommended posing the expenditure to departments (or communities, if seeking donations) as a general benefit since officers will have the equipment available not only for themselves but for civilians. "Even if you can only outfit a few officers at a time," Valone asked, "Isn't that worth it?"