Surviving a mass shooting: 4 life-saving tips

Last year, the U.S. averaged at least one deadly mass shooting per month. One of the worst feelings associated with such attacks is helplessness. Not knowing when or where it will occur, or what to do is traumatizing.

Jedidiah Ballard, DO, an osteopathic emergency physician and former Army Ranger battalion surgeon, offers four rules for staying safe and helping others amid violent chaos.

Rule 1: Protect yourself first

The first thing to do when shots are fired is to find cover. This means getting behind something solid enough to stop bullets. If no cover is available, get out of the shooter’s line of sight. Your personal safety has an impact on the safety of your fellow bystanders. If you get seriously injured, you are not only unable to help others, you become another casualty requiring medical attention—making precious resources even more scarce.

Rule 2: Stop the bleed

This singular focus really marks the philosophical difference between being an Army Ranger and an emergency physician. In combat, you stop the bleeding and don’t worry about sterile conditions or any other secondary injuries. The same is true if you ever need to treat a gunshot wound.

Remember the clock is always against you in trauma care, nothing gets better with time.

When it comes to extremities, you’ll need a tourniquet and should consider keeping them in your vehicle in case of an accident. Tourniquets are inexpensive and can be easily purchased online, but you can also make one on the spot using a belt or piece of clothing. The main idea is to get it high up on the limb, close to the body, and make it as tight as you can. Don’t worry about a loss of limb or nerves; it takes hours for that kind of damage to set in.

For a gunshot wound to the torso, apply hard, direct pressure—even plugging the hole with your finger is acceptable. Keep in mind, the closer the wound is to the middle of the body, the more serious it is. If the injury is in “the box,” the chest or upper abdomen, you want to look out for a sucking chest wound. This happens when air pressure builds up inside, collapsing the lungs and large veins leading to the heart. Treating this is as simple as it is crucial. Simply cover the wound and apply pressure. You can use a plastic bag, your driver’s license, or any object or material that won’t let air through.

Rule 3: Keep them warm

This step isn’t about comfort. Traumatic blood loss drastically lowers body temperature, which then disrupts or stops the enzymatic reactions that allow blood to coagulate. So wrapping the victim in a blanket or giving them your coat can help their body naturally slow bleeding.

Rule 4: Get to a hospital

This is especially important in a mass casualty event. There may not be enough ambulances to carry everyone. In such cases, it’s best to put the victim in a car and go. Remember the clock is always against you in trauma care, nothing gets better with time.

Be confident if you need to act in chaotic and dangerous circumstances. These steps can absolutely save someone’s life if you first follow rule No. 1.