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In the first 7 minutes after a medical incident, the approximate amount of time that it takes for emergency services responders to arrive, people can die. A person with a massive arterial bleed will generally bleed out in 5 minutes. A person who isn’t breathing or whose heart is not pumping will commonly face significant irreversible brain damage after 6 minutes, and death is imminent in 10-15 minutes. Even if emergency responders are “right around the corner” and on the scene within a minute, crews can be overwhelmed without enough hands to treat casualties if there are multiple victims. 

Magen David Adom, Israel's National Emergency Service, has been teaching various organizations worldwide how ordinary bystanders can become Immediate Responders, especially after mass casualty incidents like shootings, explosions, tornadoes, and more. Texas-based MedStar Mobile Healthcare recently offered courses in Hands-Only CPR, Stop the Bleed and Naloxone Administration. A few years back, Jersey City NJ promoted the concept of CBECs–community-based emergency caregivers; after approximately 60 hours of training with CPR, defibrillators, and oxygen, CBECs are available 24x7 to respond in their communities before EMS arrives.

Many EMS/FD/PD organizations have made training in CPR and more available for years. Response to different emergency situations may need different approaches. In an active shooter situation, ordinary citizens, even with specialized training, need to know how best to protect themselves as well as help the injured. Sometimes this may even mean getting one’s self to safety and merely being able to tell responding agencies where the victims and any remaining threat might be. While citizen responders can definitely help to save lives, sometimes just simple yet valuable information can be passed along to professional emergency responders.  Every hand and eye on the scene can be a great help.

In addition to the valuable training in CPR and defibrillators, bleeding control and the use of tourniquets, and Naloxone administration (to reverse the effects of an opioid overdose), it is also recommended to hold multiple drills to include not only the emergency responder agencies, but also the everyday citizen. Drills should be conducted to include multiple scenarios and be as realistic as possible to represent the different threats and safety needs (for instance use an empty school building over a weekend or summer break, to include the safe navigation of hallways, etc.) Ordinary citizens need to learn how to assess an area for victims/threats while ensuring their own physical safety; relaying concise information to emergency responders; and, of course, providing as much assistance to victims as possible.

EMS units need to do more than just offer classroom training. All emergency responder agencies need to involve their entire community – other agencies, layperson citizens, support services, and even media, — to ensure the safety, lifesaving treatment, and recovery of their neighborhoods after any emergency incident whether it be small or large, caused by man or caused by nature. Citizen training and drills will also help foster goodwill between your agency and the community and encourage everyone to help their neighbors.

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