PART IV: Reducing Gun Trauma by Reducing the Dying

Welcome to part four in our series on reducing gun trauma in schools, this one focused on reducing the number of unnecessary fatalities in school shootings due to slow or substandard medical response.

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The number of fatalities in most of the more serious school shootings increased due to victims bleeding out before they could receive medical attention.

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When you listen to the police dispatch radio communications from most mass shootings, there is one regular theme - chaos in the “fog of war”:

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1. At the movie theater shooting in Aurora, Colorado, there were conflicting reports about whether the shooter had been apprehended, which caused fire and medical services to set up camps far beyond ‘ground zero’ where people were still bleeding out and dying.
2. In Parkland, law enforcement didn’t realize that the school security cameras were operating on a delay, so they believed that the shooting was still ongoing, when in reality the shooter had already fled the scene. Again, victims were dying unnecessarily throughout the building.
3. At Columbine, the two suspects had already committed suicide over 30 minutes before SWAT finally breached the building, again greatly extending the period during which victims bled out and died.
4. At Uvalde, law enforcement was there quickly but took far too long to confront and end the shooting, primarily due to a lack of leadership on-site.

According to DHS, a major arterial wound can often cause death in 3-5 minutes in an adult, as all the blood is pumped out of the body. This time window is even shorter for children, as they have a much smaller volume of blood.

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From John Hopkins University:

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“In a new analysis of data submitted to Maryland’s state trauma registry from 2005 to 2017, Johns Hopkins Medicine researchers found that gunshot victims are approximately five times more likely to require blood transfusions, they require 10 times more blood units and are 14 times more likely to die than people seriously injured by motor vehicles, non-gun assaults, falls or stabs… In the United States each year, over 116,000 people are injured and over 38,000 people die from gun-related injuries.”

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Finding Victims Faster

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From the Encyclopedia Britannica reference on Columbine:

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“Despite the fact that the shooting ended by noon, police and sheriff’s deputies, believing there was continuing danger, did not move into the shooting area until several more hours had passed, during which time some victims bled to death.”

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Regarding the Parkland shooting, as reported by Fox News:

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“Two separate sources told Fox News some of the EMS teams who requested to enter the school were told they could not. One source said it was the Broward County Sheriff’s Office – which was the commanding office – that ordered some of the EMS crews not to go into the school when they requested to enter.”

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From a research paper in the American College of Emergency Physicians journal:

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“Tactical medics made medical contact with victims thirty-three minutes after the shooting started and over twenty minutes after the first law enforcement entry into the school. Tactical medics treated two victims, one of which had already been seen by LEOs.”

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On Site Medical Aid

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Every police officer is supposed to carry a tourniquet, and this simple device can prevent victims from bleeding out from an arterial wound at the scene.

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The DHS has conducted training courses and national campaigns to highlight the value of tourniquets, as they can be the difference between life and death, given the average time for first responders is 7-10 minutes. The STOP THE BLEED Project states that 40% of trauma-related deaths are due to bleeding.

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Getting emergency fire and medical workers to victims on-site faster is key to reducing unnecessary deaths from gun violence and the trauma it causes. However, doing this safely is a real challenge today, both due to real continuing and perceived risk to emergency responders, as well as physical access when the site is often surrounded by police vehicles.

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Better Response Orchestration

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In most mass shootings, the emergency response outside turns into carnage, as police cars block access for ambulances, and key assets are not employed to optimal effect.

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According to AP summarizing the report on Uvalde:

• “Some law enforcement cars were left locked and could not quickly be moved, forcing medics to frantically try various routes to the school, crisscrossing through residents’ yards.”
• “three of the victims pulled from the school had a pulse and later died, two of whom did not have critical resources available to them when it was expected there would be. Another victim survived an hour after she was shot, and was placed in an ambulance after medics finally accessed the classroom but died during transport.”
• “… at least one victim — teacher Eva Mireles, who was shot in the first few minutes of the attack — may have had survivable injuries since she was conscious and responsive when she was found. Records show that while Mireles was initially treated at the scene because an ambulance was not immediately accessible, a decision was made not to take her to the hospital. She later died in an ambulance that never left school grounds.”
• “helicopters carrying critical supplies of blood were told by an unidentified fire department official to wait at a nearby airport instead of landing at the school.”

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How Campus Guardian Angel can Help

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Campus Guardian Angel is a managed service that employs less lethal drones in an active shooter situation, piloted and controlled from a central ops center in Austin, TX. There are several ways in which our service can help reduce the dying in the immediate aftermath of a school shooting:

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1. Confirming Threat Neutralized: Drones can fly at high speeds and take risks that humans should not take. This allows our pilots to rush through the building, finding and confronting the shooter or confirming that he or she has committed suicide. It also allows us to look for other potential threats - be they human shooters or IEDs such as pipe bombs, which are increasingly being employed by school shooters (e.g. the attempted shooting at Spring Branch ISD).
2. Clearing Paths: In ALERRT training, one of the tasks assigned to law enforcement officers is to clear paths for medical evacuations. This is something that drones can also do - holding corridors and maintaining watch to allow medical evacuations. The team at Campus Guardian Angel’s headquarters acts as a force multiplier for officers on the ground, freeing up these officers to assist in the evacuation.
3. Discovering the Dying: Our drones can be flown rapidly through a school campus, and our pilots actively search for victims with gunshot wounds. Our real-time common operating picture application allows us to mark the victims we find on a 3D digital twin (map) of the campus and then share this map with law enforcement and emergency medical response.
4. Assessing Victims: Our pilots are trained to recognize arterial bleeds. Drones cannot (yet) apply a tourniquet, but a two-way speakerphone allows us to converse with victims if they are still conscious.
5. Guiding First Responders: Our drones are human-piloted, so they are essentially an additional team member, but our pilots have the advantage of a full knowledge of the layout of the school campus and the best situational awareness of the current state. Emergency medical responders do not have this information. Our drones can meet ambulance workers in the parking lot, then guide them to the highest priority victims - literally talking to them through the drone speakerphone and having them follow the drone through the maze of corridors.
6. Orchestrating the Scene Outside: Drones are not confined to the ground or pathways, so they can easily become an “eye in the sky” on-site. Our standard operating procedure is to deploy one drone outside to orchestrate with first responders. This allows us to see paths that others cannot and find ways to move emergency medical responders closer to the victims they want to treat.
7. Carrying Medical Supplies: Drones can carry objects, such as blood supplies, to first responders working on site, which could have made a difference at Uvalde by transporting blood from the waiting helicopter to where it was most needed.

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Recovery and reconstitution after an active shooter event require a team of law enforcement and emergency medical responders. Remote-piloted drones can play a role in this process, acting as a team extension and force multiplier for first responders on the ground.

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In the final installment of this blog series, we will examine how a drone management service, such as Campus Guardian Angel, can reduce the trauma caused by active shooter alarms , in both real events and false alarms (swatting events).

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