Civilian Operator 101: Trauma Care in Active Shooter Scenarios


By Hammerhead


I highly suggest you guys routinely visit sites like The Journal of Trauma and Acute Care Surgery  for applicable medical/trauma care articles like this one.

I first found out about this site Through Greg Ellifritz’ Active Response Training Weekend Knowledge Dump, which I highly suggest you guys peruse each Friday.

The acronym T.H.R.E.A.T is used to describe the course of action LEO’s, First Responders and Armed Civilians need to follow when responding to Triage and Trauma Care in these situations. For those of you familiar with the Military TCCC (Tactical Combat Casualty Care) you will recognize these principles immediately.

In reality, only the first two and MAYBE the Third step in this acronym are going to apply to the Armed Civilian, the rest will fall in the LEO’s and First Responders Wheel House.



If the bad guy (or guys) are still a viable threat, they need to be dealt with before any serious triage and medical attention can be given. Bottom line if you get hit, what is the point? Now you have two wounded people out of the fight.

The term SUPPRESSION is used here, with the ideal there will be a TEAM present to deal with the other words a couple of people lay down SUPPRESSING FIRE on the bad guy while another person triages and treats the casualty or casualties. This type of thinking is endemic to Military and Law Enforcement Trauma training, but I think for our purposes here, where we are talking about a situation with the Individual ARMED Civilian, the world NEUTRALIZE is much more REALISTIC term since we can NEVER depend on a TEAM being present to help us. It is up to you, the INDIVIDUAL to survive this day, therefore you need to KILL the Threat before moving on to medical assistance.

As CR Williams states in his new book Gunfighting and Thoughts About Doing Violence, Volume 4 The choices you will be presented with in situations like this will NEVER be good ones, but regardless of WHO is down, the PRINCIPLE remains the same: DEAL WITH THE THREAT!!

  • Team Mate Down? YES. Threat Still Active? YES.   DEAL WITH THE THREAT!
  • Family Member Down? YES. Threat Still Active? YES. DEAL WITH THE THREAT!
  • 10 Year Old Child Down and Crying for Help? YES. Threat Still Active? YES. DEAL WITH THE THREAT!

H = Hemorrhage Control

This is where carrying and knowing how to use a PTK (Personal Trauma Kit) is going to come in Really essential. If you don’t have one, creating a make-shift pressure bandage (ripped shirt/pants/etc.) and applying steady direct Pressure to the gunshot wound will suffice. The PTK I carry has both a Hemostatic Agent and a SWAT-T (Stretch/Wrap/Tuck Tourniquet) inside them.

Having the training to know how to use each item for each type of injury is MANDATORY , so before you go out and spend $100 on the latest and greatest Blowout Kit, budget the money for some good Trauma Med Training too! In an article I did four years ago Do You Mothball Your Medical Training? I cover this extremely important subject in a bit more detail.

R & E = Rapid Extraction To Safety

Although technically this does not fall into the Civilian’s area of responsibility, as with any fluid scenario, you are going to have thing fast on your feet and ACT. If you have the opportunity to help a wounded person to safety without endangering yourself or others, by all means, but typically this is not going to fall to you.

A = Assessment by Medical Providers


T = Transport to Definitive Care


Stay Alert, Stay Armed and Stay Dangerous!



5 thoughts on “Civilian Operator 101: Trauma Care in Active Shooter Scenarios

    • Lisa, Stop calling me Sir!! I keep looking around to see if my Dad is in the room or something!!

      Kudos to Wal-Mart for at least making an effort. I think all Big Box stores should do some kind of Active Shooter/Emergency Scenario training every few months…this is the NEW reality unfortunately.

  1. I second the spend the money on training before you go and buy the newest,coolest first aid/IFAK/blowout kit.
    Having all the shit does you no good if you don’t know how and when to use it.
    Get some good training first-then put together a kit that works for you and your family’s needs.
    I carry a small kit in a plastic “box” that fits in a cargo pocket or a back pocket if need be,with a repurposed SAW gunners ammo pouch that’s attached to my pack with supplies for more serious/multiple injuries.

  2. Pingback: Civilian Operator 101: Trauma Care in Active Shooter Scenarios — Hammerhead Combat Systems | Rifleman III Journal

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