First Aid and Casualty Response in Firearm Incidents
This domain tests casualty care in a shooting, with the emphasis on the order of priorities and on the few interventions that actually save lives before an ambulance arrives.
Sequence at a firearm incident
- Scene safety first: an active shooter or an unstable structure means you do not approach until it is safe, and you do not become a second casualty.
- Call for help early - medical dispatch (101) and police (100) - and state the number of casualties and the location precisely.
- Catastrophic bleeding control comes before a full airway assessment. Direct pressure, then a pressure dressing, then a tourniquet for life-threatening limb bleeding, applied high and tight and never loosened once placed.
- Airway and breathing: open the airway, and for an open chest wound apply an occlusive dressing.
- Keep the casualty warm, treat for shock, do not give food or drink, do not remove impaled objects - pad around them.
- Record the tourniquet time and hand over clearly to the medical crew.
Worked example
A casualty has an arterial bleed from the thigh and is also complaining of chest pain. Reasoning: the thigh bleed will kill in minutes, the chest injury in longer. Bleeding is controlled first - direct pressure and a tourniquet with the time written on the casualty - then airway and breathing are assessed. Treating the chest complaint first while the leg bleeds out is the classic error the exam is testing.
Traps that cost marks
- Rushing into an unsecured scene.
- Loosening a tourniquet "to let blood flow" or failing to note the time.
- Pulling out a knife or other impaled object.
- Delaying bleeding control to look for an exit wound.