How safe are we?

    With the right injury, a person can bleed to death in as little as three to four minutes.  Now why do I bring this to your attention?  Because the national standard for EMS response is either four minutes for Basic Life Support or eight minutes for Advanced Life Support, 90% of the time.




(1)  Since the fated events at Columbine High School in April 1999 the country’s school system, and the news-consuming public have been thrust into a new era of fear and uncertainty.  Active violence, natural disasters and subsequent events have changed how communities and especially schools assess security.(2)  As a result, law enforcement, fire and EMS have been forced to re-evaluate their response models.

     In the fifteen years since the Columbine incident, progress although slow, has mainly focused on reducing delays in the response of First Responders, and improving critical actions.  Yet even with new policies for law enforcement and medical responders, there remains a considerable gap in between the availability of medical care and the public’s perception of the availability of medical care.  If we look at the most recent example of the Oak Island shark attacks, we see that bystanders were able to act and arguably save the lives of the two teenagers bitten before EMS could even arrive on scene.(3)  In interviews after the event, the providers themselves acknowledged the critical role that the other swimmers and sunbathers took that day.  If we look systemically at our medical response infrastructure we see that, no matter how progressive our policies and tactics first response is still bound by the inherent delay of activation.  Someone has to call 9-1-1.  Response time to mass casualty incidents (MCI’s), Active Violence Incidents (AVI) locations, as well as law enforcement priorities will continue to impede the speed to which medical care can be applied to the injured.  Minimizing this gap in patient care must be addressed, but can only be improved once we have accepted our responsibility to each other as a community.

     It has been documented that there is an expected gap of 3-5 minutes in the arrival of First Responders (usually law enforcement) to a disaster event.(4) Unfortunately that 3-5 minute delay is critical to those affected by the incident and may be fatal to those injured. Knowing that specific injuries may be debilitating or even fatal unless addressed immediately, the need for First Care Provider training for the broader public becomes imperative.  A First Care Provider is defined as  “an individual capable of providing basic, life saving interventions in time of emergency.”  These topics go beyond what is typically covered in many first-aid-type courses.
Many school districts have also attempted to improve policies and procedures for violent events.  Strict anti-bullying policies have been created and lock-down procedures have been established.  However, the vast majority of educators receive little to no appropriate medical training with regard to traumatic injuries or emergent, life-saving techniques.(5) 

     Many districts do not require CPR or even Red Cross First Aid certifications prior to being employed by our schools.  Additionally, budget cuts have resulted in the elimination of school nurses.  It is well established that most of the injuries in the U.S. school system are due to accidents or trauma, necessitating the same level of attention to training staff on medical assessment and intervention.  Educational institutions have trained teachers and staff in basic first-aid, CPR, and Automated External Defibrillators (AED’s) for years.  Although CPR and AED training is important, the exercise of these skills is rarely necessary on a primary or secondary education campus due to the young age of students.  Furthermore, the first-aid provided is of little use in the setting of a traumatic event.  While many schools have become proactive with the placement of AED’s on their campuses, how many have taken that same proactive approach in the placement of appropriate life-saving medical equipment?   

     This concept is not new.  The military has been teaching these basic medical skills to personnel as young as 18 years old, and the results have been incredible.  Recognizing that any service member may potentially become a victim, military leadership recognized the need to educate their members to care for each other until medical care becomes available. Following the implementation of this training, reducing initiation time of life- saving interventions to the injured, the military saw a dramatic increase in survival rates of injured military personnel.(6) The First Care Provider model addresses a critical shortcoming in our public safety framework.  Utilizing the TECC guidelines, it empowers non-medical personnel to recognize and address the critical injuries commonly seen in disaster situations, mass casualty incidents, and AVI's.  These low-risk high-benefit interventions are simple, safe and proven to save lives before the arrival of First Responders. Join us in making the world a safer place.  Accept the responsibility to help others in need by becoming a First Care Provider.  Share our website, follow us, and help us spread the word. By becoming better prepared for the unthinkable, lives can be saved.

  1. National Fire Protection Association Standard 1710

  2. Erickson, W. The Report of Governor Bill Owens:  Columbine Review Commission. May 2001

  3. ”Two teens lose limbs in separate shark attacks at North Carolina beach.”  CNN. June 15, 2015.  Retrieved from

  4. Blair, P.J., Martaindale, M.H., & Nichols, T. Active shooter event from 2000
    to 2012. The Federal Bureau of Investigation Report, Law Enforcement Bulletin
    January 2014. Retrieved from

  5. Callaway, D., et al. Integrated response to the Dynamic Threat of School Violence.  Prehospital and Disaster Medicine. Vol 25 Ed 5. pp 459-464.  2010.

  6. Gerhardt RT, et al. Out-of-hospital combat casualty care in the current war in Iraq.  Ann Emerg Med 2009; 53 (2): 169-174.