available is overwhelming. Specific examples include
the following:
Ȗ Near unanimous support for deployment of kits into
public spaces (93 percent)
Ȗ Strong support for training police to provide bleeding
control as a part of their duties (91 percent)
Ȗ Substantial support for faster access to active shooter
and intentional mass casualty events (65 percent)
Current state of readiness
and national resilience
The Hartford Consensus intends to create a vision for
best-practice hemorrhage control for increasing survival after all-hazards injuries including active shooter
and intentional mass casualty events. The goal is to
inform and inspire decision makers around the country
to effect this vision by establishing appropriate metrics,
applying these metrics, and using this information to
motivate decision makers.
Metrics for readiness
Metrics to assess readiness include course completion
records for TCCC-based medical training. Examples of
these training programs include the following:
• Tactical Emergency Casualty Care
•Bleeding Control for the Injured (B-Con)
Ȗ Available through the ACS and the National Association of Emergency Medical Technicians (NAEMT)
•Law Enforcement and First Response Tactical Casualty Care
Ȗ Available through the ACS and NAEMT
•Specialized Tactics for Operational Rescue and Medicine (STORM)
Ȗ Available through Georgia Regents University, Augusta
• Advanced Law Enforcement Rapid Response Training
(ALERRT)
Ȗ Available through Texas State University, San
Marcos
Metrics for resilience
Metrics to assess resilience include the following:
•Registry data for all wounded law enforcement officers
and all casualties from active shooter and intentional
mass casualty events
•Case series reports describing injuries, treatments,
and outcomes for all casualties, including reports on
wounded law enforcement officers and all victims
wounded in mass casualty events
• Preventable death analyses for law enforcement officers
killed in the line of duty and victims of active shooter
and intentional mass casualty events
Many trauma deaths result from injuries that are
intrinsically non-survivable, whereas others occur
from injuries that were potentially survivable had
optimal care been rendered. Obtaining a clear under-
standing of the proximate cause of all law enforcement
officer deaths that result from trauma as well as all
fatalities in active shooter or intentional mass casualty
events will identify opportunities to improve care for
officers wounded in the line of duty.
Enhancing citizen resilience
All potential responders to victims of a trauma event
should be able to recognize the signs that indicate that
bleeding is life-threatening, including the following:
• Pulsatile or steady bleeding is coming from the wound.
•Blood is pooling on the ground.
The Hartford Consensus intends to create a vision
for best-practice hemorrhage control for increasing
survival after all-hazards injuries including active
shooter and intentional mass casualty events.
MAR 2016 BULLETIN American College of Surgeons
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HARTFORD CONSENSUS IV