Recent terrorist attacks in the United States, Canada and Western Europe have shown an increase in the incidence of "Active Shooters" [1]. These ruthless and desperate assassins usually attack urban and poorly protected areas (lack of armed protection) that are densely populated [2]. Utilizing their strength, they realize that their plan is to maximize the number of casualties, without counting on the consequences of their actions. The basis of their action may be based on extremely radical views. Frequent outcomes for active shooters include suicide during an attack (90%) or the resolution of the threat by the authorities [3]. In response to the ever-increasing number of assassinations and the risk of such incidents in one's immediate surroundings, comprehensive education should be widely spread. Thus, it is important to promote appropriate behaviour, rules of reaction during an attack by an armed assailant, as well as cooperation with incoming service personnel. Such actions will not only help one prevent, but also allow one to prepare for such incidences.
Accidents remain to be the most common cause of death amongst men of ages 10-39 and women of ages 5-24. The sudden occurrence of simultaneous multiple events or a mass casualty event with many patients suffering severe injuries, including severe haemorrhage, requires emergency medical personnel to modify the algorithms, which dictate their actions. The military war mission in Iraq and Afghanistan brought many experiences, which were used and applied to guidelines, which are now used for the management of patients experiencing trauma in the civilian sector. The current trauma ITLS (International Trauma Life Support) guidelines suggest to use compression bands or haemostatic dressings in order to control bleeding in case of massive haemorrhage. An example of this recommendation being used can be seen in the regional paramedic station in Poznan, Poland, where each ambulance is outfitted with "rescue packages" to be used in the event of massive haemorrhage. This practice can also be seen in Great Britain as well as Germany, where local protocols recommend the use of medical equipment taken from tactical medicine. The use of such tools allows for achieving a greater chance of rapid and effective haemostatic control in the event of massive haemorrhaging. These tools allow for more efficient use of time at the scene of the event, reducing the time a patient spends at the scene, allowing more rapid transport to hospital and more specialised surgical support. Reducing the time spent at the scene of an event while carrying out important procedures such as stabilising the patient's airway, stopping haemorrhage and immobilising the patient, markedly improves the survival of trauma patients.
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