When you are at a concert or walking through a crowded shopping center, the threat of a shooting or an explosion might not be the first thing on your mind. But being more prepared to address these sudden catastrophes can be lifesaving.
Krisjanis Steins and colleagues explored current strategies for what to do when a mass casualty event takes place in a public space. In particular, they focused on places that would have more than fifty people present. They developed a computer simulation of a bomb exploding at a shopping mall that tested the effectiveness of the placement and number of first aid kits containing tourniquets, the preferred first-line treatment for life-threatening hemorrhage from an extremity.
Kits were placed in three different locations during three different scenarios: 1) with automated external defibrillators (AEDs), 2) spread evenly across 10 locations at the mall, and 3) located right next to building exits.
Results of the simulation suggest the location of the kits alongside AEDs would help save the most injured people losing blood. As shown in the graph above, this location strategy also demonstrates that having more kits leads to greater survival outcomes. Kits that were placed in locations where they could be easily seen and used took about 18 seconds to access. Harder-to-find kits took over two minutes and wasted precious time.
Dispersing kits evenly across the mall (i.e., spaced at ninety-second walking intervals) was also useful as a strategy. Kits that were located at exits were predicted to produce the fewest survivors.
When the unthinkable occurs, every second becomes crucial to saving lives. Having a safety preparedness plan that considers where tourniquets should be positioned in crowded indoor venues is literally a matter of life and death.
Databyte via Krisjanis Steins, Craig Goolsby, Anna-Maria Grönbäck, et al. Recommendations for Placement of Bleeding Control Kits in Public Spaces—A Simulation Study. Disaster Medicine and Public Health Preparedness, 2023.