Archives for March 2018

What is an active shooter?

We see it on the news about everyday. Somewhere an active shooter or shooters have taken more innocent lives. But what is an active shooter? It is defined as one or more subjects engaged in a random or systematic shooting spree, with the intent to continuously harm others. As opposed to criminal conduct, such as robbery or hostage, killing being their objective.

Usually the active shooter is spontaneous, they give little or no warning as to what they are about to do. However, recently we are seeing more and more shooters talk about what they plan to do on social media. Law enforcement are monitoring these sites and in some cases have stopped the shooter before he or she acts.

Personal safety requires personal responsibility and awareness

There are no specific profiles for the active shooter. Many times the suspect is depressed, angry and often suicidal. These are broken people who want to get even or punish others for how life has been so unfair to them. Or the shooter may be politically motivated. In either case they will pick target rich or highly populated, soft target (no gun zones) environments. Negotiation does NOT work. The average age for a school shooter is 14.5 years.

There is no specific profile for an active shooter. On February 29, 2000, a 6 year old boy near Flint, Michigan, found a 32 caliber handgun in his uncles bedroom. He took the gun to school and shot another student at point blank range. He is believed to be the youngest active shooter in history.

Types of Active Shooters

Rampage shooter is also known as a spree killer or sometimes “In a frenzy”. Rampage killers usually attempt to kill multiple persons in a public, target rich environment. This type of shooter usually acts alone and is mad at the world. They most likely will not have a previous history of violence and will kill anyone they come in contact with. The Rampage shooter will target large groups in a soft target area.

The workplace shooter is one that is upset with his or her workplace. This may involve co-workers or supervisors. The individual may have been fired or suspended and they are looking for revenge. They will return to the workplace and start shooting people at random or they may seek out specific individuals. In some cases they are very successful in carrying out their objective due to the fact that they know the layout of the workplace, as well as the company policy’s concerning safety.

A school shooter is an individual or individuals who attack an educational institution, such as a school or university. According to national studies, factors behind school shootings include family dysfunction, lack of family supervision, and mental illness. First reported school shooting in what is now the U.S. took place in the 1700s when four Lenape Indians entered a schoolhouse in what is now Greencastle, Pa., and killed the schoolmaster and as many as 10 children.

A terrorist is a person who uses terrorism in the pursuit of political aims. They usually will seek out soft targets that have large number of potential victims. They strive for large kill rates to achieve international attention.

Key Statistics

Average time for Active Shooter Incident 12 min
37% last less than 5 minutes
49% of attackers committed suicide
34% were arrested
17% were killed
51% of attacks occur in workplace
17% occur in schools
17% occur in public places

Blair-Martindale Study

2% of incidents involve IEDs
10% shooter stopped and walked away
20% shooter went mobile
43% of time crime was over when police arrived
49% of time attack ended before police arrived
56% of attacks ended by police killing attacker

Although there is no one demographic profile of an active shooter, many may reflect observable pre-attack behaviors, which if recognized, allow for disruption of an attack.

Many active shooters occurs when an individual has a real or perceived issue that has not been dealt with. In many cases the individual will dwell on this issue and eventually plans an attack. Bystanders typically have the greatest opportunity for recognizing and identifying a potential active shooter prior to the planned attack.

Counteract the Effects of Poisons

By Tim Holman Leave a Comment

Emergency care for poisonings

You walk in to your friends home and find a 28 year old female lying on the floor unresponsive. There is an empty pill bottle near by. The patient is breathing but respirations are very slow and shallow. Her color is gray and her lips are blue. You place her on her side in case she vomits. Next you call 911.

About 78% of poisons are unintentional and 18% are intentional. In 2016 there were over 2 million poisonings in the United States. Nearly 50% of all poisonings involve children under 6 years of age.

Emergency Care

Check for pulse and breathing if victim is unconscious.
Start CPR if breathing and pulse are absent.
Call 911.
Attempt to determine what the victim has ingested.
If possible have a sample for EMS.
In some cases, if the victim is conscious, you may need to have them drink water to dilute the poison.
You can call poison control at 1-800-222-1222 anywhere in the United States.

Poisons that contact the skin or eyes.

These poisons could be any toxic substance. Examples could be herbicides, insecticides, gasoline or other chemicals. The number one treatment for poisons contacting the skin or eyes is to dilute or flush with large quantities of water.

Emergency Care

If the victim’s eyes have come in contact with a harmful substance, immediately flush the eye (with clean water) from the nose outward. This prevents the harmful material from being flushed into the other eye. Flush for a least 20 minutes.
Call 911.
If an area of skin has come into contact with a harmful substance flush the clean water for at least 20 minutes.

Poisonous Gases or Fumes

About 430 deaths each year are caused by carbon monoxide (CO). Carbon monoxide is a colorless, odorless, and tasteless gas. it is found when combustion takes place such as a gas, fuel oil or propane furnace. CO can collect in a home or apartment if the furnace flue pipe does not allow it to escape to the outside appropriately.

The most common symptoms of CO poisoning are flu-like such as, headache, dizziness, weakness, upset stomach, vomiting, chest pain, and confusion. CO is absorbed through the lungs as you breath. A CO alarm can help detect high levels within your home and prevent illness or threat from exposure.

Emergency Care

If the victim has been overcome by fumes or poisonous gases, move him or her to fresh air. Open windows and doors if you are unable to move the victim.
If unconscious or unable to walk, you can attempt to move them on a blanket or rug.

These simple measures can go a long way in helping victims of poisoning. Your quick action can help save a life.

A man was going down from Jerusalem to Jericho, when he was attacked by robbers. They stripped him of his clothes, beat him and went away, leaving him half dead. 31 A priest happened to be going down the same road, and when he saw the man, he passed by on the other side. 32 So too, a Levite, when he came to the place and saw him, passed by on the other side. 33 But a Samaritan, as he traveled, came where the man was; and when he saw him, he took pity on him. 34 He went to him and bandaged his wounds, pouring on oil and wine. Then he put the man on his own donkey, brought him to an inn and took care of him. 35 The next day he took out two denarii[c] and gave them to the innkeeper. ‘Look after him,’ he said, ‘and when I return, I will reimburse you for any extra expense you may have.’ Luke 10:30-35

Heart Attack: How you can help.

By Tim Holman Leave a Comment

Your spouse and you are enjoying an evening out at your favorite restaurant. Your conversation is interrupted when you notice a man at a nearby table. He appears to be in pain and is having difficulty breathing.

Heart attack emergency care

You walk over to see if you can be of help and you notice that he is sweating profusely. He is grabbing at his chest and appears very apprehensive. He states he is having severe chest pain and left arm pain. In addition he says he is having a hard time getting his breath. You immediately call 911. What can you do while waiting for EMS to arrive?

Over 600,000 (1 in every 4 deaths) die each year from heart attacks. Most deaths occur before the victim arrives at the hospital. Studies have shown that heart attack deaths can be prevented if proper action is taken soon after the signs and symptoms begin.

Signs and Symptoms of a Heart Attack

Pain, pressure, squeezing or fullness in center of chest.
Pain may radiate to arms, shoulders, neck, jaw and face.
The pain may be continuous or may come and go.
The victim may be sweating and color may be pale or gray.
The victim may complain of nausea, vomiting, shortness of breath and weakness.

Emergency Care

Call 911 for EMS.
Stay calm and answer all questions the dispatcher may ask.
Reassure the victim keeping them calm and try to make them comfortable.
If the victim is lying down and begins to vomit, turn them on their side to protect their airway.
If the victim loses consciousness, keep airway open and check for breathing and pulse continuously until the EMS arrives.
Start CPR if necessary.

These interventions may seem small, but I assure you that they can make a big difference in the victims outcome.

To learn CPR call your local Red Cross, American Heart Association or you local EMS.

How do you carry your gun?

By Tim Holman Leave a Comment

How we carry our weapon is important for several reasons. First, we want to assure it is concealed. We live in a time when people will freak out if your gun is exposed. Depending on the state that you live in, it may even be a crime if your concealed gun is seen by others.

The second reason it is important, is the gun must be carried in a way that it is easily accessible in a time of need. Guns may not be comfortable to carry but they are meant to give you comfort and safety.

Depending on the season, some people will change their carry position based on the type of clothing they are wearing. If you are one that changes carry positions, remember you must practice drawing the gun every time you relocate its position.

Muscle memory is something we develop over time when we practice a particular skill. Drawing your gun is a skill that you practice on a regular basis. After a period of time it becomes automatic because your mind and muscles remember the process of pulling the gun out of its holster.

Some people will change from a strong side carry to a cross draw carry. This can prove to be a problem. If an individual routinely carries their gun on the right side, practice drawing from the right side. Then switch to a cross draw, muscle memory may cause them to draw where there is no gun in a critical situation.

One of the most popular positions to care a firearm is in the waistband (IWB). This method allows for a deep concealment of your weapon. There are a wide variety of holsters that can be used IWB to meet your specific needs.

Women may carry their gun in a purse or handbag. Many are designed in such a way that provides easy access. It is import to remember if you carry a gun in your purse, make sure it is in a holster, like a pocket holster. In addition carry the gun in a compartment free of any other items. Both of these suggestions prevent items coming in contact with the trigger and causing an accidental discharge of the firearm.

In the CCW classes I teach, I ask students if they plan to carry. Many times the response is “only if I think I will need it.” If I think I’m going to need my gun when I go to a particular location, I probably will not go. The point is we never know when we will need our gun. I pray I will never need my gun. But if I’m not on duty I am always carrying my gun.

This brings up a final item to ponder. When you are in your home where is your gun located? Many people will keep their gun in a bedside table. What if a couple of thugs crashes through your front door in a home invasion? Will you have time to run to the bedroom to retrieve your gun? Your gun should be close by even when you are relaxing at home.

Carrying a gun is a right of all law abiding Americans. But with that right comes responsibility. We must make sure we carry in a safe and responsible manner.

The OODA Loop

By Tim Holman Leave a Comment

Risk management and the OODA loop

United States Air Force Colonel John Boyd is known as one of the most respected military strategist in history. Colonel Boyd developed the OODA Loop concept and it has been taught to military troops for the past several decades.

The OODA Loop is an acronym that stands for OBSERVE, ORIENT, DECIDE and ACT. It can be used as an organizational decision making model but more importantly, it can help you react more effectively in threatening situations.

OBSERVE is actively gathering information concerning the environment that you are in. More than just observing, it is recognizing all aspect of the situation and the position you are currently playing in the environment. Is anything out of place? Are the people that are sharing the immediate environment acting normal? Do they appear nervous? In other words you are identifying the dynamics of the your current environment. Observation requires the use of all your senses.

In order to perfect this stage of the OODA Loop you must practice your observation skills. When you are shopping at the grocery store, observe what other people are buying. As you pass by a cart, take a quick glance and try to identify six items they have purchased.

When you are in an airport, waiting for your flight, what are the expressions on the face’s of the people around you? Are they nervous, happy or maybe sad? What are they carrying on to the plane? What do you think their occupation might be?

When in a restaurant watch your waiter or waitress. Is he or she right handed of left handed? Watch others as well. What did they order? Do they appear to be enjoying themselves or are they upset? Watching people can give you good insight as to the environment.
A police officer shared this story with me several years ago. An individual stopped at a convenient story to buy some snacks. He was a retired Marine and had been on several combat deployments. As he entered the store he looked at the store clerk standing behind the counter. He noticed the shear look of terror on the clerk’s face. The Marine paused for a second, turned and left the store. His observations, information gathering told him something was up. He wasn’t sure what it was but it made him uncomfortable. So he left the environment.

A few minutes later a police officer entered the store. He too, glanced at the clerk. This time the clerk smiled. The police officer said hi and proceeded to pick out the items that he came for. His guard was down and the robbery suspect that was hiding behind the counter with the clerk, shot and killed the police officer.

Two people entering the same store, experienced totally different outcomes. Why? The Marine had developed exceptional observational skills. When he was deployed his life depended on it. But isn’t the same true for the police officer?

Here’s why. The Marine saw terror on the face of the clerk. The clerk feared for the Marine’s life as well as his own and it showed on his face. However, when the police officer looked at the clerk he saw a smile. Seeing the police officer gave the clerk hope that he could intervene. He felt a sense of relief. The police officer read the clerk as saying, “all is well.” That seemingly small detail cost the police officer his life. Developing good observation skills can save your life.

The second “O” is ORIENT. In this phase of the OODA LOOP you will quickly process the information that you have gathered in the Observe phase. Data collection is useless unless you are able to determine your relationship to it. In other words, I have an abundance of information but how does it relate to me. Maybe the information is benign and you determine all is well. Or you may decide that you are in immediate danger. Orientation is by far the most important phase of the OODA LOOP because it will guide your decision to act or not to act.

As a medic I must gather all the information possible for an injured victim. Once the information is obtained I must orient myself to the situation at hand. Orientation is nothing more than analyzing the information I have obtained. But, this analysis will guide my decision and ultimately my action. If I miss read the information my actions will inadvertently be wrong and detrimental to the victim.

Example: It’s morning and you are driving to work. A trip you have taken every weekday for years. The radio is on and you are listening to the news. Suddenly you notice a car approaching is straying across the center line into your lane. You have observed and gathered the information about your environment. You now orient yourself to your position within this rapidly changing environment. There is an imminent threat to you and the approaching driver. Your orientation is completed and you must now decide and then act. All of this is completed in seconds.

Police officers are frequently placed in bad light due to the actions they have taken. Because they must make life and death decisions, sometimes within milliseconds. Many departments are now training their officers in the OODA Loop concept, with the hopes of developing better and quicker decision making skills.

The third phase of the OODA LOOP is DECIDE. Now you have Observed and you have Oriented. This information is now compiled and you must make a decision. Remember the quality of your decision is based on quality of your observation and orientation. When you decide you are basing everything on the information that you have gathered and analyzed. Good or bad. In life and death situations it is important to make a decision and carry it out. Hesitation can be deadly. If you’re not completely satisfied with your information, sometimes you need to go with your gut. As you perfect the first two phases you will become more comfortable with the decide phase.

The last phase is ACT. Now that you have process the information and made a mental decision, it is time to act. Colonel Boyd eludes to the impression that the OODA LOOP is also a learning process. Your action is based on what you have learned in the other phases.

Once you act, you may find that your decision was wrong and you may have to implement plan B. Plan B is based on the continual flow of information you are receiving. They mean you will need to adapt and improvise in your actions.

The OODA Loop is a very useful tool in tactical situations as well as life decisions. Practice will help you make quality decisions and to act quickly on those decisions.

Semper vigilans