FLSD Active Shooter Medical Emergencies 4 — Questions and Answers
Question 1: During an active shooter event, a victim has a gunshot wound to the thigh with severe arterial bleeding. After applying a tourniquet, the bleeding has not stopped. What is the next correct action?
- Remove the tourniquet and reapply it closer to the wound
- Apply a second tourniquet proximal to the first one (Correct answer)
- Apply direct pressure over the tourniquet
- Pack the wound with gauze and apply a pressure bandage
Correct answer: Apply a second tourniquet proximal to the first one
If a single tourniquet fails to control arterial bleeding, a second tourniquet should be applied proximal (closer to the body) to the first.
Question 2: In the TECC (Tactical Emergency Casualty Care) framework, which phase allows for the most comprehensive medical care to be delivered?
- Direct Threat Care (Hot Zone)
- Indirect Threat Care (Warm Zone)
- Evacuation Care (Cold Zone) (Correct answer)
- Threat Suppression Phase
Correct answer: Evacuation Care (Cold Zone)
Evacuation Care (Cold Zone) allows for the most comprehensive medical interventions because the immediate threat has been neutralized.
Question 3: A building occupant is found unresponsive with no visible bleeding after an active shooter incident. The Fire Life Safety Director suspects a tension pneumothorax. Which sign would support this assessment?
- Slow, deep respirations with pink skin color
- Tracheal deviation away from the injured side and absent breath sounds (Correct answer)
- Bilateral wheezing and coughing
- Bradycardia with elevated blood pressure
Correct answer: Tracheal deviation away from the injured side and absent breath sounds
Tension pneumothorax classically presents with tracheal deviation away from the affected side and absent breath sounds on that side.
Question 4: When triaging multiple casualties in an active shooter event using START triage, a victim is breathing at 10 breaths per minute, has a radial pulse, and can follow commands. Which triage category applies?
- Red (Immediate)
- Yellow (Delayed) (Correct answer)
- Green (Minor)
- Black (Expectant/Deceased)
Correct answer: Yellow (Delayed)
A victim who is breathing, has a pulse, and can follow commands but has a respiratory rate below 30 is categorized as Yellow (Delayed) in START triage.
Question 5: A Fire Life Safety Director is coordinating with EMS during an active shooter event. Which communication action is most critical when handing off a casualty with a tourniquet applied?
- Document the tourniquet color and brand for the medical record
- Report the exact time the tourniquet was applied (Correct answer)
- Describe the wound location only
- State the victim's full name and insurance information
Correct answer: Report the exact time the tourniquet was applied
Reporting tourniquet application time is critical because a tourniquet must be removed or evaluated within approximately two hours to reduce risk of limb loss.
Question 6: During an active shooter lockdown, a person in a secured room begins experiencing signs of hypovolemic shock from a wound. Which improvised intervention is most appropriate before EMS arrives?
- Elevate the victim's head to improve airway patency
- Keep the victim seated upright to aid breathing
- Lay the victim flat and elevate the legs if no spinal injury is suspected (Correct answer)
- Have the victim walk slowly to maintain circulation
Correct answer: Lay the victim flat and elevate the legs if no spinal injury is suspected
Positioning a shock victim flat with legs elevated (Trendelenburg-modified) helps increase venous return to the heart and maintain perfusion to vital organs.
Question 7: Which of the following wounds is MOST appropriate for wound packing with hemostatic gauze during an active shooter medical emergency?
- A shallow laceration on the forearm
- A penetrating wound to the junctional area such as the groin or axilla (Correct answer)
- A closed fracture of the lower leg
- A superficial abrasion on the scalp
Correct answer: A penetrating wound to the junctional area such as the groin or axilla
Hemostatic gauze wound packing is indicated for junctional wounds (groin, axilla, neck) where tourniquets cannot be applied.
FLSD Active Shooter Medical Emergencies 4
During an active shooter event, a victim has a gunshot wound to the thigh with severe arterial bleeding.
After applying a tourniquet, the bleeding has not stopped.
What is the next correct action?