HOW TO IMPROVE SURVIVAL RATES IN ACTIVE SHOOTER SITUATIONS?

Timely hemorrhage control is critical for preventing fatalities during active shooter incidents, particularly when interventions occur before hemorrhagic shock. Agent-Based Modeling (ABM) has been widely used to inform safety policies in such scenarios and is a well-researched domain. However, a major limitation in existing studies is the assumption that all injuries are fatal, oversimplifying the complex dynamics of injury outcomes. Real-world data paints a more nuanced picture: for example, a study of 1,226 gunshot wound patients in St. Louis emergency departments reported a 93% survival rate when victims received timely care (de Anda et al., 2018). In specific incidents, such as the 2019 Gilroy Garlic Festival shooting, rapid on-site response resulted in only 3 fatalities, while in the 2016 Orlando Pulse Nightclub shooting, studies suggest that 16 lives could have been saved with timely medical intervention (C. P. Smith et al., 2020a; E. R. Smith et al., 2018).

This study employed ABM to explore strategies for minimizing casualties by analyzing factors such as the spatial distribution and quantity of Hemorrhage Control Kits (HCKs), the number of trained responders, and the impact of their placement—in corridors, classrooms, or go-bags—on accessibility during lockdowns. It seeks to address the following research questions: How can survival rates in active shooter situations be improved? What impact do hemorrhage control training and the use of HCKs have on outcomes? How does the availability and distribution of medical supplies influence outcomes?

By incorporating models of injury progression and the stabilizing effects of timely treatment, the research revealed that increasing the number of trained responders significantly improves survival rates, with optimal results achieved when all teachers are trained in hemorrhage control. The most effective strategy combined HCKs in go-bags or on responders’ persons with well-distributed corridor stations, ensuring compatibility with lockdowns and faster response times. External responders, including tactical medics and EMTs, also benefited from these strategies due to the accessibility of medical supplies. Conversely, placing kits in individual rooms was less effective, as accessibility challenges often delayed critical interventions. This study underscores the importance of strategic planning in hemorrhage control and provides actionable insights and simulation tools to guide tailored emergency preparedness and response planning.