Mass shootingsPittsburgh trauma surgeon: “Stop the Bleed” training saved lives after shooting, but stopping the need must be next

By Matthew D. Neal

Published 5 November 2018

I am a trauma surgeon who cared for many of the critically wounded victims of the Tree of Life synagogue shooting. As we raced to find the source of blood loss in one of the most severely injured patients, one of my trauma surgeon partners, a U.S. Army veteran of multiple tours, joined me in the operating room to assist. His first comment upon seeing the injuries that we were managing struck me. He said he last saw such destruction from military weaponry when he was serving in Afghanistan.

I am a trauma surgeon who cared for many of the critically wounded victims of the Tree of Life synagogue shooting. As we raced to find the source of blood loss in one of the most severely injured patients, one of my trauma surgeon partners, a U.S. Army veteran of multiple tours, joined me in the operating room to assist.

His first comment upon seeing the injuries that we were managing struck me. He said he last saw such destruction from military weaponry when he was serving in Afghanistan.

Two doors down, a second badly injured patient arrived to the operating room with extensive injuries to multiple extremities from a burst of gunfire.

Although the patient’s blood pressure was perilously low, the bleeding had been stopped prior to surgery by tourniquets applied to the limbs. Additional victims arrived, again with potentially life- and limb-threatening injuries rendered by an assault rifle, but all had received lifesaving care even prior to arrival at the hospital.

Some of this is due to an approach called tactical emergency care, where specially trained teams of physicians and emergency medical service practitioners respond and provide care along with law enforcement. A brave team of providers entered Tree of Life under active fire, along with the SWAT team. The early identification of injured victims allowed for rapid transport from the scene to our trauma center, providing the opportunity to save lives that would have otherwise been lost.

While all of the patients who arrived at our trauma centers in Pittsburgh are alive today, the sense of accomplishment and pride associated with this is blunted and seemingly selfish in the face of the carnage that occurred. No one will say “it could have been worse,” because the magnitude of this massacre that impacted the world and my hometown of Pittsburgh is incomprehensible.

Nonetheless, many of the surviving victims who will live to amplify and strengthen the message of unity that emerged in the days that followed are alive because of the evolution of a system of pre-hospital care that has necessarily changed the way the lay public, law enforcement and emergency medical care respond to intentional mass injury events.