In the days after the shootings at the Route 91 Harvest festival in Las Vegas, many stories emerged of bystander courage. Volunteers combed the grounds for survivors and carried out the injured. Strangers used belts as makeshift tourniquets to stanch bleeding, and then others sped the wounded to hospitals in the back seats of cars and the beds of pickup trucks.
These rescue efforts took place before the county’s emergency medical crews, waylaid by fleeing concertgoers, reached the grassy field, an estimated half-hour or more after the shooting began. When they did arrive, the local fire chief said in an interview, only the dead remained.
“Everybody was treating patients and trying to get there,” Chief Gregory Cassell of the Clark County Fire Department, said of his personnel. “They just couldn’t.”
The experiences in Las Vegas have implications for the nation. Emergency medical services have changed how they respond to mass attacks, charging into insecure areas and immediately helping the injured rather than standing back. Still, every minute counts, and bystanders can play a critical role in saving lives, as shown in the aftermath to the shooting on Oct. 1 outside the Mandalay Bay Resort and Casino.
“The city functioned as a trauma center,” said Dr. Sean Dort, a surgeon at Dignity Health-St. Rose Dominican Hospital’s Siena campus in nearby Henderson, Nev. “What really makes this unique is the volume.”
What the Las Vegas shooting showed, trauma experts said, is that nascent efforts to teach and encourage the public to help the wounded in mass casualty emergencies should be expanded.
“Time is the most critical factor,” said Dr. Eric Goralnick, medical director of emergency preparedness at Brigham and Women’s Hospital in Boston, one of several trauma centers that were much closer to the Boston Marathon bombings in 2013 than the closest hospitals happened to be in Las Vegas. “People would talk about the golden hour. Really, what we’re talking about is the golden minutes.”
Several national programs have been started to train more people to stop bleeding, to add to those who pick up knowledge in the military or in scouting programs and the like. But Dr. Goralnick and others are still exploring the most effective and lasting ways to turn people without medical backgrounds into capable responders. Researchers are finding that people may need prompting or training to use tourniquets effectively, even when instructional materials are present with them.