SAN MARCOS, Texas - Lieutenant Colonel Bob Mabry is convinced a device that costs less than $40 and dates back well before the Revolutionary War has been instrumental in saving countless lives in Iraq and Afghanistan.
INTERACTIVE 'AFTER AURORA' SPECIAL SECTION
The director of the military's EMS and Disaster Medicine Fellowship Program at San Antonio Military Medical Center fully believes it's only a matter of time before the device gains a better foothold in police departments across the country.
"There is no doubt that the leading life-saving device over the last 10 years in conflict in Iraq and Afghanistan has been the simple tourniquet," he told 9NEWS recently. "The number one potential cause of preventable death is bleeding from the extremities."
In addition to his role in the military, Mabry is also a doctor and is well-versed in military statistics that suggest 7 to 9 percent of all deaths during the Vietnam and Korean wars were directly the result of wounds to an extremity.
"So, in Vietnam alone, that's about 2,500 casualties who died because they didn't get a tourniquet," Dr. Mabry said
Over the course of the last decade, the military has made it a priority to better train all of its members on basic, life-threatening wound cases, and it's made a big difference.
It's the main reason why every law-enforcement officer who graduates from the Texas State University-San Marcos Advanced Law Enforcement Rapid Response Training Program (ALERRT) Active Shooter Program Level II Course does so with a tourniquet in hand.
"If we can focus the training on those things that can make a difference right there on the scene and save a life, then that's where you're going to get the most bang for the buck," Dr. Mabry said.
ALERRT is a program that has its roots based within lessons learned during the Columbine High School murders in 1999.
"As we looked at [Columbine,] we said 'We need to change the way we do things. We can't wait with patrol officers out in the parking lot while innocent people are being murdered inside a building waiting for specialized units,'" David Burns, a sergeant with the Hays County Texas Sheriff's Office and one of the founding members of ALERRT, said.
And while the lessons of Columbine have taught officers to no longer wait for SWAT before going into an active-shooter scenario, they have also now placed police officers into emotional situations where people are literally dying right in front of their eyes. That is precisely what happened to members of the Aurora Police Department when they entered theater nine inside the Century 16 theater shortly before 1 a.m. on July 20, 2012.
"We now know of mass victimization in a way that is different than reading news articles or training," Aurora Police Chief Dan Oates said during a rare interview on the subject. "We've lived it, and we want to apply those lessons. We want to be better and faster at providing aid, at least until we can get the pros in there."
"The nature of our business is that there is more [police] on the street than EMS or fire, and we're more likely to be there first," Chief Oates added.
It's why by the end of the year, he wants 450 of his officers to have gone through a Denver Health Medical Center course designed to teach police officers simple medical techniques to save lives in active-shooter scenarios. The Tactical Casualty Care Course is based upon guidance once formulated with the help of, among others, Dr. Mabry in Texas.
Aurora Police Sergeant Jack Cooley did not respond to the theater shooting but is well aware of the toll the response has taken on his fellow officers.
"We as a society are going to have to learn a new way to do our business," he said while going through the course at Denver Health. "Normally, we're the first ones on scene."
Before the course, he said, it had been years since he had gone through any medical training.
Jesse Jerome is a Denver paramedic and an instructor of the Denver Health course.
"You can bleed to death from an artery rupture in less than three minutes," he said.
The course, designed after the military's Tactical Casualty Care Course, teaches officers such things as how to apply a tourniquet on an arm or leg and how to stuff gauze in a bullet wound.
"If you can place that tourniquet effectively and stop the bleeding, then you can move to that next level of care," he added.
Dr. Peter Pons, a nationally-recognized expert in mass-casualty care, is an advisor on the Denver Health course.
"The single most important message is stop the bleeding. They can do that," he said. "The number one cause of preventable death in trauma is hemorrhage."
He also believes the country needs to change the way it thinks about ambulances responding en masse to mass-casualty situations.
"In the overwhelming majority of them, somewhere between 70 to 80 percent of [patients] get to the hospital by means other than ambulance," he said.
"Fifty ambulances will not just instantaneously appear," he added.
The Denver Health course is essentially the same course that soldiers have been going through for years in anticipation of a deployment into a war zone.
"We've taken all of [the military's] principles and asked what makes sense in a civilian world, what makes sense for a police officer. Let's move this care to the first person who is going to come into contact with many of these patients," Dr. Pons said.
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And when Aurora Police Officer Jason Petrucelli completed his course at Denver Health, he received something all of his fellow officers will receive once they complete the course.
He received a $35 tourniquet.
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