A recent USA Today study reported that an ambulance’s average response time in 50 of America’s largest cities was just six minutes. Six minutes doesn’t seem like much time until it is your blood spilling out onto the pavement. In another study, 132,000 domestic gunshot wounds were evaluated, and while only 20 percent were fatal, the vast majority of those fatalities occurred before medical care was ever administered.

Exsanguination, or bleeding to death, is the most common preventable cause of death from combat-related injuries. Blood loss from any penetrating trauma, be it a gunshot, stab wound or similar injury, starts the instant you’re hit. You might not see blood pouring from the wound, but any damage to the body’s interior produces bleeding, which, if uncontrolled by either body function (clotting) or artificial means, can result in death. How long you live depends upon a number of factors including where you’re impacted and if a major organ, artery or vein is damaged. How many times you were hit and what is done to stop or at least slow the loss of blood from those injuries is also a crucial component of that equation.

Before Taking Fire

What most people believe police officers have in terms of emergency medical skills is well in excess of the reality. Most officers leave the academy with EMS awareness and CPR certification, not medical trauma-care training. When I was in the police academy some 24 years ago, our medical training consisted of a course known as “First Responder.” This 40-hour course taught me many skills that, in the real world, were less than useful—it never addressed trauma care.

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A recent USA Today study reported that an ambulance’s average response time in 50…