ATT Concepts

Why bother getting trained and equipped?

Is training really necessary?

Isn't this why we have police, fire, and ambulance services?

This can't happen to me...

          These are common sentiments I’ve repeatedly heard over 25+ years of being involved in emergency services when I talk to people about the importance of taking your own safety, personal security, and well-being into your own hands. In a perfect world we wouldn’t have to worry about these things. In a perfect world we could rely solely on the timely response of trained professionals to deal with these unfortunate events.  In a perfect world I wouldn’t have to have this discussion with you and I’d already be living on a tropical island somewhere!

          But we unfortunately don’t live in a perfect world. Public safety professionals, law enforcement officers, firefighters, EMT’s and paramedics, emergency room doctors, nurses, and ER techs see the realities of the world first hand, day in and day out, and just how fast life can change in an instant, without warning. 

          It is not my intention to gain a financial benefit by instilling fear, but it is my desire to inform people of the realities that exist in this subject matter from my own firsthand experience.   

Responding to a man under and rescue from a train incident
ATT Concepts owner participating in the rescue of an individual who had been struck by a train
Head in the sand

          There is always a fine line between fear mongering and giving people the information they need to make informed decisions about their best course of action.  After spending a many years responding to emergency situations of all types, I can definitively say that the best outcomes were typically those incidents where actions and interventions were taken by a trained bystander prior to the arrival of professional help.  There is an innate reliance on professionals to handle the job that they are trained and paid (or volunteer in some places) to do, and in a society that is absolutely a fair and reasonable expectation.  But, time is not always on our side.  Whether we are talking about a victim in cardiac arrest or suffering from life-threatening bleeding or choking, or mass killing and active shooter events, and other critical incidents, time is never on our side, and so we have a choice to make.  We can put our head in the sand and pretend that these types of incidents will never happen to us, or we can accept the reality that these incidents do happen, and make the decision to empower ourselves through training to be self-reliant to react and respond to crisis situations and have an palpable influence on the potential for a successful  outcome of an event.


          The above statistics do paint a relatively discouraging picture for survivability without public intervention, but there are some flaws amongst these statistics, and not flaws that work in our favor unfortunately. In the study linked below from the Journal of the American Medical Association, it references average response times as when a unit arrives “on-scene”. Typically “on-scene” refers to when an emergency response unit notifies their dispatcher via radio or other means that they are on-scene.  A more accurate representation of this statistic would have to factor in the time it takes them to park, retrieve their equipment, access the location they are responding to, and finally make contact with the patient.  Working in New York City for 20 years, it wasn’t just our “horizontal response time” that was a factor, but also our “vertical response time”, which was never factored into the overall response time numbers.  How long it took us to retrieve our equipment, gain access into a building, await the arrival of an elevator, take it to the patient’s floor, exit the elevator and make our way to the patients apartment, office, etc., and finally make contact with the patient.  

          As a paramedic, it was a very motivating feeling to arrive on the scene of one of these types of critical incidents and to see that certain interventions were started prior to my arrival.  Early bystander CPR staved off brain and heart muscle tissue death by keeping the cells oxygenated, which improves the effectiveness of cardiac medications and could also improve long-term neurological outcomes if a return of spontaneous circulation is achieved. Early defibrillation benefits patients by converting life-threatening cardiac rhythms into life-sustaining rhythms, and there is a window of opportunity where these successful outcomes are most likely to take place.

          It doesn’t take long for an average-sized adult to exsanguinate (bleed to death); most texts and studies say less than 5 minutes.  But it takes even less time to enter stages of decompensated and irreversible shock from massive blood loss.  Patients who are already in advanced stages of shock from massive blood loss typically do not fare well long-term, even if they do make it to a hospital alive.  Late-stages of shock result in a cascade of organ failure and eventual death, even if bleeding was eventually successfully controlled, typically later rather than sooner.   


Statistics Sources

Journal of the American Medical Association

Emergency Medical Services Response Times in Rural, Suburban, and Urban Areas. Emergency medical service units average 7 minutes from the time of a 911 call to arrival on scene. That median time increases to more than 14 minutes in rural settings, with nearly 1 of 10 encounters waiting almost a half hour for the arrival of EMS personnel.

Journal of Prehospital Emergency Care

Time to First Compression Using Medical Priority Dispatch System Compression-First Dispatcher-Assisted Cardiopulmonary Resuscitation Protocols. Without bystander cardiopulmonary resuscitation (CPR), cardiac arrest survival decreases 7%–10% for every minute of delay until defibrillation.

           I hope you now have a little bit of a better understanding of the importance of learning some valuable skills and having access to the lifesaving equipment that is readily available, affordable, and easy to use.

           Lastly, one more thing about training; whether you are a first responder who is tasked with responding to critical incidents, a concealed carry permit holder who has decided to take their personal safety into their own hands, or a person who just wants to be better prepared to react and respond to a critical incident, it is your responsibility to ensure you can carry out your tasks professionally and competently, no one else’s.  Seek quality training from vetted and qualified instructors, don’t believe everything you read on the internet, and always continue to seek quality training to improve, refine, & master your skills & abilities as a perpetual student.  Read more about our training philosophy here