Beyond the Bleed: How to Spot and Treat Injuries When There’s No Bleeding

Stopping the bleed is essential to saving lives during an active shooter event or any other type of emergency. But bleeding isn’t the only sign of a serious injury, and it certainly is not the only type of injury you could encounter after an act of violence.

In order to treat injuries, you must also know how to identify them. In this article, we’ll address three types of traumatic injuries that don’t require bleeding control, but that do require the attention of a first responder like yourself.

 

Internal Bleeding

Internal bleeding happens as a result of trauma. It can be caused by penetration, but it can also be caused by a severe blow, which means a person can experience internal bleeding even if they are not bleeding externally.

While internal bleeding is not as immediately life-threatening as a severe hemorrhage, it is still dangerous and should be treated by medical professionals as quickly as possible. However, sometimes internal bleeding is not apparent until later. If you or someone you know is experiencing any of the below symptoms after a traumatic event, get them to a hospital as soon as possible.

Signs of internal bleeding:
  • Pain or swelling of the abdomen can be caused by bleeding in the liver or spleen.
  • Ecchymosis is a condition in which the skin turns dark purple and results when the bleeding that’s happening internally begins to bleed into the skin.
  • Swelling, tightness, and pain will occur if a broken bone causes internal bleeding.
  • Headache, seizures, and loss of consciousness are all signs that there could be bleeding on the brain.

Burns

Explosives have become an all-too-common tactic used to attack large crowds of people. We’ve seen this happen on the news more than once, and one of the most recent instances was the bombing at the Boston Marathon on April 15, 2013.

If you are ever in a situation where someone has major burns from an explosive or perhaps even after a car accident, here’s what you need to do:
  • Remove the person from the fire or accident site if there is immediate danger.
  • Call 911.
  • If clothing is sticking to the burn, leave it. Tearing it away will make the injury worse.
  • Check for breathing and provide rescue breathing or CPR if necessary.
  • Cover the burn. Use the most sterile bandage, cloth, or sheet you have on hand.
  • Position the burned person so that the most severe injury is above their heart.
  • Keep the burn from friction and pressure.
  • If possible, use a dry, sterile, non-stick bandage to separate burned fingers or toes.
Things NOT to do when treating a burn victim:
  • Do NOT apply ointments or water to the burn.
  • Do NOT break burn blisters or disturb dead skin.
  • Do NOT touch a victim who has experienced an electrical burn. Use a non-metallic object to move them away from danger.
  • Do NOT blow on the burn, and avoid breathing on it.
  • Do NOT remove clothing that is covering the burn.
  • Do NOT give the person anything to eat or drink.
  • If you suspect an airway burn, do NOT place a pillow under the person’s head as this could block the airways.

Shock

Any type of traumatic injury can lead to shock. While shock is not considered to be life-threatening in itself, someone who goes into shock could put themselves and/or others at risk, especially during a violent encounter.

Here are the best ways to prevent and treat shock:
  • Lay the person on the floor or ground.
  • Raise the feet about 12 inches off the ground.
  • Keep the person warm by covering them with a coat or blanket.
  • If they are vomiting, turn the shock victim on their side.
  • Remove or loosen tight clothing, especially around their neck.
  • Talk to them reassuringly if possible.
  • Do NOT give them anything to eat or drink.

Unfortunately, in situations such as a workplace or school shooting, the above preventative techniques may not be realistic. Use your best judgement and respond as necessary.

The right response starts with the right training.

While blogs and articles are helpful in informing a proper response during an emergency, there’s nothing that can compare to hands-on, scenario-based training. Contact us today to schedule an on-site class, or to simply ask those questions you’ve been mulling over about Active Shooter Response.

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Jim Tapscott

Instructor

Jim served as a Sheriff’s Deputy in Illinois for 30 years. During his time as a Deputy, Jim served on the SWAT team as an operator, team leader and Commander. Jim was involved in several barricaded gunman/hostage incidents as well as service of high risk arrest and search warrants.

Jim was a member of the US Marshals Great Lakes Regional Fugitive Task Force where he performed surveillance and fugitive apprehension. His team was responsible for thousands of high risk felony fugitive arrests. Jim also served in the patrol division where he earned the rank of Sergeant and was responsible for patrol operations. Jim received numerous awards throughout his career to include Deputy of the Year, medal of valor and unit citation for SWAT operations.

Jim was a state certified CQB (Close Quarter Battle) SWAT instructor as well as an Active Shooter Response instructor, providing training for multiple law enforcement agencies throughout the state of Illinois.

Jimmy Pregel

Medical Instructor

I’m a proven leader with a diverse background in defense, law enforcement, and emergency response. My career began as a Scout Sniper in the U.S. Marine Corps, where I earned the Navy and Marine Corps Commendation Medal. I then served as a security contractor in Afghanistan and Iraq, further developing my tactical and crisis management skills.

Domestically, I served as a Deputy for the Greenville County Sheriff’s Office, earning a Medal of Valor, and as a firefighter, where I was awarded a Life Saving Ribbon. These roles reflect my commitment to safety and service, demonstrating leadership under pressure and a passion for protecting others.

As part of the Proactive Response Group Team, I design and deliver comprehensive medical training, developing lesson plans and conducting hands-on sessions. I ensure that participants are equipped with essential medical skills, fostering a culture of continuous improvement and readiness. My role is vital in preparing our team to handle medical emergencies confidently and competently.

Chris Taylor

Instructor

Chris is a retired Major from the Greenville County Sheriff’s Office in South Carolina. Chris was third in command over operations, overseeing more than 300 sworn Deputies as well as all special teams within the Sheriff’s Office. In 2012, Chris helped to organize a Dignitary Protection Team within the Sheriff’s Office that assisted the Secret Service with Presidential and Vice Presidential visits throughout the state. In addition to his normal duties, Chris performs private security for dignitaries, celebrities, as well as 12 years with the Miss America Organization. Chris has been instructing Active shooter Response with ProActive Response Group since 2021.

In his down time, Chris enjoys time with his wife and daughter, as well as watching sports and fishing.

Tyrie Fowler

Instructor

Tyrie Fowler is an Active Shooter Response instructor at Proactive Response Group and an Emergency Medicine Trauma Nurse at Prisma Health in Greenville. A Greenville native, Tyrie earned his Exercise Science degree from the University of South Carolina and his nursing degree from Mary Black School of Nursing. He joined Greenville Health System in 2015, transitioning from Orthopedic Trauma to Emergency Medicine. At Prisma Health, a Level One Trauma Center, he is part of the Trauma Nurse Leader team, with training in Advanced Trauma Care (ATCN) and Tactical Emergency Casualty Care (TECC). Tyrie is pursuing certifications in Emergency Nursing (CEN) and Trauma Certified Registered Nurse (TCRN).

Tyrie enjoys Fall for its long runs, college football (Go Gamecocks!), and hunting, including deer and quail. He also loves smoking recipes with a creative twist. As a medical instructor, Tyrie empowers bystanders to provide critical assistance in emergencies, teaching them to control bleeding and manage injuries, ensuring they leave his class confident in making a difference.

Steven Anderson

Instructor

Steven J. Anderson is currently an Active Shooter Response Instructor for ProActive Response Group; he enjoys empowering people to survive in life threatening situations. Steve grew up in central Minnesota and spent three years with the United States Army. He graduated from St. Cloud State University with a degree in Criminal Justice. Steve worked as a federal agent for the United States Border Patrol where he was a member of the U.S. Border Patrol Tactical Unit (BORTAC): completing multiple assignments in Central & South America, an assignment with the United Nations and the Deputy Director (A) of the National Air Security Operation Center. In 2020 he retired from working in Federal Law Enforcement.

In his spare time he enjoys the outdoors especially bow hunting. Steve is a proud husband and father to 3 wonderful daughters.

Rob Christian

Instructor, Sales

Rob is originally from Louisville, CO. He joined the U.S. Marine Corps in 2003 and served as a Combat Engineer Officer until 2012. Rob deployed in support of Operation Enduring Freedom in 2009 and 2010 where he planned and implemented force protection strategy, counter improvised explosive device operations, and mobility operations for Third Battalion Sixth Marine Regiment and Third Battalion Seventh Marine Regiment . Upon his departure from the military, Rob began to teach firearms and tactics with Arizona based Alpine Arms while simultaneously running his own small residential security consulting firm. Rob relocated the South Carolina in 2021 and joined ProActive Response Group in early 2023.

When not working Rob spends time with his wife Lindsey and son Theo. He enjoys stand up paddle boarding, visiting the rifle range, four wheeling, and camping.

Beyond the Bleed: How to Spot and Treat Injuries When There’s No Bleeding

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Founder

Chad Ayers

Chad Ayers served as Sheriff’s Deputy for Greenville County in South Carolina for 12 years. He has worked undercover in multiple state and federal investigations and in high-pressure environments, including active shooter events and hostage negotiations. Chad was a member of the SWAT team, where he served as assistant team leader and also assisted in the creation and implementation of the Greenville County Sheriff’s Office active shooter response program. Chad starred in season one of A&E TV’s Emmy-winning documentary LIVEPD and is a frequent guest commentator for FOX News, Law & Crime Network, and On Patrol Live.

Founder

Andy Sexton

Andy Sexton spent 12 years with the Greenville County Sheriff’s office in South Carolina, where he held the rank of Uniform Patrol Sergeant. His experience includes serving as an assistant SWAT team leader, involvement in high-risk incidents, including hostage rescues and the protection of dignitaries, working in criminal investigations (including armed robbery and homicide), and serving on the training committee for the Greenville County Sheriff’s Office.

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