It’s one thing to put a tourniquet on a 195-pound adult – it’s quite another to put a tourniquet on a child.
Or is it?
Many people are terrified by the thought of treating a child or an infant suffering from severe bleeding or another life-threatening injury, but for anyone who ever finds themselves in that situation, a few moments of hesitation could reduce a child’s chances of survival.
We’ve seen time and again that no place is immune to premeditated acts of violence. From church nurseries to daycare centers, every facility and organization should have trained personnel onsite, Bleed Control Kits on hand, and a practiced emergency response plan in place.
Now, let’s look at emergency response when treating children and infants specifically.
Bleeding is easier to stop for children than it is for adults. The smaller the child, the less forceful the bleeding will be. It is important to note both a child’s size and the seriousness of their injury before providing treatment. While you may need a tourniquet to treat an older child with a severe hemorrhage, you may be able to stop the bleeding on a small baby with the same injury by using gauze to cut off blood flowing into the limb or by applying direct pressure to the injury site.
While bleeding is easier to stop in children, that does not mean that you have more time to stop it; in fact, you have less. Because a smaller child such as a toddler has less blood flowing their body than an adult does, children will bleed out more quickly than an adult with the same type of injury would. Therefore, a quick response is essential.
Shock is one of the body’s natural reactions to trauma. Sometimes treating a child’s injury will reduce shock, but many times, victims will experience shock even after their condition is stable.
To treat a baby suffering from shock, cradle them closely in your arms to keep them warm and comfortable. You may also want to cover them with a blanket. Infants need human contact to feel safe and secure.
For older children, you should respond much like you would with an adult. Lay them on their back (assuming this does not aggravate their injury) and elevate their feet, ideally with a cushion if one is available. (Note: If raising the feet will increase bleeding to an injury site in the upper body, do NOT do this.) You can also loosen tight clothing around the neck, chest or waist to help relax a child suffering from shock.
If you are unsure whether or not a child is suffering from shock, monitor their breathing and pulse, and try to get them to respond to you. If a child is or becomes unresponsive at any time, check for airway obstructions.
If possible, do not leave a child who is in shock unattended. However, the very nature of an active shooter event or other act of violence will likely require you to treat multiple injuries on multiple children, and stopping life-threatening bleeding should always be prioritized over treating shock.
You know this – calling 911 should be your first reaction to an emergency. However, traumatic events can cloud a person’s recall and inhibit their problem-solving skills – a major reason we recommend scenario-based, hands-on training.
When treating a child (or an adult) with severe bleeding, it is best to clear clothing away from the injury site so that you can see the injury that you are treating. However, if there is an object lodged in the injury site, such as a piece of glass or metal shavings, leave it alone. Your priority is to stop the bleed and save a life. A medical professional will deal with foreign objects later when the injured person is secure.
In an article by Dr. Lenworth M. Jacobs, Jr., a professor of trauma and emergency medicine, he wrote, “We are a nation of people who respond to others in need. It is no longer sufficient to ‘see something, say something.’ Immediate responders must now ‘see something, do something.’”
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.
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.
Email: jpregel16@gmail.com
Phone: 720-382-3184
LinkedIn: https://www.linkedin.com/in/james-pregel-67765451/
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.
Email: ctaylor@proactiverg.com
Phone: 864-979-0978
LinkedIn: https://www.linkedin.com/in/chris-taylor-331b00150/
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 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 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.
Phone: 720-382-3184
LinkedIn: https://www.linkedin.com/in/robert-christian-29579649/
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.
