Last thing that you remember is that you were standing with few of your friends in street, now you are laying on ground and looking around you and there is blood running next to your leg, there is something in your throat and it suffocates you, you are trying to remove it with your fingers but nothing comes out, you are trying to swallow it but it is of no help, you are trying to scream but nothing comes out of your mouth. And thing that scare you most is that you notice blood on your pants in groin region, and you think that all future fun is gone.
Your friend gets you on your feet and his mouth are moving but you can not hear sh!t. With his hands he is explaining you that shell exploded some 50 meters from you and your friends.
You are (hopefully only temporary) deaf from blast, you can not talk because blood in your throat because you bite your tongue when that thing exploded. “Luckily” blood running next to your leg is not yours, it is your friends , he is seriously wounded.
And that wet stuff running down your legs and on your pants is not your blood, you just lost your bladder control when detonation happened. It happened unconsciously not because of fear, you did not have enough time even to feel fear.
And then (thanks God) you pass out. Everything starts to hurt later.
This all happened long time ago, but I still remember everything like it is happened yesterday, or like it is happening everyday. I feel very sorry for those innocent killed people in Boston.
I feel sorry for wounded too. Even when they recover they will be wounded for the rest of their lives.
Few times people told me that my experiences are war experiences and they are not applicable to some future SHTF scenarios. Horrible event in Boston clearly shows that you do not need to be at war to have civil victims because of explosions.
I witnessed numerous explosions, blasts, detonations etc. And also I helped many bomb explosions victims, during war and later in emergency services. Unfortunately here carrying small bomb with you is not so unusual (even today). Its considered here weapon just like knife or gun and we have bombings in our area still every month.
So I have been with people immediately after the explosions and later too during the course of healing.
Also I helped lot of people to cope with psychological injuries that they sustained from similar events. And I suffered from that too.
Being at the scene of incident that involves many injured people will „hit“ you like a train, and even if you do not succumb to the widespread panic and start to help injured people it will require some kind of training and knowledge.
Never forget one thing: in any kind of incident your absolute priority is your safety. If you get hurt or killed you are not gonna help anybody. Always assess safety of scene.
Of course you are gonna help injured people in any way that you can, but in order to give as best help as you can you need to understand what actually happens with people with blast injuries.
Explosion and injuries from explosion can be divided into the three parts.
In first phase injuries are caused by the pressure wave of the blast. Injuries like pulmonary bleeding, pneumothorax, perforation of the gastrointestinal organs. The pressure just blasts your soft part inside.
Important thing too is that wave can cause severe damage or death without external signs of injury. Common injuries in first phase are also burns on the body area that are exposed to the side where explosion happened.
In this phase injuries occur from the flying pieces of glass, wood, stones metal etc. So you are gonna see lacerations, burns, fractures.
In this phase body of the victim is becoming missile and is thrown against object. So you can expect injuries at the point of impact. Usually trauma injuries and some bleeding, depends on where body lands on.
Now this three phases maybe look to you not important in terms of helping the victim, so you could say that injury is injury whatever phase it is.
It is not so simple, especially when specialised help is not so close, you need always to suspect the most serious injury until it is ruled out.
For example after some explosion you find man who looked perfectly OK, but actually he suffers some serious internal injuries from whom he can die in half hour without proper treatment. You can not help people with internal bleeding much but you can make them priority to get professional help. Transport them before transporting others and so on.
Some of the signs of internal bleeding can be:
Pain and swelling (pain and swelling in the leg can be caused by fracture of thigh bone for example)
Victim looses consciousness (internal bleeding in the brain)
Abdominal pain can be sign of damaged internal organs and bleeding
Disorientation of victim, dizziness and fainting
Most of these signs do not necessary need to be signs of internal bleeding, but point is for you as a man who want to help it is very important to always suspect worst case injury, let the professional medical services rule bad conditions out.
Don’t forget laws if they still exist
We are talking here mostly about time when there is no law, but still we need to mention (just in case) that you need to be familiar with laws in your area.
So in some countries you could end up in jail if you try to help victim and actually you do some harm (by mistake, or lack of knowledge…) in some other regions law is actually protecting you.
Level of knowledge
It is all up to you what kind of knowledge and skills you are gonna learn and use when SHTF. There is a system of course today so you can choose to go for first aid classes knowledge or EMT or you are gonna choose to learn what you think it is important to know.
Nobody says it is forbidden to you to go online and research how to stitch (sew) wounds or splint broken leg.
What to expect and how to act
Now we are coming to most important part of all this. You need to prepare yourself mentally to deal with injured , possibly dying people.
Some says that there are people who are born to stay cool in stressful environment, other say that training is key. I can say that after more that 20 years in medical field, including SHTF period that on some things you can not get used to and dying people is one of them.
What you can do with proper knowledge and training is to reduce the moments between shock and reaction, and to act how you are prepared (train).
Emotions and stress
Nature of emergencies are that they are stressful. Be ready to be overwhelmed by emotions and be ready to cope with stress.
Stress alone is huge topic, and you are gonna deal with some events even after 20 years, but important thing is to DEAL with it. Do not be alone with your problem.
Jay has background in psychology and has helped people with traumatic events here is his part on what everyone can do to help people after disaster, even without any training. I see these things also work every day in emergency situations at my job.
—–Jay about helping survivors in the acute aftermath of traumatic events—–
1. If you are safe, make sure other people and victims of the event feel safe as well. Tell them what happened and that they are safe now (and help is on the way if that’s the case). If necessary affirm the victim multiple times that they are safe now and the event is over. They just experienced something that was very hard to even imagine for them before and they need to come to terms with that. They will show all sorts of emotions, from anger to fear to depression and disbelief.
2. Make sure they are in a comfortable position. Do not make them move if they don’t want to, they might have injuries that you do not want to make worse. Let professionals take care of this unless you know what you are doing.
3. Talk to them in a calm voice and ask them neutral questions about what happened. What happened before the event and what lead to the event? Let them run through everything step by step. Ask specific questions and try not to get emotional in any way. This will calm them down and help them to understand what happened.
4. If you set off to find out more about friends or relatives of the victim who might have been also injured or killed, explain what you are going to do and that you will be back shortly. Give people the feeling you are there for them as good as possible.
5. Be honest about the information you share. If someone got killed say it in a compassionate way. Lying about this and then the victim finds out about it because the corpse of her relative gets carried away just means a deeper fall and loss of trust in you which can make the situation even worse (what else might be the wrong information? Am I really safe?….)
7. People after traumatic events sometimes act as if nothing happened. They might want to find transportation to get to where they planned on going to or call work to let them know they are late. This is normal because many people simply do not accept that what happened is part of their reality. Its a protection mechanism. If it doesn’t hurt the victim try to be supportive and borrow them your mobile phone or help them in any other way.
In general people can handle natural disasters best, while man-made disasters or violence is the worst because the fundamental trust in people is destroyed.
Here is some personal advice from me.
I experienced many explosions, I mean very close explosions, not sure how many but it was way of living for year.. From hand grenades, tear gas grenades, mortars, tanks, howitzer, improvised bombs…
But all comes down to same. Jump down and pray to God, later you stand up, clear debris from hair and clothes, throw up maybe from smell and blast that shocked your organs and go on. If you survived, and without injuries. Only thing that changed over the time that we all (more or less) became numb to all of that, so we just care for everything less and less.
I describe how I transition from normal young man to this numb creature that just wants to survive in interviews in my survival course. I bleed from ears several times after the explosions. I hear poorly on my right ear for the rest of my life.
Events like mass killings, bombings and similar will change you completely, and you are not gonna be same anymore. Event alone is traumatic with injured people, screams, blood and all that, and there is few basic rules in helping the victims and helping yourself to cope with everything.
Sometimes listening to victim is gonna be only thing that you gonna be able to do. You can not „treat“ victim with listening only, but trust me to man who is in pain, great fear and uncertainty is he going to survive to have someone beside him makes a great difference. Maybe you are gonna find yourself in situation that man is dying, man who is total stranger to you, but he is gonna have only you for comfort.
Because fear and shock, you can expect all kind of reactions from injured people, and very often that reaction gonna be angry one. Just be tolerant, that anger is not actually directed towards you.
After being involved with dealing to the victims of some catastrophic event you can also experience excess stress. It can be triggered by simple traumatic event or many of them. For someone it can be caused by watching a car accident for example.
Some of the symptoms of stress are: problems with concetration, irritability, anxiety, loss of sexual interest, nightmares etc.
Dealing with stress (this has worked for me):
Change your food habits. Avoid fatty foods, nicotine and alcohol
Relax. Try meditation or check what relaxing techniques are good for you
Spend more time with your family and friends, talk to them and just go and include them in your stress problem solving.
This is what Jay and me think about this. The bomber from Boston is not only one who benefits from people being afraid. People who are scared are easier to control. Just dont let the bomber be a prepper…
Please share in comments what you think about Boston bombing and maybe also personal tips how to deal with traumatic events.