The incidence of Pulse, the gay night club in Orlando where 49 people were gunned down and 53 injured, is and should be a wakeup call for many. But are we preparing to deal with, or prevent, another similar event? Trauma experts at the University of California, Massachusetts General Hospital, and Women’s Hospital in Boston believe we are not, insisting there is an immediate need for more trauma research, trauma funding and response in the US.

“Great lessons have already been learned, but more are still to be taught,” said M Margaret Knudson MD, specialist in trauma and emergency surgery and the lead author of the opinion paper citing the need for more work on health emergency response.

Mass casualties due to both manmade and natural causes are expected to rise in the next few years. If the US disaster response is not up to par then many more lives will be lost in the coming future. According to the non-profit organization Gun Violence Archive (GVA), gun-related violence and terrorism in the US has been steadily rising. In 2016 alone, there have been a total of 179 mass shootings and 7,199 gun violence related deaths.

Therefore, trauma physicians have decided that more research and funding is immediately needed to properly prepare physicians for the tasks at hand. Evidenced based research in trauma surgery will allow physicians to make immediate decisions on how to handle a crisis and reduce the death toll. Public responders, the first people, either civilians or professionals, to reach the incident site can prove to be the first line of care in the currently dangerous and unsettling world. The opinion piece focusing on trauma research was recently published in the journal Trauma Surgery & Acute Care Open.

The authors claim several ‘promising developments’ are already on the agenda. One of these developments was a meeting held in June between leading orthopedic, trauma surgeons and US military representatives to discussion minimization of mass casualty events.

The Orlando shooting also triggered the lifting of a ban placed on ‘gun violence research’ by the American Medical Association (AMA). The association has admitted ‘gun violence is a public health issue’ and therefore research in the field has become necessary. Already two initiatives are actively addressing the issue of mass casualties currently. The first initiative is the Hartford Consensus IV which was formulated to educate the police and paramedics on stopping bleeding by using military techniques and equipment. The second initiative, launched by the White House in 2015, the National Stop the Bleed campaign, aims to show the public on how to deal with injured trauma victims before help arrives.

Mass casualties experienced in the US in the past decade, including the Fort Hood firing incident in 2009, the Boston Marathon bombing in 2013, and the Sandy Hook shooting incident in 2013, are all calling for better reinforcements. Likewise treatment of casualties in the Iraq and Afghanistan wars have provided physicians with ample knowledge on how to deal with the issue.

The authors claim that although the above mentioned events are tragic, it provides an opportunity to examine and learn lessons from each one of the experiences, so the US can be prepared in the unfortunate case of another massacre.

“Adequate trauma research funding by governmental agencies, the military sector, and private industry should become a priority at a time when trauma has claimed so many lives and is unfortunately destined to claim more,” said Knudson.

Especially the education and empowerment of the common man can work a long way towards preventing loss of life because professional help did not come in time. The authors emphasize the need to learn cardiopulmonary resuscitation (CPR) i.e., emergency medical measures for restoring normal heartbeat and breathing, which can save countless lives in case of a manmade or natural disaster. The life-saving technique CPR consists of manually performing chest compressions along with artificial respiration in case of emergencies where a person’s heart stops beating. Other than a shooting or bombing incident, learning to perform CPR can prove to be useful in case of drowning or a heart attack.

Previously, a survey carried out on bleeding control involving 1,051 individuals revealed 90% of people had the potential to deliver first aid assistance, but 98% of them did not properly know how to administer proper medical intervention in case of severe bleeding.

Other than shooting incidents, natural calamities have been rising in the US, which makes public intervention necessary for preventing loss of life. In January 2016, a blizzard hit the Northeast and Mid-Atlantic regions of the United States resulting in 55 deaths due to weather-related accidents. In case of such accidents, death can be prevented if the civilians nearby know how to perform CPR or stop immediate bleeding.

In the paper Knudson also warned: “Failure to take action at this time in our history would be the biggest tragedy of all.”