Active shooter and intentional mass casualty events

Active shooter and intentional mass casualty events (AS/IMCE) are increasing in frequency in the United States and around the world. Despite this, and despite a focus on "all-hazards" preparedness in many communities, the response to these incidents is often inadequate. Convened to examine these incidents, and others like them, the group now known as the Hartford Consensus has worked to improve survival from AS/IMCEs. A critical component of the effort to improve survival from these events has been the integration of hemorrhage control training and the lessons learned from the implementation of the Tactical Combat Casualty Care program. Ultimately, through integrated hemorrhage control training in law enforcement agencies, fire-rescue/EMS departments and the public in general, the goal of the Hartford Consensus is to craft a seamless system of hemorrhage control across all spaces in the United States and beyond. Using this goal, and the tools mentioned in this chapter, we should move closer to zero preventable deaths from trauma.