Other experts began addressing the rise in mass casualty incidents, but my background in this area was based on experience rather than theory. My work in hemorrhage control, tactical medical support, and prehospital trauma care came from treating injured patients, working alongside law enforcement, and studying how injuries occur before hospital arrival.
I researched injury patterns among law enforcement officers and the effects of bleeding prior to hospital care. I also participated in studies examining how first responder agencies communicate during high-stress events. This work drew from my experience in both the trauma center and the field. Observing recurring issues made it evident that early action could prevent many deaths.
During the initial meetings of the Hartford Consensus, the discussions mirrored those we had already been having in Dallas. Early bleeding control was crucial. The discussions revolved around the importance of communication between law enforcement and medical providers. The transition from the scene to the hospital was a crucial aspect to consider. I personally experienced these issues, which are now receiving national attention.
My early input to the Hartford Consensus came directly from experience. I had seen uncontrolled bleeding overwhelm even aggressive resuscitation. I had also seen how unclear roles and poor communication caused fatal delays. The Hartford Consensus gave structure to concerns many of us had carried for years and created space for practical solutions rather than abstract recommendations.
As more reports emerged, I continued to participate by engaging in discussions, writing, and providing education. I met with clinicians, public safety leaders, and policymakers to explain the intent of the Hartford Consensus. The goal was not to promote products or organizations, but to emphasize why timing matters and why preparedness cannot begin at the hospital door.
I continue to teach, offer tactical support, and serve in roles focused on operational medicine and emergency preparedness. These roles allow me to assess what works in real settings.
One of the most visible outcomes of the Hartford Consensus has been the focus on early hemorrhage control. Training civilians to recognize life-threatening bleeding and take action changed how the first minutes after injury are viewed. Most of my work has focused on education and reinforcing a simple message: waiting is rarely the correct choice.
Tourniquets and bleeding control kits are now increasingly common in public spaces. Preparedness discussions have expanded to schools, businesses, and community organizations. These changes have not eliminated risk, but they have improved readiness.
The Hartford Consensus represented a convergence of experience, evidence, and urgency. It was not about recognition. It was about acknowledging what was not working and improving it. The resulting recommendations continue to guide how agencies prepare for mass casualty incidents. For me, the work has always been personal. Each improvement in preparedness creates the possibility of a better outcome than those we could not change.
