We live in a world where many people are CPR certified and have a basic understanding of how and when to use an automated external defibrillator (AED). There is a fire extinguisher, first aid kit, and AED marked on maps and easily accessible in most public offices. But there’s one very reasonably priced piece of equipment that is often overlooked, ignored, or even avoided.

A tourniquet.

Now I know that historically this has been a scary word but let’s consider the following…

It is known that due to cardiac or respiratory distress permanent damage or death can occur after 5 minutes of oxygen deprivation to the brain. It is also known that a good femoral or brachial bleed can cause death in less than two minutes. I’ll say that again, two minutes. We have amazing first responders, but unless they’re pre-staged on the scene of an accident or emergency, they won’t make it in two minutes.

With practice, a tourniquet can be applied on yourself or a friend in about a minute. Now, that’s assuming two things: 1) You have a tourniquet available. A make-shift tourniquet might work, but it’s less likely to be effective compared to a commercial product. And 2) you know how to effectively apply it.

As I said, tourniquet has historically been a scary word. It was believed that the application of a tourniquet all but guaranteed the loss of that limb. Based on military studies of the Vietnam war, and lessons learned from Mogadishu, Iraq, and Afghanistan, we know that isn’t necessarily true. It is generally believed that permanent tissue damage won’t occur until 2–3 hours after the application of the tourniquet and the blood has stopped moving into that specific limb.

So, compare the pros and cons of the situation. You have approximately two minutes to possibly save the life of a friend, family member, if you can get a tourniquet on and stop severe bleeding. Combat situations aside, most places in America can receive emergency medical services within that two-hour time frame before permanent damage might set in. But if you don’t apply the tourniquet, death might occur within minutes. It’s your decision.

Think about your work place. Are you in construction? Are there powerful and sharp power tools everywhere? Are there significant fall hazards? Are you in transportation? Could you be in an accident at any moment? Most workplaces can come up with a scenario where it might be good to have a tourniquet or two available, and to have folks trained in how to use them.

Now let’s get scary and a little uncomfortable. Let’s talk about gun shots. Gang shootings, accidental discharges, or active shooters. If you’re in a situation where you’re able to safely render aid, would you? Or maybe the more pertinent question is, Could you?

There’s a little more to it than just tighten the belt as hard as you can. Seek out traumatic first aid training. Find a company that can teach you and you staff how to handle these situations. You train on how to react to the unlikely, but possible, scenario of encountering a cardiac or respiratory emergency, why wouldn’t you seek out training on the unlikely, but possible, situation you may need to save someone with a life-threatening hemorrhage?

Unfortunately, this is the world we now live in. An explosion wound, shrapnel wound, or gunshot wound is the same in London, San Bernardino, or Orlando as it is in Mosul. The paradigm of typical and standard for basic medical training for laypersons is shifting. Get ahead of it. Prevent the unnecessary loss of life. Prepare for the worst, hope for the best. Protect yourself, loved ones, and strangers.

About the Author: Brian Hampel, M.S. is the co-founder and Vice President of Hampel Security Consulting, Inc. Brian is a three-tour combat veteran, a former federal police officer, and 14-year Military Police Soldier. Brian earned his Master’s Degree in Terrorism and Counter Terrorism from Henley-Putnam University.