Dr. Raj Lal, a cardiovascular thoracic surgeon and disaster medicine expert in Oak Brook

Dr. Raj Lal is on a mission to get people prepared for crisis.

Lal, a cardiovascular thoracic surgeon in Oak Brook, wants people to know how to react when put in a horrifying situation like the mass shooting in Orlando earlier this month. He said people knowing battlefield techniques, such as how to apply tourniquets, is vital for victims’ survival in everything from shootings to car accidents.

“Time is of the essence,” Lal said. “Police and fire come to the scene, but bystanders are the real first responders. How they react, how they are educated, is essential.”

Joshua McGill, a patron at Pulse nightclub the night of the Orlando shootings knew how to react. After fleeing the club with his friends, McGill hid behind a car in the parking lot and noticed a man with gunshot wounds to his arm and back. A nursing student, McGill pulled the man, a bartender at the club, behind the car and used the victim’s shirt to stop the bleeding on his back.

“I told him ‘Everything would be OK,’” McGill told a CNN reporter. “‘I got you, just calm down. I need to cut off as much blood as I can.’”

McGill went with the bartender, Rodney Sumter Jr., to the hospital, keeping pressure on the wounds and helping him stay alert and calm.

Lal, a member of the Illinois Emergency Medical Response Team, said such knowledge and abilities need to be second nature for everyone in our state, nation and world.

“Shootings are haphazard. I don’t think our culture is aware of the way these things happen,” Lal said. “There have been school shootings, shootings at hospitals. No place is exempt. We all need to take the initiative in the equation and prepare ourselves. We will know how to react if every person takes personal responsibility.”

Lal said he continually lobbies to ensure that tourniquet use is included in first-aid programs. He even went before his own Village Board to instruct them on the importance of residents knowing how to use tourniquets.

“It is a slow process,” he said of his efforts to educate more people about the need for tourniquets and to have people put tourniquets in their cars and places of employment. “… It takes time.”

He said having tourniquets available should be as common as having a flashlight on hand in case of a power outage. People should also watch YouTube videos on how to apply a tourniquet just in case, Lal recommends.

Dr. Raj Lal said people knowing battlefield techniques, such as how to apply tourniquets, is vital for victims’ survival in everything from shootings to car accidents.

Lal said tourniquets should be stocked at public places just like defibrillators now are. He said it should be a requirement that first responders have tourniquets in their vehicles.

“Unless it is mandatory, nothing is going to happen,” Lal said. “We need to train our kids. We need to have a culture of safety and responsibility to our fellow human beings.”

Education must be a grass-roots effort, Lal said.

“It has to start in the the community,” he said, “in the churches, temples and synagogues. We need a massive education effort. (Firefighters) have to know what to do. Everyone should know how to render aid.”

Lal said scarves, belts and shirts are not as effective as actual tourniquets, “but anything applied is better than nothing.”

Applying pressure to control the bleeding and using a tourniquet to restrict the flow of blood to a wounded area is something that can be easily learned.

“Everything takes practice, but you can apply a tourniquet in 10 seconds,” Lal said.

The surgeon said getting a person stabilized is vital. Once a victim goes into shock from blood loss, his or her chances of survival drop significantly, Lal noted.

“If you apply a tourniquet before shock occurs, there is an 80 percent-plus survival rate,” Lal said.

Such battlefield techniques need to be part of a national trauma care system, according to a report released Friday in The Journal of American Medical Association.

Representatives from the Institute for Healthcare Improvement in Cambridge, Mass. and the National Academies of Sciences, Engineering and Medicine in Washington D.C. said that nearly 1,000 service members died of potentially survivable injuries in Afghanistan and Iraq, and that 20 to 30 times that number of U.S. trauma deaths each year may be preventable.

“Given the challenges and high stakes for the nation in the face of foreign and domestic threats, the White House should lead the integration of military and civilian trauma care to establish a national trauma care system,” Donald M. Berwick, M.D., Autumn S. Downey and Elizabeth A. Cornett wrote. “Such a system would unite military and civilian trauma care leaders around a common, core aim established at the highest level in the nation: namely, to achieve zero preventable deaths after injury and minimize trauma-related disability.

“The White House should direct both the U.S. departments of Health and Human Services, and Defense to organize to pursue that aim.”

That would be part of changing our mind-set as a society, something we need to be more prepared, according to Lal.

“All humans think we are all safe,” Lal said. “Unless we think we are unsafe and we have to take action, we are not going to learn what to do.”

— Doctor stresses need for training in light of Orlando shootings —