PRESIDIO OF MONTEREY, Calif. -- Gunshots. Stab wounds. Shrapnel. They're injuries often associated with combat -- but increasingly, police departments are adopting lessons learned from battlefield injuries to train law enforcement officers facing deadly situations here at home.

To help prepare and protect its officers for such a possibility, Presidio of Monterey Police Department hosted a Law Enforcement Tactical Life Saver Course for more than 30 local and regional law enforcement officers Nov. 16.

"One of the things we've all focused on in the past few years is active shooter training," Major Stephen Krueger, PoM Police Dept. Operations Officer and acting Chief of Police, said.

Officers participating in the training learned about tourniquets, clotting bandages, and special bandages designed to seal a sucking chest wound.

They learned to stop bleeding, treat shock, use a nasopharyngeal tube, and identify signs of tension pneumothorax (air leaking into the chest cavity through a hole in the lungs).

Then, they trained to perform those critical, potentially life-saving interventions while under fire.

"We want to give them the tools that they need to care for anyone who's been shot, stabbed, bleeding to death from what we call penetrating trauma," said Dr. Lawrence Heiskell, owner and lead instructor for the International School of Tactical Medicine, which conducted the training.

Heiskell is an emergency room physician, and has been a reserve police officer for 25 years.

"Good medicine can be bad tactics," he said. "They need to have the skill set so when the perp has been neutralized, they can save as many lives as possible."

In a hands-on exercise, officers simulated providing critical first aid in an "officer down" scenario drawn from a real-world incident.

"Where's the bad guy? Keep your gun up," warned Matt Willette, a course instructor.
In an active shooter scenario, officers could be called on to pull security even while giving -- or receiving -- buddy aid.

"That's the difference between tactical and emergency medical services," Willette, who brings experience as reserve police officer and an Army veteran to the training, said.

"We're not fixing anyone, we're just doing what's needed to keep them alive until the doctor can get to them," he said.

The course was coordinated and funded through the Bay Area Urban Areas Security Initiative, a partnership for San Francisco Bay-area law enforcement agencies that provides joint training opportunities for member departments through its Regional Training & Exercise Program.

"This is kind of cutting edge, to combine tactics with advanced first-aid techniques," Sergeant Marco Vazquez, PoM Police Dept. training coordinator, said.

First-aid training is especially important for police officers because they may have to escape or wait for evacuation from an active crime scene before they can access care, he said. "Medical aid can't respond until the scene is secure. We have to rely on each other (for care) until they arrive."

Participants said tactical first-aid training is the kind of training every officer wants to have, but hopes to never use.

But while the tactical scenarios focused on buddy aid to officers injured in the line of duty, the training could also help citizens with injuries at crime and accident scenes, officers pointed out.

"In our department, I've been there three years and already seen situations where this would be good information to have," said Guadalupe Gonzales, a City of Salinas police officer who took part in the training.

Vazquez agreed, saying he hopes the training helps PoM police officers better protect both themselves and the community.

"That's important to me, that people know we don't just 'shoot bad guys.' Our job isn't to take life, it's to save lives," he said.