Nurse practitioner Tina Quon clicked through a gory slideshow with images of wounds and squirting blood. She paused, looking to her roughly 25 trainees at Oakland's Highland Hospital. She asked for ideas about what to use as a makeshift tourniquet.
Someone called out, "a belt!" Another voice said, "shoe strings!"
In her mint-green scrubs and bright blue sneakers, Quon nodded her head in approval. She moved on, getting into the specifics and techniques for how to use tourniquets correctly and how to apply pressure to serious wounds.
Stop the Bleed began as part of a federally supported effort to teach civilian bystanders critical medical skills they can use during a shooting or other disasters. The idea is that bystanders can save lives by preventing victims from bleeding to death. That can happen in minutes, long before the ambulance arrives and even before someone has the chance to call 911.
Stop the Bleed started in 2013, in response to the December 2012 Sandy Hook school shooting. The American College of Surgeons, working closely with federal agencies, developed a simple, step-by-step training focused on hemorrhage control. The goal is to make the techniques as accessible and widespread as basic first aid, CPR, or the Heimlich maneuver.
"With all these mass casualties," Quon said, "there were a lot of people that had extremity injuries who could have had their lives saved or had their limbs saved by having a tourniquet placed."
The Obama administration furthered these initiatives by launching a Stop the Bleed campaign in 2015, then under the Department of Homeland Security.
At Highland Hospital, where Quon works in trauma surgery, the nurse has led this training many times for staff. But this class, held at the end of January, was the first offered to members of the public. This workshop helps the hospital do community outreach around the subject of trauma prevention -- something that is required of Level 1 trauma centers like Highland. Level 1 centers offer the highest level of lifesaving trauma treatment.
After Quon's presentation, class members practiced applying pressure to mannequin legs, and lightly twisted tourniquets on each other's arms.
Kevin Grant, along with some of the other attendees, works for Oakland Unite, an organization with the goal of interrupting and preventing violence in the city. While Grant hasn’t seen a mass shooting, he said he has seen more than his share of individual homicides in Oakland.
"Oakland has a steady drumbeat of violence that will match the Vegas shooting in a year," Grant said.
For more than a decade, Grant has responded to Oakland shootings by racing to the scene. One of his goals is to de-escalate any retaliatory violence that could happen. When he arrives, he often finds a victim.
He recalled one incident in East Oakland, when he knelt on the pavement next to a young man who was shot in the legs.
"One of the last things he said to me is, 'Kev, don't let me die,' " Grant remembered. "I said 'I got you. Stay woke.' I didn't have training on that."
That young man survived, but Grant knows many others who did not. After the Stop the Bleed training, Grant said he feels like there’s more he can do to save a person, and not just comfort them.