Practice Management Alert

‘Muscle memory’ and knowing emergency response plans inside and out could save your life.

At this point, it may be impossible to prevent an active shooter situation from occurring. Do everything you can to mitigate the risk of loss of life, including knowing and practicing various responses, so you can act quickly.

“Active shooter events evolve rapidly and end quickly, often before law enforcement can arrive. In the initial phase, bystander intervention and civilian response are essential,” says Steven Crimando, MA, BCETS, CHS-V, principal at Behavioral Health Applications, in a presentation titled “Active Shooter Preparedness and Response in Healthcare.”

If you are faced with an active shooter situation, the U.S. Department of Homeland Security has helpful, possibly lifesaving tips, which are written here in full:

1. Evacuate

• If there is an accessible escape path, attempt to evacuate the premises.
• Be sure to:

                    o Have an escape route and plan in mind.
                    o Evacuate regardless of whether others agree to follow (As healthcare providers, this directive is a bit murky; make sure you account for patients in all of your plans.).
                    o Leave your belongings behind.
                    o Help others escape, if possible.
                    o Prevent individuals from entering an area where the active shooter may be.
                    o Keep your hands visible.
                    o Follow the instructions of any police officers.
                    o Do not attempt to move wounded people.
                    o Call 911 when you are safe.

2. Hide out

• If evacuation is not possible, find a place to hide where the active shooter is less likely to find you.
• Your hiding place should:

                    o Be out of the active shooter’s view.
                    o Provide protection if shots are fired in your direction (i.e., an office with a closed and locked door).
                    o Not trap you or restrict your options for movement.

• To prevent an active shooter from entering your hiding place:

                    o Lock the door.
                    o Blockade the door with heavy furniture.

3. How to respond when an active shooter is in your vicinity

• If the active shooter is nearby:

                    o Lock the door.
                    o Silence your cell phone and/or pager.
                    o Turn off any source of noise (i.e., radios, televisions).
                    o Hide behind large items (i.e., cabinets, desks).
                    o Remain quiet.

• If evacuation and hiding out are not possible:

                    o Remain calm.
                    o Dial 911, if possible, to alert police to the active shooter’s location.
                    o If you cannot speak, leave the line open and allow the dispatcher to listen.

“Understandably, this is a sensitive topic. No single answer exists for what to do, but a survival mindset can increase the odds of saving a life,” says Paul Brennan, president of International Association of Emergency Medical Services Chiefs, in Washington, D.C., in a presentation on active shooter situations for healthcare service providers and workers. “As appropriate for your healthcare facility or campus, it may be valuable to schedule a time for an open conversation regarding this topic.”

“Though some healthcare staff may find the conversation uncomfortable, they also may find it reassuring to know, as a whole, their healthcare facility is thinking about how best to deal with this situation,” Brennan says.