Are You Prepared for an Active Shooter Incident?


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Source: Cliff Akiyama, MA, MPH

On the 4th of July, 2022, there were two highly publicized “active shooters,” one in Highland Park, IL, in which the 21-year-old shooter killed 7 and injured 40, who were all having a fun time, cheering and celebrating the 246th year of the birth of this nation. The second shooting occurred in the Parkway area in Center City Philadelphia, during the Wawa Welcome America Independence Day celebration, injuring dozens and specifically two police officers. The Philadelphia police are still looking for the shooter. Before these two attacks just a few days ago, two 18-year-old individuals were accused of carrying out massacres in Buffalo, NY, and in Uvalde, TX. What is even more disturbing is that the shooters are young. Both suspects followed a similar path, openly sharing menacing thoughts online and buying semi-automatic rifles as soon as it was legal. In March 2021, a 21-year-old man was arrested after an attack that killed 10 people at a supermarket in Boulder, CO. Another 21-year-old was charged with gunning down shoppers at a Walmart in El Paso, TX, in August 2019, killing 20 and injuring 26 people. A 19-year-old former student went back to Marjory Stoneman Douglas High School in Parkland, FL, in February 2018 and killed 17 students and staff. Since January of 2022, within the past seven months, there have been a total of 240 active shooting incidents in the United States.

It is critical that forensic nurses and those in charge with the direct care of individuals learn to counter an active shooter, which involves a multidisciplinary team with a multidimensional approach. There is no one approach that works all the time, and the threat must be continually assessed. Below are some recommended steps to take when preparing for an active shooter incident:

  • Establish a framework for how to deal with an active shooter in the hospital
  • Involve everyone in the facility
  • One should develop multiple scenarios and practice routines
  • Invite law enforcement to help develop a robust program and understand the risks
  • Develop a culture of reporting without reprisals
  • Develop a method of recognizing the problem and have a reporting system in place
  • All security measures should be fully active, and this includes the following:
    • Employees must wear a name badge with photo identification
    • Employees should be able to report suspicious activity or an individual without fear of reprisal
    • All badge or card access readers must have the ability to be reprogrammed to block a former employee from entering the hospital
    • Establish staff reporting stations
    • During an active shooting event, there must be maneuvers in place to keep all doors closed and/or locked
    • Have an effective means of communication for all workers in the hospital
    • Develop a protocol for evacuation
    • Workers must be aware of emergency escape routes
    • Ensure that there are safe locations if an escape route is blocked
    • Educate employees on self-defense and harm reduction