I am part of the Employee Safety Committee for my work area. A big part of our responsibility has been training staff in what to do during attacks on our facility. Included in the training are presentations by the security supervisors, videos, posters, and tabletop simulations. As part of this, I produced a memo outlining procedures for our specific unit. After the event in Florida, a resident MD (who is active-duty military with combat experience) and I updated the guide. I left some descriptions of specific locations in our area as an example; these, of course, are not applicable to every workplace.
With Las Vegas, Kentucky, and Florida in the news, I’m again going to address a scary possibility: An active shooter in the hospital. We all should have had the class from Security and have seen the posters. You, therefore, know the strategy: Run, Hide, Fight. I will be discussing the specific tactics for our department.
You first need to recognize an active shooter situation. Do not wait for an overhead announcement. Multiple gunshots, explosions, or the sudden appearance of several people with wounds will alert you.
Run! Do not stop to provide first aid. If you can, carry or assist any injured people in escaping, but stopping to provide care will result in you both becoming victims. This is not patient abandonment! You are not going to be of any help to anyone if you are killed or injured. Alert other staff and patients. Direct them to safety. Do not argue, immediately alert the next room and keep on going. Push IV carts and mobile computers into the center of the hall as you pass and close fire doors to provide cover for you and slow down the attacker.
Remember that you have one advantage over any stranger attacking the hospital: You know the layout better than they do. They are not going to be as comfortable moving through the environment as you are. Our unit has only four exits; move quickly to the safest one. This exit is the one nearest to you and furthest from the shooter. The staff hallway to the in-patient rooms is good since it leads away from the front of the hospital. Enter the stairwell at the end of the hall, go down to the next floor and leave the hospital through the door to the Patient Park. (Do you even know about that door?) The hallway from the entrance past the waiting rooms leads to the back of the hospital as well.
Run along walls; do not run across open areas; avoid or duck under windows. Do not congregate in groups within sight of the hospital. If you are in an open area and are being shot at, take shelter behind solid objects: Large tress, concrete pillars, or the engines of cars.
Hide. If all the exits have been blocked or you cannot get to them, you need to hide. Be familiar with the area you are working and immediately go to a room with a solid wood door that can be locked. Avoid a room with windows if possible. Push any objects in the room against the door and crouch on the floor (behind the door; the walls provide less protection). The best hiding place in our unit is the administrative area: It has two entrances, providing an exit if one door is breached, and has multiple internal rooms with lockable doors and no windows. In minor care, all the doors are solid, so you can push a stretcher against the door and lock the wheels. Once you are in a room, stay down and be quiet. Turn off your phone! Do not open the door until you are sure the danger has passed.
Fight. If you or cornered by the shooter, your only way to survive is to attack them. Throw things, spray them with a fire extinguisher, scream and run at them. If they have a rifle or shotgun, you are safer the closer you are to them, past the muzzle of the weapon. Bite, kick, scratch or strike with objects; do not hit with your fist unless you are a trained boxer. Strike at the eyes, throat, wrists or groin.
Lastly, when, the event is over, stay where you are. When you are approached by the police, stay on the ground with your hands open, empty and away from your body. Do exactly what the officers tell you. Until the officers have confirmed who you are, expect to be searched and possibly handcuffed.
The most important thing to do is have a plan beforehand so you take action without freezing. Periodically, look around your work environment and think: Where would I run? Where would I hide? What can I use as a weapon if I’m attacked?
The great likelihood is that such a traumatic event will not happen here. If it does, however, I hope this little guide will prepare you to survive.
In addition, Medscape has recently published an article on active shooters.