An active shooter is defined as an individual who is actively
engaged in killing or attempting to kill people in the hospital
or on the hospital campus. In most cases active shooters use a
firearm(s) and display no pattern or method for selection of
their victims. In some cases active shooters use other weapons
and/or improvised explosive devices to cause additional victims
and act as an impediment to police and emergency responders.
Chemical, biological, radiological, nuclear and explosive (CBRNE)
events refer to the uncontrolled release of chemicals, biological
agents or radioactive contamination into the environment or
explosions that cause widespread damage. CBRNE events can be
caused by accidents or by terrorist acts.
Healthcare institutions are increasingly being targeted with
theft or manipulation of electronic data, including patient
financial and medical records, as well as malicious attacks that
disrupt computer systems. 80 percent of hospital
information-technology practitioners said their organizations had
one or more data breaches that involved the loss of patient-care
information*. Recent cyber attacks have effectively shut down
entire hospitals, delaying procedures and test results and
impacting patient care. *2009 survey by the Ponemon Institute and
LogLogic Inc.
Hospital plans for full or partial evacuation should incorporate
pre-planning and address the incident command and management
structure established for its operational area (community). In
advance of an event, Hospitals should understand and incorporate
local plans and protocols that are in place to support evacuation
and should establish Memoranda of Understanding (MOUs) with other
hospitals, as necessary, for transfer and mutual aid during an
emergency.(See CHA Hospital Evacuation Plan Checklist)
When potential or actual evacuation is first contemplated, the
hospital should alert the local emergency medical services agency
(LEMSA), Emergency Operations Center (EOC), and/or Medical Health
Operational Area Coordinator (MHOAC) in accordance with the
protocols established for emergency notification in the area.
The LEMSA or EOC may assist the hospital with identifying and
coordinating placement and transport of patients and other
support while the hospital is preparing and staging for
evacuation of patients in accordance with local plans and
protocols. If the LEMSA or EOC are unable to provide assistance,
the hospital is responsible for identification of receiving
facilities and securing the consent of those facilities for
transfer. The hospital should have established protocols for
evacuation, including medications, supplies, equipment, medical
records summaries and patient tracking.
Because attending physicians may not be available for all
patients involved in an immediate evacuation, it is anticipated
that hospital-based physicians (for example, emergency,
hospitalists, medical director) will coordinate with the sending
and receiving hospitals. Medical record summaries should
accompany each patient and the patients attending physician
should be notified of the location of the patient.
When a catastrophic emergency occurs, hospital morgues will
quickly reach capacity and hospitals will need to implement
internal mass fatality plans.
Hospitals should plan for the appropriate bagging and storage of
the dead, and consider the evidentiary needs (bodies stored with
some space/distance between bodies, appropriate
identification/labeling of the body). If the body is
contaminated, special bagging, handling and labeling procedures
must be ensured. The hospital plan for management of mass
fatalities must also include a procedure for providing
information about viewing the dead by family members. Careful
identification and tracking of the dead must be documented by the
hospital and provided to authorities when requested.
Because of unique vulnerabilities of children, their special
needs should be addressed in hospital disaster planning to
ensure that health care providers and health care facilities are
prepared to meet the needs of this vulnerable population.
Disasters can occur in just a few seconds. Personal preparedness
lessens the impact on families, on workplaces and on communities.
Since hospitals play a particularly important role during
community disasters, it is imperative that hospital staff
understand the importance of personal preparedness.
Preparedness of hospital staff has a significant impact on the
hospital’s ability to provide uninterrupted service to the
community. Every hospital staff member has an important role in
hospital operations and in the ability of hospitals to provide
care to the community regardless of circumstance.
Personal preparedness has a direct impact on the effectiveness of
the hospital during critical times. Hospital staff can focus on
their jobs if they are prepared at home and have planned for the
safety and well-being of their family during a disaster.
Learn about vulnerability to natural hazards in your
neighborhood by visiting My Hazards website below and getting a
customized report based on your home’s address.
 Robert Eplett OES.jpg "Photo provided courtesy of Robert A. Eplett, OES California")
