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Active Shooter

Overview

Planning for Active Shooter Incidents

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.

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Hospitals and Healthcare Facilities: Security Awareness for Soft Targets and Crowded areas
US Department of Homeland Security - CISA Division

The Department of Homeland Security has released an action guide for active shooter incidents specifically for hospitals and healthcare facilities.

ACTION GUIDE

Direct Regional Support

Additional resources and information on active shooter incidents

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HSCC Released Updated Active Shooter Guidance
Active Shooter Planning and Response in a Healthcare Setting

Active shooter events in a healthcare setting present unique challenges: a potentially large vulnerable patient population, hazardous materials (including infectious disease), locked units, special challenges (such as weapons and Magnetic Resonance Imaging (MRI) machines (these machines contain large magnets which can cause issues with firearms, or remove it from the hands of law enforcement), as well as caregivers who can respond to treat victims. There is no single method to respond to an incident, but prior planning will allow you and your staff to choose the best option during an active shooter situation, with the goal of maximizing lives saved. For hospitals and healthcare care systems, the HSCC has provided the updated guidance document “2017 Active Shooter Planning and Response in a Healthcare Setting.”

Active Shooter Planning and Response in a Health Care Setting Guidance 2017

Incorporating Active Shooter Incident Planning into Health Care Facility Emergency Operations Plans 2014 

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Active Shooter Resources

Resource Collection: Active Shooter Incidents

Cal OES Active Shooter Awareness Guidance

DHS Translated Active Shooter Resources in the following languages: Arabic, Chinese, English, Korean, Punjabi, Russian, Somali, Spanish, and Urdu

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Active Shooter Resources for Hospitals
Department of Homeland Security

DHS Active Shooter Preparedness Program

Active Shooter: How to Respond

Active Shooter Pocket Card

Hometown Security Fact Sheet 4-6-16

Security Assistance Fact Sheet 4-7-16

Connect/Plan/Train/Report

DHS Active Shooter Pamphlet Quick Reference Guide

Active Shooter Response Poster

Planning and Response to Active Shooter 11-2015

National Terrorism Advisory System Bulletin 9-14-18

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Active Shooter Resources
Hospital Association of Southern California (HASC)

70432491

HASC developed the Security and Safety Active Shooter Drill Tool Kit to create greater awareness of workplace violence among hospitals and other health care facilities, and to provide the tools necessary for each facility to develop a plan that leads to a safer, more prepared environment.

Based on an active shooter drill held at LAC + USC Medical Center in March 2013, the materials feature templates, checklists, industry guidelines, scenarios, safety rules, participant releases and staffing suggestions for planning a similar event. This video also provides a firsthand account of the HASC drill with scenes from the simulated attack in clinical and office settings.

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Active Shooter Training Video
US Department of Homeland Security

This instructive video demonstrates possible actions to take if confronted with an active shooter scenario. The video reviews the choices of evacuating, hiding, or, as an option of last resort, challenging the shooter. The video also shows how to assist authorities once law enforcement enters the scene.

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Florida Hospital CEO Shares Thoughts Following Fort Lauderdale Airport Shooting
Hospitals and Health Networks Magazine Article

One Florida Hospital’s Lessons Learned From Last Week’s Airport Shooting

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Health and Medical Response to Active Shooter and Bombing Events
National Academy of Medicine Discussion Paper June 17, 2016

Terrorist attacks have a profound emotional and physical effect on a community. While preventing these attacks would be preferred, agencies must work swiftly and cohesively to improve patient outcome when an attack does occur. Read full discussion paper.

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Hospitals Increasingly Anticipate Mass Shootings
U.S. News June 13, 2016

Emergency doctors and nurses now expect to treat victims of terrorism – and they are getting prepared. Read the full article.

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CDC Releases Blast Injury Mobile Application

The Centers for Disease Control and Prevention (CDC) recently announced the release of a new Blast Injury mobile application to assist in the response and clinical management of injuries resulting from terrorist bombings and other mass casualty explosive events. The application provides clear, concise, up-to-date medical and healthcare systems information to assist healthcare providers and public health professionals in the preparation, response, and management of injuries resulting from terrorist bombing events.

CDC Blast Injury App for iPhone and iPad

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CHA Workplace Violence Prevention Webpage

For information and resources on preventing workplace violence click here.

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CHA Commends Hospitals, Emphasizes Emergency Preparedness

CHA commends the hospitals that received and treated patients from the active shooter tragedy that occurred in San Bernardino County this week, and is proud of the hospitals and health systems that have planned and trained with law enforcement agencies, local emergency medical services and fire agencies in preparing for and responding to such incidents. Additionally, CHA encourages all hospitals to utilize the multitude of resources that are available on the CHA emergency preparedness website. In addition to the existing CHA planning and training for active shooter resources and links, UCSF Medical Center has recently shared its training video and template table top exercise to assist other hospitals.

San Bernardino police praised – Los Angeles Times article on lessons learned

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Active Shooter Drill Preparedness
UCSF Medical Center December 4, 2015

The following resources have been provided by UCSF Medical Center to assist hospitals in their planning and training for active shooter incidents.

Click here to watch video. 

Click here to download the Active Shooter TTX Template.

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Hospital Code Silver Activation – Active Shooter Planning Checklist

In the wake of the Newtown, Connecticut shooting, the CHA Hospital Preparedness Program (CHA-HPP) released its most recently developed tool “Hospital Code Silver Activation – Active Shooter Planning Checklist”. The checklist is provided to support hospital efforts in reviewing and developing active shooter response plans.

This resource was initially developed to support the CHA-HPP course “Planning and Training for Active Shooter Events”.

The tool was developed with key advisements from agencies such as FEMA, Department of Homeland Security and the International Association for Healthcare Security and Safety.

Hospitals should direct any questions to Mary Massey at 714-315-0572, or by email at mmassey@calhospital.org. 

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Planning & Training for an Active Shooter Event
Executive Summary

The California Hospital Association’s Hospital Preparedness Program has developed a course for the active shooter incident. A course by and for hospitals which helps participants review organizational aspects of planning and training to increase survivability of patients, visitors and staff in an active shooter event.

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Run-Hide-Fight: Surviving an Active Shooter Event
Produced by the City of Houston Mayor's Office

The City of Houston, Texas, has produced a six-minute, graphic video on what to do when encountering an active shooter. The video is entitled “Run-Hide-Fight: Surviving an Active Shooter Event” and was produced with a $200,000 grant from the U.S. Department of Homeland Security.

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Active Shooter Webinar
US Department of Homeland Security

This 90-minute webinar can help private and public sector personnel understand the importance of developing an emergency response plan and the need to train employees on how to respond if confronted with an active shooter.

The presentation describes the three types of active shooters–workplace/school, criminal, and ideological–and how their planning cycles and behaviors differ.

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“Active Shooter: What You Can Do”
FEMA IS-907 (Interactive web-based course)

All employees can help prevent and prepare for potential active shooter situations. This course provides guidance to individuals, including managers and employees, so that they can prepare to respond to an active shooter situation.

This course was written for non-law enforcement personnel. The material may provide law enforcement officers information on recommended actions for non-law enforcement employees to take should they be confronted with an active shooter situation. Upon completing this course, the participant will be able to:

  • Describe actions to take when confronted with an active shooter and responding law enforcement officials.
  • Recognize potential workplace violence indicators.
  • Describe actions to take to prevent and prepare for potential active shooter incidents.
  • Describe how to manage the consequences of an active shooter incident.

Prerequisites: None.
Course Length:  Approximately 45 minutes

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Hospital-Based Shootings in the United States: 2000 to 2011
Report: Annals of Emergency Medicine

This report was published by the Annals of Emergency Medicine (Volume 60, Issue 6, December 2012, Pages 790–798.e1) and was presented, in part, at the Society for Academic Emergency Medicine annual meeting, May 2012, Chicago, IL. 

The report is the result of a study on workplace violence in health care settings and characterizes US hospital-based shootings from 2000 to 2011. For more information or to purchase the full report, go to: www.sciencedirect.com/science/article/pii/S0196064412014084

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The Dark Knight Shooting: A Mass Casualty Event for Hospitals
www.emergencymgmt.com

July 2012 – For emergency managers, events such as these are mass casualty events.  There will be a regional response from all first responders, police and emergency medical technicians.  Hospitals will need to gear up to receive victims, the dispatching of patients to multiple hospitals will need to be orchestrated by a Hospital Control entity.  In this case the event happened late at night.  Command staff are not present and it is important that those on duty have the training and knowledge to respond to a larger event and initiate proper command and control procedures.