Embed Size (px)
Citation preview
RANDY G. FISCHER
Discusses potential characteristics of an
active shooter
Potential warning signs for an active
shooter
Strategies for surviving an incident
Law Enforcements response to an active
shooter incident
Incidents of Active Shooters
2000-2013
160 incidents
Combined 1,043 killed and
wounded, not including
shooter(s)
486 killed
557 wounded
Incidents of Active Shooters
2014 and 2015
40 incidents
Combined 231 killed and wounded,
not including shooter(s)
92 killed
139 wounded
Shooter events occurring with
greater frequency and loss
Three active shooter events, over the course of
less than 17 months, produced more than 50%
of the casualties reported from 2000 to 2013.
Pulse Nightclub in Orlando, Florida (June 12,
2016): 49 dead, 58 wounded
Las Vegas, Nevada (October 1, 2017): 59 dead,
441 wounded
Sutherland Springs, Texas (November 5, 2017):
27 dead, 20 wounded
Two of the deadliest tragedies on record
happened within five weeks of each other.
*
*Shooter Statistics from 35 active shooter events in
2012:
*- 57% were known to the others in their target area
*- 71% just walked into the location
*- 63% had somehow shared a perceived injustice
*- 74% entered through the main entrance
*- 37% of the attacks were over in under 5 min.
*- 63% of the attacks: over in under 15 min.
*No profile exists for an active shooter
*De-escalation of volatile situations is the most
important preventive measure
*Know the signs of a potential volatile situation
for prevention and detection
*Report concerning behaviors to
Director/Manager, or Law Enforcement
a) Development of a personal grievance
b) Recent acquisitions of multiple weapons
c) Escalation in target practice and weapons training
d) Recent interest in explosives
e) Fascination with previous shootings or mass attacks
f) Experience with a significant real or perceived personal loss such as death, breakup, divorce or loss of a job
g) Few offenders had previous arrests for violent crimes.
Potential pre-attack behavior that could be
indicators of concern per FBI
“Active Shooter” is defined as an individual or others who are “actively
engaged in killing or attempting to kill people in a confined and populated
area.
Active shooter situations are unpredictable and evolve quickly.
Because of this, individuals must be prepared to deal with an active shooter
situation before law enforcement personnel arrive on the scene.
In many cases the shooting is over before Law Enforcement arrives
The primary purpose of a response plan is to:
Prevent,
Reduce,
Limit access to potential victims and
mitigate the loss of life
The 4 A’s is a 4 step process to prevent or reduce loss of life in an active shooter event
1.Accept that an emergency is occurring
2.Assess what to do next so that you can save as
many lives as possible
3.Act: lockdown (lock and barricade the doors, turn off the lights, have patients get on the floor and hide)or evacuate
4.Alert law enforcement
*Startled
*Feel fear and anxiety
*Experience initial disbelief and denial
Expect to hear noise from alarms, gunfire, and
explosions and people shouting and screaming
People might be deceased or badly wounded
*Run, Hide, Fight is a three step process to prevent or reduce loss of life in an active shooter event.
1.Run- is to immediately evacuate the area
2.Hide-seek a secure place where you can hide and/or deny the shooter access
3.Fight-where your life or the lives of others are at risk, you may make the personal decision to try to attack and incapacitate the shooter to survive. This is
NOT a requirement but is an option.
*Dial 9-911 when safe to do so: if able dial 9-911 and
leave phone off the hook and evacuate or hide.
* If safely evacuated call Dispatch and provide
information on the shooter
* If able provide the location of the Shooter
*Number of shooter(s)
*Physical description of shooter
*Number and type of weapons held by the shooter
ie, hand guns, shot guns, Rifle etc.
*Page over head if safe to do so. Any staff can
make this announcement
*Page “Active shooter _________. Shelter in
Place or evacuate building
*Use cell phone to notify 911
*LE main objective is to locate and neutralize
the shooter
*Remain calm and follow officer's instructions
*LE will NOT stop to assist injured until the
shooter is contained.
*Immediately raise hands & keep hands visible
*Avoid making quick movements toward officer
*Avoid pointing, screaming and or yelling
*DO NOT stop to ask for officers help precede in
directions that officer is entering
*Follow directions of LE officer
*Staff not on duty to report to staging area
*Site of Active Shooter immediately becomes a
crime scene
*Director/Manager will develop information to
disperse to staff/families/children and news
media
*Behavioral Health services should be made
available to all staff
*Debriefing
*Offer Behavioral Health Services
*After action report
*Update plans as needed
*Exercise/drill
*
*One of the biggest misconceptions involves the denial
that this can happen to one’s self.
*One of the first hurdles to overcome is denial. This idea
that it is not going to happen where we live. It’s
Nebraska. It’s not going to happen here. That is one of
the most difficult things to make people realize and
face. It can happen anywhere.
*The best thing to do is prepare for the worst, and to
just be alert in case the unfortunate scenario of an
active shooter happens.
**It is lunchtime at your facility and the staff are assisting
residents with their meals. You glance up and observe a
noticeably agitated adult male entering the building. He
is wearing a jacket and carrying a duffle bag.
*As he enters through the front door, you recognize him as
“John Smith”, a disgruntled employee who had recently
been terminated as a result of several altercations with
the administrator.
**John enters the administrators office and is overheard
angrily addressing him/her. His voice begins to
escalates in volume as he becomes more agitated. You
hear him yell, “You can’t do this to me!”
*Suddenly, you hear loud screams and “popping noises”.
You stand frozen in place by shock and disbelief. Other
personnel in the immediate vicinity rush into the
hallway to see what is going on.
**As John turns to leave the administrators office, he
spots the people in the hallway, raises his weapon and
begins firing rapidly. People begin screaming and trying
to run away. The scene unfolds in what seems to be
slow motion. It is utter chaos.
*Thirty seconds later, John has fired an entire magazine
of ammunition and 5 people lay dead or injured.
*He reaches into his bag, pulls out another clip, and
begins to reload……..
*
*In the time you have worked at your
organization, has there been at least
one incidence where you thought as
co-worker, patient/resident or visitor
was contemplating attacking another
person?
Apply firm, steady pressure to stop bleeding.
* Understand when to use a tourniquet.
* Apply a tourniquet.
*
*Stop the Clock!
*Every minute with uncontrolled bleeding decreases the chance of survival!
*35% of pre‐hospital traumadeaths are due to blood loss
*
*When your body loses approximately half its
blood volume, it cannot survive –
regardless of the quality of medical care
you eventually receive.
* You can lose that amount in just minutes!
*This is the averageamount of blood inthe body.
5 liters
2.5 liters
*
*
Find the source(s) of bleeding.
If you have something to put in between the blood and your
hands, use it. Examples include gloves, a cloth, or a plastic
bag.
Apply firm, steady pressure directly on the source of the
bleeding. Push hard to stop or slow bleeding – even if it is
painful to the injured!
Keep applying pressure until EMS arrives.
*
Think of a tourniquet as another
way to apply firm, steady pressure
when:
The injury is to an arm or leg.
The bleeding is so severe it
cannot be controlled otherwise.
*
Place as high up as possible on the injured
limb – closer to the torso. It can be placed
over clothing. Pull the strap through the
buckle.
Twist the rod tightly until bleeding
stops/slows significantly. This may be
painful!
Secure the rod.
If bleeding doesn’t stop, place a second
tourniquet.
Leave in place until EMS takes over care.
*
If you don’t have a commercially available tourniquet, you
can attempt to improvise one using material that is:
Broad
Flexible
Strong
Able to be twisted, tightened, and secured.
* Apply firm, steady pressure on the source of bleeding.
If you cannot control the bleeding with manual pressure,
then consider applying a tourniquet.
Continue applying pressure and do not remove a
tourniquet until professional first responders arrive.
DEVELOP A PLANRUN
HIDE
FIGHT
HELP IS ON THE WAY
*
45
* Active Shooter Planning and Response in a Healthcare Setting. April 2015
* Department of Home Land Security (DHS) Active Shooter Response Booklet
* U.S. Department of Homeland Security. Washington, DC 20528
* [email protected] www.dhs.gov
* U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response, Incorporating Active Shooter Incident Planning into Health Care Facility Emergency Operations Plans, Washington, DC, 2014.
* Violence in Hospitals: Assessing your risk and developing a response. Live process aha October 2011. October 3, 2011.
*
*What if…
