Surviving Mass Shooting Incidents

I posted this article on my EMTreview.com blog in December after reading about a shooting at a fast food restaurant in Chicago. The recent event in Aurora, CO, is another reminder that we may find ourselves in the middle of an incident like this.

The focus of the article isn’t how to respond to the scene as an EMS provider, it is how to survive if you find yourself in the middle of the unthinkable. The concepts remain valid today.

I scan several news feeds every morning. It is inevitable that I see at least one multiple or mass shooting incident every day. I define this as a situation where one or more people begin shooting in a public place. Yesterday’s incident was in Chicago but the list is added to daily—sometimes more than once.

With this in mind, here are five tips to surviving a mass shooting incident:

Be alert for signs of escalating violence.

The Chicago incident was a dispute between two people that spilled into a fast food restaurant where two people were killed and four injured. The lesson here is being aware of what was going on outside might have given you a few seconds warning to react when the shooting erupted inside. Be alert for any discord, tension, raised voices or aggressive behavior. Only a small percentage of these will escalate into shooting, but awareness is the key to prevention.

Be alert for suspicious people.

People who enter a public place intending to harm people can often be identified in advance. Look for clothing or body mannerisms that indicate a weapon may be hidden. According to the Omaha police chief and security cameras, the 19-year-old who walked into a mall in Omaha, NE, "appeared to be concealing something balled up in a hooded sweatshirt." It was an AK-47 with two 30-round magazines. This allegedly caught the attention of mall security guards who began to observe, but didn’t have time to act, before gunfire erupted. Robert Hawkins killed eight and wounded two.

People on a mission to kill are often hyper-focused in their actions, may have an affect ranging from a total lack of emotion to rage, and are often concealing large or multiple weapons. This person would stand out as “not right” to someone who has been in the emergency services field for any amount of time.

Create an escape plan.

This brings us to point three: When you see elements in the first two points above, begin forming an escape route. The urgency in developing or using an escape route depends on the level of threat you observe. There will be times you notice something that makes you casually look for an exit. There will be other times you will immediately start moving in a safe direction. In the Chicago example it likely happened very fast. In that case, a few steps toward safety likely made the difference between life and death.

In a mall, remember that many stores have rear exits for employees and deliveries. These might be a quick way out, or at least a place to go, lock the door and look for cover.

Take cover.

In addition to a safe escape, taking cover is also a vital component of surviving. You might not have an immediate exit, or the path to the exit might leave you too exposed. In that case cover, getting behind something that stops bullets, is crucial. It might be a giant planter or a support column. Take a look around with this in mind next time you are at the mall.

Ideally, a combination of escaping and cover is best. While the cover will stop bullets, this won’t help if a shooter moves toward you. Always look for the next safe place if yours is compromised.

The “incident” is bigger than you think.

Public shootings are stressful and complex. They occur over vast spaces with multiple victims. This means that your decision-making before, during and immediately after the incident is key. Consider the following:

• You may be with family members. You will also need to keep them safe.
• As an emergency service provider you will also want to help others. This is honorable, but risky. You may have the ability to shepherd a group of people to safety. You must balance your personal safety while doing so.
• There may be multiple shooters or other threats (e.g., secondary devices) in multiple locations. Remain observant.
• Dispatchers will need a calm, observant person to talk to. Calmly call 9-1-1 when safe to do so and be a solid source of information/intelligence.
• You may not be able to help with care for the victims immediately. Follow officers' instructions carefully. Officers won’t know if the shooter is still on the loose so you will likely be herded out in groups. When safe to do so, identify yourself to EMS command and get in the game if you are physically and emotionally able and invited to do so.

Remember that the odds of finding yourself in the middle of an event like this are statistically very small. I want to be clear, I’m not advocating a military approach to shopping or going to the movies. It only takes a little extra awareness every day, using the skills and intuition you already have developed as an EMS provider.

In EMS we spend considerable time training and drilling for the “big one” when we are working. It is time to begin thinking about how to handle these situations when off-duty. Share the first few points in this article with your family, too. A little awareness goes a long way. And as details emerge from the shootings in Aurora, CO, additional lessons may be learned.

Dan Limmer, EMT-P, is an EMS provider, police officer, author and conference speaker with more than 30 years' experience in public safety. He is a principal in Limmer Creative, which produces EMS review products for smartphones, tablets and computers.