Webinar Stresses Training for Active Shooter Responses in Hospitals

In a world where active shooter situations are becoming more common, more preparation and education is necessary, says Steven M. Crimando, principal of Behavioral Sciences Applications and an expert on active shooter response.

Crimando discussed some of the necessary steps to prepare for an active shooter situation in a healthcare setting in his webinar Active Shooter Preparedness and Response in Healthcare in February.

Crimando says one of the important things to realize about active shooter situations is their frequency. “These are not black swan events, and every organization needs training in this area,” says Crimando.

Healthcare environments, he says, are increasingly becoming the targets of active shooter situations. In the last six years, there was an average of 16.7 shooting incidents in healthcare settings per year, nearly double the number from the previous six years.

Of these shootings, 59% happen inside the building, and nearly a third of those happen in the emergency department, making it the most common area of healthcare environments for an active shooting situation to occur.

Crimando says one of the important pieces of training for an active shooter event is knowing what to expect. By definition, an active shooter situation is different than a normal shooting incident. An active shooter is someone actively engaged in killing or attempting to kill people in a confined, target-rich environment.

“Active shooters pick a place that gives them the most access to the most targets,” Crimando says.

However, the types of active shooter situations are evolving with time, Crimando says, with hybrid targeted violence becoming more prevalent. HTV is defined as the use of violence targeting a specific population using multiple and multifaceted weapons. HTV can include different teams of attackers and different weapons, like a combination of firearms and bombs. Elements of an HTV attack can be found in the recent San Bernadino shooting and the Boston Marathon bombing.

An important piece of HTV is a high likelihood of a secondary device being aimed at incoming first responders.

Crimando says one of the most important parts about active shooter response in a healthcare environment is training employees to know what to do during the attack and in the immediate aftermath.

The national average for a police response time is five to seven minutes, he says, and the majority of active shooter incidents are over within eight to 12 minutes with a large portion lasting about five minutes.

“The ability to intervene absolutely saves lives,” Crimando says.

Crimando suggests providing healthcare personnel with training that enhances their confidence in their abilities to handle what’s in front of them. He suggests training them in basic terms they will be likely to remember during the event, such as DATTS, an acronym for down and to the side, as an instruction on where to push the weapon if they encounter the shooter.

More important, Crimando says training the employees to focus on “stopping the dying, not just the shooting,” in the immediate aftermath of the event is key. As EMS is not always able to immediately come into the building and tend to the wounded, and a high rate of patients in active shooter situations die due to blood loss, it’s key that bystanders know how to stop the bleeding.

He suggests having casualty kits readily available in these environments similar to AEDs. These would have basic medical equipment necessary to stop hemorrhage, and would contain step-by-step instructions so even someone not trained to use them could work to stop the bleeding.

“Depending on the magnitude of the event, law enforcement officers may need to search, clear and secure every part of the facility,” Crimando says. “These kits have the potential to provide bystanders with quick and easy access to stop life-threatening bleeding.”

 To view the webinar, visit everbridge.com.