1. Facilitated by: Charlie Bunn RN CEN CCRN

2. A History Lesson. Law Enforcement procedural change after the Columbine tragedy. List measures that can be employed to reduce the effectiveness of an active shooter. Describe actions that can be expected from responding law enforcement officers.

3. . Two armed mentally disturbed young men killed 12 students, One teacher & themselves in 43 minutes. 5 minutes after SWAT arrived they committed suicide. On April 20, 1999

4. On April 16 th, 2007 a mentally disturbed individual kills 32 and wounds 25 people. Two separate incidents within 2 hours.

5. Set up a perimeter and call S.W.A.T. Patrol deputies/officers had limited fire power. No Specialized training for patrol to respond to active threats.

6. Agencies reevaluate responding to “Active Shooter situations”. 1 st units on scene engage the suspect. 4 man, 3 man, 2 man teams have been implemented through-out the U.S.

7. Departments instruct officers to secure the immediate area, assess the danger. Determine where the threat is at and move toward the gunfire to stop the shooting. Once officers/deputies find the suspect, either disarm him/her or terminate the threat.

8. Desire to kill without concern for his safety or threat of capture. Normally has intended victims and will search them out. Accepts targets of opportunity while searching for or after finding intended targets. Victim mentality.

9. Will continue to move throughout building or area until stopped by law enforcement, suicide, or other intervention. This has necessitated a change in tactics by law enforcement. * Studies have shown that mere Law Enforcement presence has ended an Active Shooter incident.

10. Losses can be mitigated with community preparedness training and response during an actual event. Having some fore-thought can help prepare yourself if the need arises.

11. Your Actions will influence others. Try to stay Calm. Assure others that you and the police are working to protect them.

12. Secure the immediate area. Lock the door- This may require some advanced planning to ensure availability of someone who can do this. Most doors in Hospital buildings are solid core and many walls are block and brick. This may provide some protection. Block the doors using whatever is available-desks, file cabinets, other furniture.

13. If you are trained, treat the injured. Remember basic first aid. For bleeding apply TOURNAQUATE, pressure and elevate. Rescue efforts will be delayed until the shooter is stopped.

14. As discussed earlier, a shooter will not stop until his objectives have been met, unless engaged by by someone with a gun. Attempts to rescue people should not be made if they will endanger other persons in a secured area. A shooter may bang on the door and yell for help to entice you to open the door.

15. Doors, Windows, Openings, and Noise Close blinds Block windows Turn off radios and computer monitors if necessary Silence cell phones Signs can be placed in interior doors, windows, but remember the shooter can see these Place signs in exterior windows to identify the location of injured persons Keep occupants calm and quiet After securing the room. People should be positioned out of sight and behind items that might offer additional protection - walls, desks, file cabinets, etc.

16. Emergency 911 911 may be overwhelmed Busy signal Multiple rings

17. Your specific location -Building name -Office/Classroom number Number of people at your location Injuries -Number of people injured -Types of injuries

18. -Suspect Information -Specific location -Number of suspects -Race and Gender -Clothing color and style -Physical features -Type of weapons -Backpack Do you recognize the shooter? What’s his/her name?

19. If you find yourself in an open area, immediately seek protection. Put a physical barrier between you and the suspect. Consider your options: -Escape -Shelter in place

20. Law Enforcement’s goal is to locate, contain and stop the shooter. The best place for you is inside a secure room. The shooter will generally not flee when law enforcement enters the building.

21. Instead he will have new targets to shoot. *If not end his own life. Remember, the shooters main goal is not escape, but rather to kill as many people as possible.

22. Injured Persons: Initial responding officers will not treat the injured or begin evacuation until the threat is neutralized/stopped. You may need to explain this to others in an attempt to calm them. Fire Rescue will respond as soon as it is safe to do so.

23. Evacuation Safety corridors will be established. This may be time consuming. Remain in secure areas until instructed otherwise by police. Make sure the commands are being issued by law enforcement and not the shooter… You may be searched when exiting. You will be escorted out of the building by armed police officers. *Follow their instructions at all times.

24. Information will be released to the general public and media as quickly as possible. The entire area will be treated as a crime scene. Once you have been evacuated you will not be permitted to retrieve items or access the crime scene. After evacuation you will be taken to a holding area for medical care, interviewing, counseling, etc.

25. Does your office/department have a plan of action? Think about- Target hardening your area, i.e. Door chimes, restrict access, cameras, panic buttons. Code Words- Red Folder, or something that would alert another employee to call for Help without arousing suspicion.

26. We can no longer predict the origin of the next threat. Assailants in some recent incidents across the country were not students or employees. There were no obvious specific targets and the victims were unaware they were targets, until attacked. Be aware of your surroundings, coworker troubles, suspicious incidents/suspicious persons.