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NORTHERN COCHISE COMMUNITY HOSPITAL
ACTIVE SHOOTER POLICY/PROCEDURE
DEPARTMENT: Safety
SUBJECT: Active Shooter/Attacker
Reviewed By:
| Review Date:
| Committee
| 07/20/17
| Med Staff
| 08/28/17
| Governing Board
| 09/26/17
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REFERENCES: CMS Guidelines, OSHA Guidelines, ALICE Institute
SCOPE: All Hospital Staff. The following procedure has been adopted by local and Federal law Enforcement response procedures to address such threat as quickly as possible. The following information is provided to guide you in protecting yourself, your patients and visitors. Depending on the situation that may be confronted with the use the following options – RUN, HIDE, or FIGHT. As the situation develops or changes, it is possible you will need to use more than one option. To the extent possible, always consider the needs of others (Patients, visitors, and co-workers), as well as yourself in protecting the most lives. Consider the greater good as well as your own interests.
POLICY: Active Shooter Incidents. As defined by US Dept. of Homeland Security, an active shooter is “an individual actively engaged in killing or attempting to kill people in a confined and populated area; in most cases, active shooters use firearms, (but may include bladed weapons), and there is no pattern or method to their selection of victims”.
Hospital Incident Command system will be activated and follow the Active Shooter – Incident Response Guide.
PROCEDURE:
The following Instructions are intended for incidents that are emergent in nature, (imminent or in progress). These instructions are categorized in the following manner;
A- Immediate Actions of Staff
B- Unified Command of NCCH & Law Enforcement
C- Incident Command and Hospital Command Center
D- Subsequent procedures and information
A- Immediate Actions for Staff,
1. Assess the Situation
- Try to remain calm; your actions will influence others.
- Try to identify where the event is taking place, how close is it to you and your location, how many layers of protection are there between you and the shooter, do you have time to move yourself and people out safely, do you have time to secure your area, etc…
2. Evacuate and shelter in place and if necessary, prepare to protect yourself and others (RUN, HIDE, FIGHT).
- Dependent upon your patients acuity level and the units location in regards to the active shooter, remove all patients, staff and visitors from the area to a secure location, if safe to do so.
- If patients, staff and visitors cannot be moved or it is unsafe to do so, you must shelter in place. Lock or barricade all doors, block doors using heavy furniture, desks file cabinets, hospital beds, etc.
- After securing the doors, turn off lights and get away from the doors and behind any solid objects.
- Additional protective actions to reduce your vulnerability;
- Relocate yourself to a pre-established safe room/s within your department.
- Close blinds or block or obscure interior windows.
- Turn off sounds to radios or computer monitors
- Silence cell phones and nurse call phones
- Place signs in exterior windows to indicate your location and location of injured persons.
- Keep people calm and quiet
- After securing the room, people should be positions out of sight and behind items that may offer additional protection (desks, etc…).
- Monitor and or obtain updates in your email box or via emergency text messages, once you and your patients are safe, notify 911 and NCCH internal communications if possible , provide the following ;
- Your location
- How many people are with you
- Last known location of shooter
- Number of shooters
- Description of shooter and what they are wearing
- Number of victims, if known
3. As a last resort and only as a last resort, prepare to defend yourself and your patients.
- You must commit to becoming an aggressor
- Distract, disorient and disable the shooter by using tactics such as throwing heavy or sharp objects; discharging a fire extinguisher in shooters face.
- Once a shooter is distracted or disoriented, take action to disable the attacker.
4. Issues to consider;
- The attacker may not stop until their objective/s have been met or until engaged or neutralized by law enforcement.
- Attempts to rescue people only should be made if it can be done without further endangering the persons in a secured area.
- Be aware that the attacker may bang on the door, yell for help or otherwise attempt to entice you to open the doors of a secured area. DO NOT OPEN your area for anyone with the exception of law enforcement.
- Do not purposely confront the attacker unless your immediate are and you or others are in danger.
- Whenever possible work as a team, if you must confront the attacker.
5. Communications
- As soon as the situation becomes apparent, Law Enforcement should be notified, and NCCH Emergency Communications will be sent out using all means available, overhead page, mass notifications', text & Email, cell phone, and the such
- Plain messaging will be used (no codes) - “armed shooter or intruder” and location take appropriate actions.
B- Unified Command – NCCH and Responding Law Enforcement
1. Remember the First Priority of Law Enforcement is to contain the attacker from roaming the hospital and then subduing the attacker.
A. Initial Law Enforcement Response
- Law Enforcement will locate, contain and stop the attacker/s.
- The safest place for you to be is inside a secure room. If safe rooms or spaces are available, law enforcement will direct staff patients and visitors to them when the lock down occurs.
- The attacker may not flee when Law Enforcement enters the building, but may target arriving officer or commit suicide.
B. Injured persons
- Initial responding officers will not treat the injured or begin evacuations until the threat is neutralized and /or the area secure.
- You may need to explain this to others in order to calm them.
- Once the threat in neutralized or area secured, Officers will begin treatment and evacuation of those injured.
C. Evacuation
Responding officers will establish safe corridors for persons to evacuate.
- Remain in secure area until instructed otherwise.
- You will be instructed to keep you hands up and finger spread apart
- You may be searched
- You may be escorted out of the building by Law Enforcement- follow their direction.
- After evacuation you may be taken to a staging/holding area for medical care, interviewing and counseling, etc…
- Once you have been evacuated you will not be permitted to return to the area to retrieve items until Law Enforcement releases the crime scene. This may be time consuming.
C- Incident command
Responding law Enforcement will set up an Incident command center outside the building. NCCH will activate its HICS Process and establish a joint Hospital Command Center in Conjunction with Law Enforcement. NCCH will follow Hospital Incident Command System (HICS), and follow the Active shooter Response Guide, these items will include;
- Areas of Refuge & Assembly points
- Medical Treatment of Victims
- Immediate required staff return to a building point (IE- ER staff to ED).
- Media Relations point
- Dept. Lockdowns after the incident & Crime scene processing
- Family reunification and information point
- Other as need determined
D- Immediately following the incident
All capable Medical staff need to be prepared to move into Mass Casualty Incident (MCI) operations. The ER facility may or may not be available, depending on where the incident occurred. Historical data of past incidents show that 23% of attacks occur in ER departments.
- If alternative ER cannot be established a MCI triage will be conducted with mutual aid responses from EMS and other Public Safety resources and victims will be transported to other facilities.
- Once all clear has been given, NCCH will activate Post Emergency plans for continuity of operations that include post care for staff, (IE- critical debriefing, counseling, etc…)
SAFE-POL-003
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