Active Shooter

To Implement – The Active Shooter protocol will be implemented when a person or persons enter our building or grounds armed with a firearm with the intent to do harm or threatening to do harm to those present or is actively shooting.

• If an armed intruder enters our building the first response will be to protect as many of our patients, visitors and staff as possible. At the same time we will summon help from internal and external resources.
• Your personal response may need to be made in a hurry. Difficult decisions will need to be acted on quickly. Make the best response decisions you can and try to limit the harm inflected on yourself and those around you.

Lincoln Location Information (EC.A.82)

Notification by observing person/employee

• Make the best decision you can as to order of notifications
• Call “6” (if in a hospital building or a building attached to the hospital)
• Call 9-911 (Medical Center) or 911 if not connected to the switch board
• Notify your Manager or Supervisor, if possible
• Provide this information:
  • The 911 Call say: “This is Bryan Medical Center (give location, plus area) we have an armed intruder in the building, gunshots (not) fired.”
  • The “6” Call say: ”We have an Active Shooter in the building (provide area), gunshots (not) fired.”
  • If possible provide a description of the person(s) and their location

Announcement

The Telecommunications Operator will announce three times: “Active Shooter + Location + Do not go near this area, leave the building if safe to do so”.

Personal Response, follow this as a guide; your response may vary depending on the circumstances.

Remember ADD, it may add to your chances for survival

A – Avoid, the goal is to completely stay away from the armed intruder

• Do NOT respond to the area of the armed intruder 
• Leave the armed intruders area
• Help visitors and patients to safe areas
• Leave the building if possible, unless involved in patient care

D – Deny Access, the goal is to keep the armed intruder moving and not finding victims

• Move into a room with a locked door
•  Lock your door, turn off lights, make no noise
• Barricade doors, make entry as difficult as possible
  • Patient care areas;
  •  Block or lock entry doors, including stairwells
  • Close patient doors
  • Stay out of hallways as much as possible
  • If possible place one person in each occupied patient room, close door and block it with everything available
• Do not come out until the all clear is announced

D – Defend, the goal is to survive a face to face encounter with an armed intruder

• If you cannot avoid or deny access, you may have few options, and may include:
  • Play dead among the other victims
  • Fight back; this is very dangerous and may be your last option
    • Use anything handy as a weapon (fire extinguisher, piece of a file cabinet, pen, letter opener, stapler etc.)
  • Follow their directions
• Make your decision based on what you think is best for the circumstances you are in.
• At this point we can only provide suggestions, you will need to do what you think is best

Personal Response to police

• The police may not know who is the armed intruder so be prepared to be treated as a suspect until things are sorted out
  •  Raise your hands, keep your hands in view
  • Do not brandish weapons when encountering police or exiting the building 
  • Ensure that you do not appear to be a threat
  • Follow directions
  • Provide as much information as possible

Hastings Location Information (SAF229.00)

Notification by observing person/employee

• Make the best decision you can as to order of notifications
• Call the hospital 402-984-4950. Inform  the operator of the Active Shooter.
• Call 911 and inform the operator of the Active Shooter.  
• Notify an Administrator, Supervisor, or Faculty member, if possible
• Provide this information:
  • When calling 911 say: “This is Mary Lanning (give location, plus area) we have an armed intruder in the building, gunshots (not) fired.”
  • When calling the hospital say: ”We have an Active Shooter in the building (provide area), gunshots (not) fired.”
  • If possible provide a description of the person(s) and their location

Announcement

• The Switchboard Operator will announce three times: “Active Shooter”  
• If you have a panic button in your area this would be a suggested time to activate it.

For those not involved in the initial or direct response:

1. Remain Calm - Think about where you are in regards to where the active shooter(s) is/are present.
2. Run - If you are not in the area where the active shooter(s) is/are and you are not involved in patient care, leave your belongings and area by finding the nearest exit and get a safe distance away from the MLH facility you are located at.
   • Bring others that are able, visitors, and colleagues if you can.
   • Do not stop to wait or allow your escape to be hindered by anyone. The shooter(s) are looking for easy targets in large groups
3. Hide
   • Find a safe location, lock the door, and place heavy objects against the door to impede progress.
   • Turn off lights and silence your cell phones to give the appearance of being in an unoccupied area.
   • Hide behind turned tables, desks, bookshelves, or anything else that might offer shelter.
     • If you are with a patient and they can get out of their bed please move them to a chair, place the bed behind the door and apply the brake.
     • If you work in a clinic, use any furniture that locks or is heavy enough to block the door.
     • Turn off the lights and any other electronic devices that make noise.
     • If you have a vocera on your person, remove the battery so as not to take the chance of messages coming through.
4. Fight - ONLY AS A LAST RESORT!
   • Find some type of improvised weapon like a fire extinguisher, a chair, or other heavy and possibly sharp objects.
   • Form a group and a plan. Commit to your actions and move those that are unable to the back or behind objects.
   • Act aggressively towards your attacker(s) and do your best to incapacitate them.
   • Once you have them down remove the weapon from their hands and leave the area.
   • Report to the first security officer or law enforcement person you find when leaving the area.
5. When law enforcement arrives they will assume command of the situation.
   • The facility will provide assistance as needed, which may include providing access badges or keys, floor plans of the area, and any live feed cameras that the facility can provide.
   • Law enforcement responding to an active shooter are trained to proceed immediately to the area in which shots were last heard in order to stop the shooting as quickly as possible.
   • The first responding officers may be in teams; they may be dressed in normal patrol uniforms, or they may be wearing external ballistic vests and Kevlar helmets or other tactical gear. The officers may be armed with rifles, shotguns, and handguns.
6. Tips to remember when law enforcement arrives at your location:
   • Remain calm and follow their instructions.
   • Put down any items in your hands.
   • Immediately raise hands and spread fingers.
     • Law enforcement is taught that hands use weapons therefore hands can kill.
   •  Avoid making quick or sudden movements toward officers such as attempting to grab or hold onto them for safety.
   • Do not stop to provide first aid to the injured. Proceed to the nearest exit.
   • Avoid pointing, screaming, or yelling.
   • Do not stop to ask them for help or directions when evacuating, simply listen to their commands and move as instructed.
7. Hospital Incident Command will establish a Unified Command with Law Enforcement and the Fire Department.
   • Location will be determined after consultation with law enforcement.
   • Law enforcement will be determined when an active shooter situation is clear.
   • Recovery will be directed by Hospital Incident Command.
   • Hospital Incident Command will work with law enforcement regarding continuity of operations as the location(s) of the incident are considered a crime scene and may not be available for patient care or staff access.
   • Hospital Incident Command will work with law enforcement regarding staff and visitor retrieval of personal items.
8. For Staff, Faculty, & Students - once you have given the all clear by law enforcement:
   • Search your area for hiding or injured persons.
   • Report to direct supervisor or staff member.