Active Shooter Incident Preparedness in the Emergency Department Topic Brief-Active Shooter Incident Preparedness in the Emergency Department Topic Brief

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Active shooter incidents (ASIs) are a significant public health concern in the United States, occurring in various settings and communities. The emergency department (ED) is particularly high-risk due to its role as the receiving area for patients with undetermined mental and physical health conditions. Between 2000 and 2013, the FBI recorded 160 ASIs, with an average of almost 17 shootings per year in hospitals between 2006 and 2011. The potential for violence in the ED is a serious public health and safety threat. <br /><br />The Department of Homeland Security defines an active shooter as an individual actively engaged in killing or attempting to kill people in a confined and populated area. There is no consensus definition for a mass shooting, but it generally refers to incidents where three or more people are killed. In hospital settings, 39 fatal shootings were reported between 2010 and 2020, with the ED being the most common site of attack. <br /><br />To prepare for ASIs, hospitals should involve local law enforcement in planning, develop a communication plan, establish processes for patient and employee safety, train and drill employees, and plan for post-event activities. The "Run-Hide-Fight" response is widely recommended for immediate response, and ongoing training for staff is essential. After an ASI, debriefings should be conducted, and mental health support should be available for those affected. <br /><br />Mitigation and preparedness strategies include education, training, and developing clear channels of communication between emergency management teams, administration, and law enforcement. Response and recovery strategies emphasize the importance of the "Run-Hide-Fight" approach, ethical decision-making, and psychological support. <br /><br />Overall, comprehensive emergency action plans that involve planning, education, training, and preparation are necessary to effectively respond to ASIs, minimize casualties, and ensure the safety of staff, patients, and the community.

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active shooter trauma

active shooter mass casualty

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Keywords

Active shooter incidents

public health concern

United States

emergency department

high-risk

violence

Department of Homeland Security

mass shooting

hospital settings

preparation strategies