Emergency Response to Weapons on Site, Active Shooter and Bomb Threats
The right message at the right time can save lives.
Mental health and recovery facilities can be dangerous places. From 2015 to 2017, health care institutions reported a 30 percent increase in violent crime, with more than 12,000 incidents, mostly directed at employees. Assaults linked to gangs, drug dealing and homelessness spill in from the streets, domestic disputes involving hospital personnel play out at work, and disruptive clients lash out. The added component that comes with drug and alcohol use and mental instability only escalates the potential. Facilities must have strong policies to react quickly to threats to keep employees and clients safe.
Emergencies and crises happen. In a crisis, affected people take in information, process information, and act on information differently than they would during non-crisis times. People or groups may exaggerate their communication responses. They may revert to more basic or instinctive fight or flight reasoning.
Effective communication with a well-understood, planned response can make the difference between life and death.
It is the responsibility of each hospital or facility to create a procedure for emergency situations. The staff should be fully trained on the expectation for response.
This course will briefly explore how facility’s approach weapons on site, active shooters and bomb threats.
WEAPON ON PREMISES
Florida Statute section 394.458 states that “except as authorized by law” it is a third degree felony for any person to bring, carry, possess, or transport a “firearm or other dangerous weapon” upon the grounds of any “hospital (or mental health facility) providing mental health services.”
As a practical matter, almost every hospital and hospital emergency room provides mental health services. This means that from a purely technical standpoint, the statute seems to prohibit firearms or weapons anywhere on its grounds.
Most hospitals or facilities employ an overhead code system to alert staff to what situation is occurring. When the code is announced overhead it alerts the staff in the event of a weapon (i.e.: gun, knife, etc.) is on the premises and posing a potential deadly threat to patients, employees, visitors, etc.
The following procedures are suggestions to be employed in the event of a threat posed by a weapon:
- Page Code (TBD) overhead clearly three (3) times with exact location.
- Call 911.
- Employees not in immediate area of danger are to calmly evacuate everyone not involved in situation from the building.
- Do not attempt to physically remove weapon from threatening party.
- Utilize verbal de-escalation techniques if appropriate.
KEEP YOURSELF AND CLIENTS SAFE UNTIL POLICE HELP ARRIVES.
Consider the following tips for your location’s weapons policy:
TIP #1: A weapon should be clearly defined in a policy. Law-enforcement officers may carry several types of weapons, from guns to batons to pepper spray.
Determine which weapons, if any, are allowed in certain parts of the facility.
TIP #2: Know your state’s weapon laws. Many states have laws that outline which weapons can be brought into certain facilities, while other states may not define hospitals or healthcare facilities as weapon-free areas. This course will discuss Florida law.
The public doesn’t necessarily understand not to bring a weapon into a hospital,
TIP #3: Your facility should consider whether to hold weapons such as guns in lock boxes or storage areas. If your hospital or facility chooses to store them, assess the liability of what that means should the gun get lost, stolen, or into the wrong hands. Employees should know what to do in this case.
TIP #4: If you forego weapon storage, develop a protocol of what to do with a weapon.
TIP #5: Make sure to have a process in place and educate law-enforcement officials about the policy/protocol.
As an employee if you are unclear on any of these ask for clarification.
A bomb threat requires specific activities to be followed to ensure the safety of all those in the building and on the premises. In addition to specific activities required by the person receiving the threat, evacuation of the building should take place. As with the weapon on site, if a facility has an overhead code system, employees should be made aware of the code for a bomb threat.
If you receive a call / information about a bomb threat, listen carefully and record answers to the following questions (use a Report Form if your facility has one readily available):
- When is it going to explode?
- Where is it right now?
- What does it look like?
- What kind of a bomb is it?
- Why did you place it here?
- Time called:_________________
- Male or Female caller: M____ F____
- Adult or Child: Adult____ Child____
- Background noises:_____________________
- Other important notes__________________
Page the code overhead and begin following procedures:
- Call 911
- Begin a search of your immediate area for any “package or device” that does not belong there or appears suspicious.
- If such a “package or device” is found, DO NOT TOUCH OR MOVE IT.
- Safely evacuate building and do not cause panic in patients or others.
For further information on the procedures for your facility please speak to human resources or your supervisor.
An active shooter is defined as “an individual actively engaged in threatening with a firearm, killing or attempting to kill people in a confined and populated area”; in many cases there is no pattern or method to their selection of victims.
In order to preserve life and address the reality of an active shooter event, these guidelines have been established to guide a response to this event to maximize survivability.
Most importantly, quickly determine the most reasonable way to protect your own life. Speak to your supervisor about your facility’s specific response protocol.
The intent of most active shooters is to kill as many people as quickly as possible. Traditional law enforcement response will include the concept of “surround and contain” in order to minimize the number of victims. In order to save lives, the law enforcement agency having jurisdiction will initiate an immediate response.
Upon discovery of an active shooter situation, as soon as possible and when safe to do so, notify law enforcement (911) and if your facility has an overhead code system provide the announcement and location.
The phone call to 911 (from the area where they are safely concealed) should provide the following information:
- Description of suspect and possible location.
- Number and types of weapons.
- Suspect’s direction of travel.
- Location and condition of any victims
Safety & Security Officers and/or the Administrator/Person in Charge should meet and guide law enforcement officers, if possible and as appropriate.
The goal of law enforcement is to locate, isolate, and neutralize the shooter as quickly as possible to prevent additional deaths or injuries.
If there is an accessible escape path, attempt to evacuate the premises.
Be sure to:
- Have an escape route and plan in mind
- Evacuate regardless of whether others agree to follow
- Leave your belongings behind
- Help others escape, if possible
- Prevent individuals from entering an area where the active shooter may be
- Keep your hands visible
- Follow the instructions of any police officers
- Do not attempt to move wounded people
- Call 911 when you are safe
If evacuation is not possible, find a place to hide.
- Direct personnel into resident rooms or other adjacent rooms, close the door and attempt to barricade the door.
Your hiding place should:
- Be out of the active shooter’s view
- Provide protection if shots are fired in your direction (i.e., locating into a resident bathroom and locking the door, stay as low to floor as possible and remain quiet and still)
- Not trap you or restrict your options for movement
To prevent an active shooter from entering your hiding place:
- Lock the door
- Blockade the door with heavy furniture
If the active shooter is nearby:
- Lock the door
- Silence your cell phone and/or pager
- Turn off any source of noise (i.e., radios, televisions)
- Hide behind large items (i.e., cabinets, desks)
- Remain quiet
If evacuation and hiding out are not possible:
- Remain calm
- Dial 911, if possible, to alert police to the active shooter’s location
- If you cannot speak, leave the line open and allow the dispatcher to listen
An “all clear” code should be announced if possible when the situation has been addressed and law enforcement officials declare the scene safe.
The health and wellbeing of patients, residents, clients and employees is critical. As soon as possible after law enforcement has relinquished Command and Control of the scene, the facility administrator and social worker will develop information strategies to address resident, employee, and family questions related to the event.
Initially, the site of a violent incident should be secured as a crime scene. After the authorities have completed their investigation and have released the scene, management will need to have the facility appropriately cleaned and sanitized.
Cleanup for the safe removal of bio-hazardous substances including blood borne pathogens must take place, yet must be sensitive compassionate, and caring for those involved in the situation.
Effective coordination with the media and timely dissemination of information can help reduce media pressure on those who are the most vulnerable. Assistance with employee benefits and other administrative issues can reduce the burden on victims and families. An administrator should be designated as the Public Information Officer who is authorized to speak on behalf of the facility to the media.
All employees involved in incident have to write an incident report and incident will be reported on IRAS as a Sentinel Event with DCF.
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