EM:RAP Emergency Medicine: Reviews and Perspectives

2013  ›  December Episode

Active Shooter

Ilene gets the scoop from Mike about how to deal with active shooters. Also, some great tips for dealing with mass casulaties and reducing PTSD related to decon in peds patients. Run! Hide! Fight!

Contributors

  • Ilene Claudius, MD
  • Mike Clumpner

Comments on Active Shooter

Jennifer M.

Wow!! Sure makes me nervous to listen to this and work in a hospital that sees a lot of prisoners. Thanks for sharing!!!
I am going on trauma in 2 weeks. Is it recommended all GSW patients be undergo decontamination or only those from mass casualties? Thanks!!

James W., M.D.

Within last week I had elderly patient flown in. Had hand in pocket entire time. He tried to pull out small semi automatic pistol out of his pocket with full clip and round in chamber. Nurse caught his hand as he was pulling it out of his pocket. As I was making weapon safe with my back turned to him he then proceeds to pull large pocket knife. Fortunately my partner noticed and grabbed his hand first.

Sean G., M.D.

I began training in Brazilian Jiu Jitsu several years ago as a result of my decision to work the overnight shifts in smaller ED's. In 17 years of EM I have only had two jobs, but my security guards have typically been a 70+ year old retired sheriff of a small town. At Temple and Drexel in Philly where I did Med School and Residency we had a veritable police force of armed security and I felt quite protected. I would highly recommend self defense training for any ED doc. Since I have trained in BJJ I have used the training at work twice, each time disabling an aggressive patient without leaving a mark, and sending a very clear message to the aggressor that aggression is a bad idea.

James O'S.

I'm a resident at Newark Beth Israel and earlier this year we were thrown into some high fidelity scenarios staged on a military base here in New Jersey. The site was a mock up of a small town designed to simulate an urban environment for SWAT team and military training. As we began to work up some cases in our mock ED, the sound of gunfire interrupted us. We barred doors with beds, tried to come up with a quick plan and generally tried to get a handle on the confusion. One of the residents jumped out a window and split, another actually tried to wrestle the gun from the shooter's hands! It's hard to imagine the impact of the noise a machine gun firing in a small space has on your ability to think clearly. After our ears stopped ringing we engaged in a second scenario where an armed group forced entry to our ED and took hostages of those of us who didn't make the exit. An ex-NYPD hostage negotiator couldn't talk them down so the building was stormed by a SWAT team, firing over our heads at the hostage takers as we huddled on the ground. We went home after but in real life the stats say some of us wouldn't. We learnt the need to plan ahead of time and to make for any available exit as fast as possible when it starts. Dr Joe Kotora and Dr Mark Merlin from our EMS/Disaster Medicine Fellowship put the day together, along with other parnters from the police and military. It was a great experience and the podcast reminded me of some important issues from that day. Thanks for raising the topic guys, be safe.

Pierre M., M.D.

I was horrified listening to this segment. As a Canadian, these ideas are foreign. The most horrific part of it is the acceptance by Americans of a society that endorses gun ownership by its citizens. "It's not guns that kill people, it's other people". Really? I'm pretty sure it's the guns that kill the people. It's shameful.

Robert H.

Good section, I was wondering if Mel et al would be willing to post an MP3 where I can refer colleauges/staff to or even download so they can hear it to. I think this is important and more so important for hospitals that are small and feel security is a luxury they cannot afford. Many even go so far as to have a "hands off" policy for situations and don't back up employees when this happens. Real eye opener, THANKS!

John W.

Robert, don't you mean an MP5? This small submachine gun will deal to the most determined 'active shooter' as well as being a great way of clearing a crowded waiting room!

Greg L.

Great information. Hard to listen to. Not because of the content, but the audio quality. Is there anything you can do to clean up the audio before publishing it.

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