Hospital shootings: What to do when disaster strikes

With more than 150 shootings at hospitals across the United States from 2000 to 2011--30 percent of those in emergency departments--the threat to patients and staff safety is real. At an April symposium at Johns Hopkins, experts examined ways to prepare for an active shooter situation, according to a MedPage Today article.

When prevention fails, there are ways hospitals staff can protect themselves, their colleagues and their patients, said Matthew Levy, D.O., senior medical officer at the Johns Hopkins center of law enforcement medicine, who broke situations down into three zones--hot, warm and cold.

The hot zone means there a direct threat to life, in which case staff must quickly assess the situation by asking a series of questions, including "how close is the shooter?" and "should staff shelter in place?"

Sometimes the only option is to stand your ground and commit to disabling the shooter, George Economas, senior director of security at Johns Hopkins Medical Institution, told MedPage Today. 

In the warm zone, patient well-being is a priority, and care providers must work to stabilize and remove patients from the area. In the cold zone, staff should stay put and await instructions, even if the shooting stops, listening for an "all clear" call from police. 

As much of hospital violence occurs in EDs, Nurses should constantly scan the environment for mounting patient frustration associated with long ED wait times, intoxication and drug-seeking behavior, FierceHealthcare previously reported. Controlled access, managing the number of bedside visitors, panic buttons and bulletproof glass are some environmental interventions that can keep staff safe as well. Staff should consider flagging files of patients who were violent in the past. 

To learn more:
- check out the symposium announcement
- read the hospital shooting study
- here's the article