J.
Randolph Mullins, MD, FACS
Deputy, GCSO/SWAT
And other light hearted subjects
An individual who is actively engaged in
killing or attempting to kill people in a
confined and populated area
An individual who displays or overtly
threatens use of a weapon in order to gain
compliance with their demands.
The armed intruder is much more common
and much simpler to deal with.
Shootings in hospitals are statistically
uncommon
and always targeted against a specific
person
The seemingly random active shooter of
shopping malls and schools is virtually never
seen in the hospital
Annals of Emergency Medicine
Volume 60, Issue 6 , Pages 790-798.e1,
December 2012
Hospital-Based Shootings in the United States:
2000 to 2011
Using LexisNexis, Google, Netscape, PubMed,
and ScienceDirect, we searched reports for
acute care hospital shooting events in the
United States for 2000 through 2011. All
hospital-based shootings with at least 1 injured
victim were analyzed
154 shootings were identified, 59% inside the
hospital and 41% on hospital grounds with 235
injured or dead victims.
Perpetrators were men (91%) but represented
all adult age groups.
Shootings occurred in the ED (29%), parking lot
(23%) and patient rooms (19%).
Most events involved a determined shooter with a
strong motive: grudge (27%), suicide (21%),
euthanizing an ill relative (14%), and prisoner
escape (11%).
Ambient society violence (9%) and mentally
unstable patients (4%) were comparatively
infrequent.
Most common victim: the perpetrator (45%).
Hospital employees were 20% of victims;
physician (3%) and nurse (5%) victims were
relatively infrequent.
In 23% of shootings within the ED, the weapon
was a security officer's gun taken by the
perpetrator. Case fatality inside the hospital was
much lower in the ED setting (19%) than other
sites (73%).
Were unlikely to be injured by a weapon while
working in healthcare!
But, that doesnt mean it CANT happen
Nor are we always at work!
Cooperation, NOT confrontation
Attempt to escape the area!
Notify security immediately
Barricade any patients or others who cannot flee
DO NOT attempt to disarm the intruder!
Presume anything they tell you is UNtrue
Do NOT intervene in an escape attempt or assault
involving weapons
Understand they are from a culture you probably
do not know, do not understand and should not
want to be involved with
Presume the LE guarding the prisoner might have
a clue about what theyre doing
Who would do such a thing?
Why?
What do I do if Im there when he gets started?
Andrew Kehoe
--Engineer, Farmer, School Board Member
--Disgruntled over property taxes
--Quite a reputation
--Learned his farm was to be foreclosed
On May 18
th
, he got out of bed
Ate breakfast
Killed his wife
Blew up his own house
Then, he drove to town.
And triggered the explosives hed been wiring
for months.
Killing 45 people, 38 of them children
1927
In an interview this summer with the Christian
Science Monitor, Arnie Bernstein, author of
2009s Bath Massacre: Americas First School
Bombing, noted that there wasn't a media
frenzy like today. The media came in and left.
Three days after it happened, Lindbergh took
off and flew to Paris, and that part of it was
over.
social isolates who harbored feelings of hate
and anger.
very few had "previous arrests for violent
crimes
many had a significant emotional event: loss
of significant relationships, changes in financial
status, loss of a job, changes in living
arrangements, and/or feelings of humiliation
or rejection on the part of the shooter.
We know active shooters are social isolates,
With a grudge,
And a significant emotional event, usually
centered on rejection and loss,
Significantly mentally ill or a religious zealot
Perhaps the first ever useful government
video.
Run, Hide, Fight
Get out!
Know where you are!
Know how to get out of where you are.
Have a plan on how to keep going..
Improvised/environmental weapons: observe,
think, be creative.
Im going to stop and help those poor people
Ill talk the poor, misguided youth out of it
Itll never happen to me
Im going to be armed and take care of
business
Ill talk the poor, misguided youth out of it
Itll never happen to me
Ill be armed and take care of business
Do NOT pull your weapon, then run through
the building, trying to get out while waving it
LISTEN for the sirens and commands
When the police arrive, both hands should be
visible, your gun should not
Know that most active shooters self destruct
when faced with armed resistance
There is NO sign hovering over you that says
GOOD GUY
They cannot read your mind
