Fed Program Initiates Life-Saving Training for Shootings, Terror Attacks

The length of time victims wounded in school shootings and terror attacks must wait for help from an EMT could be minutes or hours—during which time they could bleed to death. This has happened in a number of cases, including a shooting at an Orlando nightclub in June, when a woman bled to death while waiting for help to arrive.

These incidents have prompted the Department of Homeland Security’s Stop the Bleed campaign, a nationwide initiative to empower individuals to act quickly and save lives in emergency situations. Bystanders are asked to take simple steps to keep an injured person alive until medical care is available. Security guards, custodians, teachers and administrators are being trained at schools and other places to administer first aid until help arrives.


Stony Brook University Hospital’s trauma center is spearheading training for school districts and colleges across the country. According to the Associated Press:

At a recent training session, paramedics and doctors brought in fake body parts—blood spurting from the wounds—to show staffers of a Long Island school district how to tie tourniquets and pack open wounds with whatever they have.

“Seconds matter. It really can be minutes when you can lose your life,” said Dr. James Vosswinkel, the chief of trauma and emergency surgery at Stony Brook University Hospital, who led the training.

Doctors emphasized that in the critical seconds after an attack it’s important for teachers and other school staff to stay calm and begin assessing injuries. Teachers learned to apply tourniquets in case a student is shot in the arms or legs—using T-shirts or belts, if necessary—and to stick anything they can to pack wounds in the torso.

Stony Brook doctors have reached out to local schools to offer the training, but are looking to expand the program as part of a federal Department of Homeland Security initiative to other schools, colleges and police departments across the country.

“Nobody should die from preventable hemorrhage,” Vosswinkel said.

Active Shooter Preparations Lagging, Study Finds

Between 2014 and 2015, the United States experienced nearly six times as many active shooter incidents as it did between 2000 and 2001, according to the FBI. The report, Active Shooter Preparedness by Everbridge, found that even though U.S. companies are overwhelmingly concerned about violence and violent acts in the workplace, they remain unprepared.

Out of 888 organizations surveyed about their safety plans and ability to manage an active shooter situation, only 21% felt that they were prepared; and 79% said their organizations were at best somewhat prepared for an active shooter incident. Even among those who feel they are prepared, only 7% are “very much prepared,” Everbridge said.

Preparedness is important, as companies cannot rely solely on police and other government assistance. According to an FBI study of active shooter events between 2000 and 2013, 60% ended before the police arrived. Adequate preparedness requires communication and practice plans to make sure responders know who is at risk and that people know what to do if an event happens.

Despite this, close to 40% of respondents said they did not have a communications plan in place for active shooter events.
Plan 2

The survey also found that executives of organizations are much more concerned about employee or student safety than they were two years ago—the overwhelming majority (79%) said they were.
Chart 3

Other Findings:

  • 69% of respondents view an active shooter incident as a potential top threat to their company or organization. Workplace violence was cited as a top threat by 62%.
  • Communicating to people who may be in an impacted building and confirming their safety was seen as the biggest challenge during an active shooter situation (71% of respondents).
  • Safety concerns are growing: 79% of executives/leaders are more concerned about employee or student safety than they were two years ago; 73% said that employees or students are willing to exchange some aspects of privacy for enhanced security.
  • 61% do not run any active shooter preparedness drills at all.

Another Reminder About Emergency Planning for an Active Shooter

Washington Post shooting calendarYesterday, Dec. 2, 2015, marked the 336th day of the year and 355th mass shooting, according to the Mass Shooting Tracker, which logs incidents in which four or more people are shot. Indeed, there were two mass shootings yesterday: a smaller incident in Georgia in which a woman was killed and three men injured, and the slaughter of at least 14 people and injury of 17 at an office holiday party at San Bernadino’s Inland Regional Center, which provides social services to residents with developmental disabilities. No motive has been found thus far, but two shooters have been identified as a county employee who had attended the party and his wife.

As I wrote in the November issue of Risk Management magazine, researchers from the Harvard School of Public Health and Northeastern University found that the rate of mass shootings has tripled since 2011. According to a study released last year by the Federal Bureau of Investigation, active shooter incidents, where police arrive to a shooting in progress, are also on the rise. The FBI found that 160 of these incidents had taken place in the United States between 2000 and 2013, 70% of which occurred in either a business or educational environment. An average of 11.4 incidents occurred annually, averaging 6.4 in the first seven years studied, and 16.4 in the last seven years.

With the growing frequency and ever-increasing fatalities, risk managers clearly cannot afford to become so inured to these incidents. Rather, much like they do for other forms of crisis, from fires to tornadoes, they need to be acting now to train employees, develop emergency plans, and ensure business continuity provisions are in place.

“You have smart people leading organizations who know they need to do something, but you see them fall into a pattern of planning to have a plan, and they confuse that with taking action on the issue,” said Jay Hart, director of the Force Training Institute. “Planning to have a plan is not a plan. They need to understand that this is a leadership issue, because it is about protecting the people in the company.”

For tips on preparing for an active shooter incident, check out the Q&A with Hart from the December issue of Risk Management, and “Preparing for an Active Shooter Incident,” from the November issue. When developing a plan to respond to an active shooter crisis, make sure to:RM11.15_ff_shoot_side.630

Minimizing the Dangers for Hospital Nurses

Nurses in Emergency Room

In “Bad Medicine,” from the December issue of Risk Management magazine, Alan H. Rosenstein wrote about managing the risk of disruptive behaviors in health care settings, which he defined as “any inappropriate behavior, confrontation or conflict, ranging from verbal abuse to physical or sexual harassment, that can negatively impact patient care.” More than half of respondents in one survey felt these events led to medical errors and compromises in patient safety and quality of care, Rosenstein reported.

But the risks nurses face do not just come from within the staff—simply doing their jobs presents a minefield of potential danger to physical and mental health. According to the Occupational Safety and Health Administration, those who work in nursing are the most likely to face violence on the job. Over 54% of emergency room nurses report experiencing physical violence or or verbal abuse on the job, of whom 41% report they have been punched or slapped at work and almost 28% report being pushed, shoved or thrown. Nearly 98% of physically violent incidents against nurses are perpetrated by patients, who are also responsible for 92.3% of verbal abuse in the health care setting.

Check out the infographic below for more details on the risks nurses face, and some preventative best practices to minimize risk for hospital workers:
The Dark Side of Nursing
Source: TopRNtoBSN.com