If you observe an armed intruder(s) inside or outside the facility, notify the PBX Operator or 911 if outside the facility.

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1 If you observe an armed intruder(s) inside or outside the facility, notify the PBX Operator or 911 if outside the facility. Communicate the following information: Exact location of the assailant Direction assailant is headed Number of assailants Description of assailant(s) and type of weapon Approximate number of persons being held or in the danger area Number of individuals who may be hurt or wounded and type of injuries, if known Armed Intruder & Active Assailant Policy The PBX Operator will ensure an overhead page of the facilities emergency code for an Active Assailant and announce via the PA system 3 times.

2 The Administrator on call will activate the Hospital Incident Command System (HICS) and assume the role of Incident Commander. The IC should determine the safest location for the Hospital Command Center (HCC) and notify the PBX Operator of the HCC location and phone extension. The Chief Executive Officer (CEO) should be notified by the House Supervisor or AOC.

3 RUN: If not actively involved with direct patient care and if there is an accessible escape path, attempt to evacuate the building. Be sure to: Have an escape route and plan in mind. RUN: If actively involved in direct patient care, discontinue care as soon as patient safety would allow and follow the steps below. Take the patient with you, if possible. If unable to safely or easily evacuate the patient with you, reassure the patient, close the door behind you and lock or barricade, if possible. Evacuate regardless of whether others agree to follow. Leave your belongings behind. Help others escape with you, if possible, including patients that are easily mobile, but do not allow the hesitation of others to delay your evacuation Prevent individuals from entering an area where the active assailant may be located. Keep your hands raised and visible. Follow the instructions of any police officers. Do not attempt to move wounded people. Do not re-enter until given the all clear.

4 HIDE: If unable to safely discontinue active participation in direct patient care (i.e. surgical or invasive procedure), or evacuation is not possible (i.e. shooter s location obstructs exit or is unknown) find a place to hide or shelter in place, where the active assailant is less likely to find you. Be sure to: Seal off the area. Lock doors if possible. Blockade the door with heavy furniture. Turn out the lights. Silence your cell phone and/or pager. Close any blinds. Turn off any source of noise, if possible. Identify any items that could be used, as a weapon, if you need to fight. Remain quiet. Listen for overhead announcements and follow instructions. Stay sheltered in place until released by ALL CLEAR announcement or directed by police. Do not respond to fire alarms unless you see or smell smoke. Do not respond to Code Blue announcement/page.

5 FIGHT: If evacuation or hiding/sheltering in place are not possible or if the active assailant is likely to find you. Be sure to: Improvise weapons, such as a fire extinguisher, IV poles, or chairs or throw items. Act as aggressively as possible against the assailant. Commit to your actions with the intent of incapacitating or disrupting the assailant. Scream loudly. Remember, the strength in numbers approach has been shown to be effective.

6 If you are taken HOSTAGE, follow these basic survival tips: Remain calm. Treat the captor(s) with respect. Be prepared to wait. Make no unnecessary movements that might cause the individual to harm you or others. Discard anything that may label you as a person of importance or someone the captor(s) may fear. Do not speak unless you are specifically addressed or questioned. Do not volunteer information or make suggestions. Do not attempt to negotiate with the captor(s). Cooperate and follow instructions.

7 When Law Enforcement arrive: Remain calm and follow officers instructions. Officers may shout commands and push individuals to the ground for their safety. Raise hands, spread fingers and keep them visible at all times. Avoid making quick movements toward officers such as attempting to hold on to them for safety. Avoid pointing, screaming or yelling. Do not stop to ask officers for help or direction when evacuating, just proceed in the direction from which officers are entering the area.

8 All persons actually involved or witnessing the incident should remain available to talk to Law Enforcement. Ensure that injured/wounded are cared for. An Incident Debriefing and/or After Action Review will be completed. Offer Employee Assistance Program (EAP), or Psychological First Aid Restore facility to normal operations. Complete Damage Assessment and Repair. Cleanup. Complete any necessary reports.

9 KNOW YOUR HOSPITAL S POLICY AND BE PREPARED TO Maintain a constant awareness of your surroundings including: Questionable behavior triggering a safety concern Awareness of at least 2 exits Rooms which could easily be lock or barricaded Items in the environment that could be use as a weapon to fight, if needed, as a last resort Talk to your leadership, colleagues and conduct practice drills. RUN HIDE FIGHT

10 This concludes this educational activity. Please complete the post test. RUN HIDE FIGHT

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