OK, so forgive me for this morbid and dreadful topic, but after after hearing a talk last week on the Aurora and Columbine shootings from an ER doctor on-scene, I had to share these lessons.
I hope you never need them. But if you do, they may save your life.
Do you know what to do in a mass casualty disaster? I’m not talking aliens, or “Iron Man”. I mean Aurora. Columbine. Oklahoma City.
As an ER doctor, I’ve received education and drills to prepare for these events, (they’re usually run by an ER physician alongside other emergency services)–and it’s a good thing, because every time we do these, I learn something new and potentially life-saving (like opening the hospital room door during the drill because I thought it was safe and coming face-to-face with the “pretend” shooter). Last week, our department had Dr Christopher Colwell, the Medical Director for the Denver Paramedic Division and Fire Department, and the ER physician on-scene at Columbine, speak to us on this topic.
While no amount of training could ever truly prepare you, this information is extremely useful for ANYONE faced with one of these situations. A key aspect is that what our intuition tells us may be wrong in these situations, so read below to protect yourself.
- If you are injured, go directly to the medical triage tent on-site, where there will be a “command center” with an ER doctor and other emergency care. They’ll check you and determine where you should go, preventing everyone from flooding one ER and delaying care. Some people with non-life-threatening injuries will be directed to different locations, even on-site tents with doctors to deliver them the most efficient and safe care.
- If you do need to go to a hospital, and have only minor injuries, try to go to one that is not in the immediate area of the event, as those closest will quickly become crowded. What often happens is the less wounded get to the nearest ER first on their own, so that by the time the severely injured are evacuated by emergency personnel, the ER is already swamped, slowing care for EVERYONE.
- Make necessary calls then GET OFF YOUR PHONE. Call 911 if they’re not aware. Call your loved ones, let them know where you are and that you’re ok, and get OFF. During these events, everyone is on their phone and it swamps the cell lines—preventing emergency services from being able to use them
- Only go where directed by emergency medical personnel. If the suspect is still on the loose, the LAST thing you want is to be somewhere that the police are looking for the suspect. Don’t end up in a sniper’s viewfinder because you wandered where you shouldn’t and happened to be dressed like the suspect.
- Beware of a “2nd hit”. Another important reason to go where directed by the medical triage tent is the risk of “second hit”—ie, a second location that was intended to also be targeted–like the suspect’s own apartment in the Aurora shootings. Emergency personnel will know which places are at higher risk of a “second hit” and will have this in mind when they are directing people.
- If you’re a physician or have medical skills, check in with medical command first to see if they can use your help.
- Don’t drive there. A major hindrance in getting victims to the hospital is the massive amount of vehicles that drive to the scene (in some cases, they had to use an army tank to literally push cars out of the way of the ambulances). Keep your car away from the scene AND from the hospital, which will be similarly crowded. If you have loved ones not in the area of the event, tell them to avoid driving to the area.
- Stay OUT of damaged buildings—medical personnel and bystanders running into damaged buildings can often become victims if there is further collapse.
- If you are in the middle of an event, be mentally aware of everything around you—exits, hiding places or other methods of protection (the Dept of Homeland Security says to find a hiding spot that protects you, while not trapping you or restricting your options when it’s time to leave, and note every detail possible about the suspect without attracting attention to yourself). Once in a drill in our emergency department, we were instructed to hide a room and close the door—but we were SO tempted to just open the door a hair and “peek” out to see if it was safe—which left me nose to nose with the person acting as the “shooter”. Do NOT open it to “see what’s going on” outside until you hear police, or you could come face to face with the attacker.
- When the officers arrive, keep your hands up and visible, and avoid making quick movements towards them. You may want to run and hug them. Don’t. Keep in mind, they still may not know who/where the shooter is.
For more information:
-DHS “How to Respond” www.alerts.si.edu/docs/DHS_ActiveShooterBook.pdf