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Active Shooter Planning for Health Care Facilities

Introduction

1. Which of the following means the capabilities necessary to eliminate or reduce the loss of life and property damage by lessening the impact of an event or emergency?

A. Prevention B. Protection C. Mitigation D. Response

Challenges

2. Which of the following statements is true with regard to health care facilities being potential targets?

A. Many health care facilities are repositories for critical research, sensitive information, radioactive materials, and other dangerous pharmaceuticals and narcotics. B. Health care facilities often sponsor activities and events that increase their vulnerability. C. It is common for major research institutions to employ prominent people and conduct research in areas such as nuclear medicine, biochemistry, and controversial general medicine procedures and practices such as stem cell and animal research. D. All of the above.

3. When an emergency occurs within a facility, HCF personnel should react immediately, providing first aid and triage safely in secure areas, notifying response partners, and providing direction through actionable information in accessible formats before first responders arrive.

A. True B. False

Active Shooter Incidents

4. Law enforcement generally applies the active shooter incident definition to situations where an individual is armed with at least one gun and has come to the area with the intent to kill people or to commit another crime.

A. True B. False

5. During an active shooter incident, the natural human reaction, even for those who are highly trained, is to:

A. Be startled B. Feel fear and anxiety C. Experience initial disbelief and denial D. All of the above

6. Nurses should be trained to do which of the following first?

A. Run B. Hide C. Fight D. None of the above

7. Each nurse carries the responsibility to do all of the following, except:

A. Learn signs of a potentially volatile situation and ways to prevent an incident. B. Learn steps to increase survival of self and others in an active shooter incident. C. Learn proper self defense techniques in the event of needing to fight. D. Be prepared to work with law enforcement during a response.

8. An effective plan should include which of the following?

A. Proactive steps, including training, that can be taken by employees to identify individuals who may be on a trajectory to commit a violent act. B. A preferred method for reporting active shooter incidents, including informing all those at the health care facility or who may be entering the health care facility. C. Lockdown procedures for individual units, offices, and buildings. D. All of the above.

9. Optimal shelter-in-place locations have at least one of the following, except:

A. Thick walls made of steel, cinder block, or brick and mortar. B. Thick windows and a view of the hallway. C. Solid doors with locks. D. First aid and emergency kits designed for hemorrhage control, communication devices, and telephones and/or duress alarms.

10. Designated "shelter in place" locations are often designed for natural hazards, such as earthquakes or tornadoes, which makes them ideal for active shooter incidents.

A. True B. False

11. While there is a sense in the popular culture that a clear warning may induce panic, research shows that people do not panic when given clear and informative warnings.

A. True B. False

12. Which of the following is not one of the observable, pre-attack behaviors that, if recognized, could lead to the disruption of a planned attack?

A. Previous arrests for violent crimes. B. Development of a personal grievance. C. Contextually inappropriate and intense interest or fascination with previous shootings or mass attacks. D. Experience of a significant real or perceived personal loss, such as a death, breakup, divorce, or loss of a job.

13. It is not uncommon for people confronted with a threat to first deny the possible danger rather than respond.

A. True B. False

14. Nurses should be trained to overcome denial and to respond immediately.

A. True B. False

15. The simple act of exiting the building and going to an evacuation site via practiced fire drill routes allows for the person(s) to remain safe, out of harm's way, and easy for emergency responders to find.

A. True B. False

16. Nurses should be trained to do all of the following, except:

A. Leave personal belongings behind. B. Use escalators or elevators for a faster escape route. C. Call 911 when safe to do so. D. Take others with them but not stay behind because others will not go.

17. Nurses should be trained to understand and expect that law enforcement's first priority must be to locate and stop the person or persons believed to be the shooter(s), and all other actions are secondary.

A. True B. False

18. Nurses should be trained to contact the police and share with them essential information, such as:

A. The location and description of attackers. B. Types of weapons. C. Methods and direction of attack. D. All of the above.

19. Once the active shooter is apprehended or incapacitated, the situation and the location will be an active crime scene, therefore, nothing should be touched unless it involves tending to the wounded.

A. True B. False

Appendix A: Information Sharing

20. The Privacy Rule includes several permissions for circumstances that may necessitate the disclosure of PHI during an emergency, including which of the following?

A. To alert law enforcement to the death of an individual when there is a suspicion that the death resulted from criminal conduct. B. To report PHI to law enforcement when required by law to do so, such as reporting gunshot or stab wounds. C. To respond to a request for PHI from law enforcement for purposes of identifying or locating a suspect, fugitive, material witness, or missing person, but the information must be limited to basic demographic and health information about the person. D. All of the above.


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