SCPS Public Safety Webinar 02 | Mandala Collections

Hello everyone and welcome to the University of Virginia's Masters of

Public Safety program webinar series on Active Shooter Incidents in the

Healthcare setting. This webinar is brought to you by the School of

Continuing and Professional studies. The title of this webinar is Active Shooter

Incidents in the Healthcare Setting: Operational Considerations for First

Responders. I'm Meghan Stepanek and I'll be your presenter today. This is the

second of three webinars; we hope you take a look at each one to see the full

scope of the content. In the first we discussed collaborative planning for

active shooter incidents in healthcare facilities, including the requirements

applicable to response stakeholders, coordination of crisis communications,

and training. In the second webinar we will discuss operational considerations

for first responders including what they need to know about the healthcare

context. In the third webinar we'll discuss operational considerations for

healthcare facility responders. At the conclusion of this session learners will

be able to: 1. discuss what Public Safety Agency responders need to know

for interactions with healthcare entities in response to active shooter

incidents. 2. Identify healthcare operational considerations for Public

Safety responders, and 3. discuss the potential safety and health hazards

particular to healthcare facility response and the related training and

personal protective or PPE needs. Our first segment is what public safety

agency responders need to know about interactions with healthcare entities in

response to active shooter incidents. Health care entities utilize healthcare

or Hospital incident command system otherwise known as the HICS structure

HICS aligns with the general incident command system or ICS structure that

first response agencies also use as discussed in the first webinar. Most

healthcare entities are now required to have all hazards emergency plans that

include communications, planning,training, and testing, especially in larger

jurisdictions. It may not be feasible for pre-planning to fully inform law

enforcement and other first responders about the detail on

health care facility Public Safety. Responders will need to request

particular information from health care contacts at the time of the incident to

ensure operational decisions are informed by patient care and employee

safety concerns, and that necessary surveillance and intelligence

information is shared. Intelligence information provided by HICS

representatives may reveal information to law enforcement about the facility as

a potential target, and/or help an investigation of the incident. Public

safety response agencies, including law enforcement, EMS, and fire service will

need to interact with facility specific security and/or Police Force personnel

which include contracted security. Some campus areas may even have contract fire

and EMS units. Many facilities work closely with local and state health

departments for public health emergency planning. This established relationship

with public health officials could be leveraged for liaison functions and

other incident coordination aspects. Our second segment is identifying health

care operational considerations for public safety responders in the study of

hospital policies. Detailed instructions for staff to consider in this step of

evacuation were left out, the rationale was attributed to the well known

expectation of caregivers to protect their patients. Many health care

facilities, especially hospitals, have special patient care units and patient

populations. As noted in a study by researchers Jacobs and Burns, part of

what makes hospitals different from other places where an active shooter may

occur, is the vulnerability of patients. For some even minutes left unattended by

medical personnel could, and most likely, mean death. Patients might not be able to

flee to safety or to understand commands because of their medical conditions, the

procedures they've had, or treatments they're receiving. For example some

patients may have difficulty following law enforcement's verbal orders for them

to raise their hands. First responders should be aware of the many specialized

treatment areas within different facilities. In some instances patients

may be safer when sheltered in place instead of evacuating. Examples of

specialized areas within healthcare facilities include operating units with

surgical procedures underway, intensive care units, and burn units with patients

that may be sedated, intubated, and on ventilators. Dialysis units with patients

connected to treatment machines, bariatric patients with extreme obesity

who may require special lifting equipment to move, psychiatric units with

patients that may not follow commands and if unaccompanied could pose a danger

to themselves or others, and pediatric units with patients that may or may not

be accompanied by parents and caregivers. In addition to the health care workers,

other patient populations of particular concern are detainees and prisoners.

These incarcerated individuals transported to health care facility for

care are a flight risk and compose a danger to themselves or others. While

these individuals may legitimately need medical attention,

some might seek out health care specifically for the purpose of

attempting to escape, or to delay or avoid detention in her correction

facility. Balancing needs for the detainee's patient care with the risk they

pose to the facility requires close coordination between law enforcement

accompanying the detainee, hospital security and clinical staff. The

authority for maintaining the security of the patient is important to clarify. A

sufficient level of protection for guarding of the patient is needed in

all phases of care so that the detainees does not have the opportunity to

overpower Guard personnel. The care setting where the inmate is held must

also be controlled to prevent weaponization of objects or equipment.

Past incidents exemplify the danger posed by inmates at healthcare

facilities. In 2017 an inmate receiving treatment as a patient at North Western

medicine Delmore Hospital in Illinois was unshackled by a corrections officer

guarding him in order for the inmate to use the bathroom. The inmate then

overpowered the officers, stole his gun, took healthcare staff hostage, and raped

a nurse. In 2006 a prisoner taken to Montgomery

County Regional Hospital in Virginia overpowered a deputy, stole his gun, and

killed an unarmed hospital security guard before escaping and fatally

shooting a sheriff's deputy. While the inmate is at risk of perpetrating a

crime within the facility, they are also at risk of seizing any opportunity from

a disruption that occurs to escape and inflict harm to others. Our final segment

is discussing the potential safety and health hazards particular to healthcare

facility response, and related personal protective equipment or PPE needs. Health

care facilities have unique hazard and safety considerations for first

responders. Many facilities, such as academic hospitals, may have research

laboratories. Research conducted inside these facilities can include bio hazards.

The degree of hazard of the biological agent is classified by numbered level

and indicates what PPE is required for safe entry into the workspace. Healthcare

facility representatives can be key sources of information to identify these

hazards and related precautions. Most healthcare facilities also rely on

medical gases, especially oxygen, in patient treatment areas. Medical gases

may be in cylinders or tanks at the patient's bedside, or in other spaces

such as operating rooms. Gases may also be piped in through the walls of the

facility and connected to larger supply tanks. Examples of other common gases

used in healthcare facilities include nitrous oxide, nitrogen, and carbon

dioxide. The containers should also be clearly labeled. The label numbers can be

quickly referenced using the US Department of Transportation

Emergency Response Guidebook, or ERG. The ERG is a reference that all local hazmat

and Fire Service responders typically carry in their response vehicles. The ERG

can be used to determine immediate actions needed for fires, spills, and

leaks. It also includes information on the selection of the appropriate level

of PPE, as well as first aid measures. Hospitals and other health care

facilities may have magnetic resonance imaging,

or MRI machines,that can pose risks to responders. The powerful magnetic field

around MRI machines has the potential of pulling in firearms in, even accidentally

discharging them. They can also pull in other objects including responders who

may be wearing metallic gear such as firefighters. Most MRI magnetic fields

are continuously on and only turned off by quenching the magnet - a process that

can take several minutes, and requires a trained technician. Magnetic fields

cannot be seen or felt so it's important responders work closely with

representatives from the healthcare facility to know before making entry. The

active shooter or shooters can also introduce special hazards to the

incident response by use of incendiary or explosive devices to cause confusion

and greater harm. Improvised explosive devices, or IEDs, are sometimes used to

include chemicals enhanced with various materials that when detonated can cause

severe injuries and destruction to the facility. Even if not detonated the

identification of an IED on the scene of an active shooter incident can

complicate the response because of the need for special unit involvement such

as a bomb squad. While not all hazards presented at an

incident can be known in advance, pre-planning, training, and exercise can

help first responders become familiar with some of the known hazards before

they're called on to the scene during an incident.

The references shown on these slides were utilized in developing the content

for this webinar. These sources include those from government, healthcare

academia, nongovernmental organizations, industry publications, and news media. We

hope this session will spark your interest in the University of Virginia's

Master of Public Safety program. We encourage you to take a look at the

website to find out more about the learning opportunities and the resources

available through the program and the UVA School of Continuing and Professional

Studies

Mandala Collections Audio-Video

Explore SCPS Public Safety Webinar 02

Rating

Video Overview

Mandala Collections Audio-Video

Rating

Video Overview

Related A/V Titles

Details

People

Availability & Access

Technical Metadata