How Prepared Are You for an Active Shooter at Work?

If an Active Shooter Situation can happen in Midland-0dessa, TX, it can happen anywhere!   Midland and Odessa are connected cities and the recent site of random, senseless shooting deaths and injuries by one perpetrator.  The two cities have a population total of 326,730 and approximately 959 hospital beds.  These cities are much like most of America. The nearest level 1 trauma center is 117 miles away in Lubbock, TX.

Do you think your city or town is safer from this type of crime?  Probably not!  In the first 8 months of 2019 there were 297 mass shootings in the US, killing 335 people and wounding 1,219 people.  Only 7 occurred at schools or universities and 2 at places of worship.  There is no completely safe place, however, you don’t have be unprepared.

What can be done to ensure visitor, staff and patient safety, should an active shooter event occur at YOUR hospital?

First, let’s define what the term “active shooter” is and give some statistics.  According to the Federal Bureau of Investigation (FBI), an “active shooter” is one or more individuals that are “actively engaged in killing or attempting to kill people in a confined and populated area”.


  • An average of 11.4 incidents occurred annually.
  • An average of 6.4 incidents occurred in the first 7 years studied, and an average of 16.4 occurred in the last 7 years.
  • 70.0% of the incidents occurred in either a commerce/business or educational environment.
  • 10 Shootings occurred in 40 of 50 states and the District of Columbia.
  • 60.0% of the incidents ended before police arrived.


Active shooter events in a healthcare setting present unique challenges: a potentially large vulnerable patient population, hazardous materials, locked units, special challenges (such as weapons and MRI machines), and caregivers who can respond to treat victims.  From 2000 to 2011 there were 154 hospital-related shootings and since 2010 an additional 7 events. [1]  The one major problem with active shooter events in a healthcare facility is that there are potentially hundreds or thousands of patients every day in many different departments.  Prevention and planning pose its own unique challenges due to each facility’s differences in size, location, type of care, security measures, and law enforcement availability.  There is definitely not a one size fits all plan of prevention and action.

Moreover, hospitals have many entrances and exits, and this makes planning for an active shooter incident very complex.  Further adding to the complexity of an active shooter is the fact that most events occur without any hindsight and end quickly; often before law enforcement even arrives.  Thus, during the initial phase of an active shooter at a health care facility, intervention by bystanders, hospital personnel, and other civilians may be necessary if one is going to develop a preventive plan.

No matter the differences from one setting to the next there is a common set of principles.  The first of these principles should seek to maximize the protection of life.  Evacuate if possible and facilitate law enforcements response.  Another core principle is that individuals must assess the situation and make decisions based on their assessment in how best to maximize the protection of life and what tactics to employ.  Another important principle to include in your planning is that caregivers have a duty to care for patients, staff training will be key for this principle.  Creating a plan should include input from several stakeholders ranging from executive leadership, legal, nursing, security, facility engineering, human resources, emergency management and local law enforcement.  For more information about active shooters and planning check out our live CE event on 10/19, Run, Fight, Hide – Active Shooter Protocols.  This event can be attended n Houston at our corporate office or online via webinar.


8502 Tybor Dr.
Houston, TX 77074



Kelen GD, Catlett CL, Kubit JG, Hsieh YH. Hospital-based shootings in the United States: 2000 to 2011. Ann Emerg Med. 2012 Dec;60(6):790-798.e1.


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