Skip to main content
×
×
Home

An In Situ Simulation-Based Training Approach to Active Shooter Response in the Emergency Department

  • Mark S. Mannenbach (a1), Carol J. Fahje (a1), Kharmene L. Sunga (a1) and Matthew D. Sztajnkrycer (a1)
Abstract

With an increased number of active shooter events in the United States, emergency departments are challenged to ensure preparedness for these low frequency but high stakes events. Engagement of all emergency department personnel can be very challenging due to a variety of barriers. This article describes the use of an in situ simulation training model as a component of active shooter education in one emergency department. The educational tool was intentionally developed to be multidisciplinary in planning and involvement, to avoid interference with patient care and to be completed in the true footprint of the work space of the participants. Feedback from the participants was overwhelmingly positive both in terms of added value and avoidance of creating secondary emotional or psychological stress. The specific barriers and methods to overcome implementation are outlined. Although the approach was used in only one department, the approach and lessons learned can be applied to other emergency departments in their planning and preparation. (Disaster Med Public Health Preparedness. 2018;page 1 of 8)

Copyright
Corresponding author
Correspondence and reprint requests to Mark S. Mannenbach, MD, Assistant Professor of Pediatrics, Mayo Clinic GE-GR-G410, 200 1st Street SW, Rochester MN 55905 (Mannenbach.Mark@mayo.edu).
References
Hide All
1. US Department of Homeland Security. Active shooter. How to respond. October 2008. https://www.dhs.gov/xlibrary/assets/active_shooter_booklet.pdf. Accessed December 12, 2017.
2. Blair, JP, Schweit, KW. A study of active shooter incidents, 2000-2013. Texas State University and Federal Bureau of Investigation, Washington, DC: US Department of Justice; 2014.
3. Hick, JL. At a glance: lessons learned from the Pulse nightclub shooting: an interview with staff from Orlando Regional Medical Center. ASPR TRACIE Exchange. 2016;1:2-10.
4. Keitel, A, Ringleb, M, Schwartges, I, et al. Endocrine and psychological stress responses in a simulated emergency situation. Psychoneuroendocrinology. 2011;36:98-108.
5. Kharasch, M, Aitchison, P, Pettineo, C, et al. Physiological stress responses of emergency medicine residents during an immersive medical simulation scenario. Dis Mon. 2011;57:700-705.
6. Langhan, TS, Rigby, IJ, Walker, IW, et al. Simulation-based training in critical resuscitation procedures improves residents’ competence. CJEM. 2009;11:535-539.
7. Wang, EF. Simulation and adult learning. Dis Mon. 2011;57:664-678.
8. Zigmont, JJ, Kappus, LJ, Sudikoff, SN. Theoretical foundations of learning through simulation. Semin Perinatol. 2011;35:47-51.
9. Spurr, J, Gatward, J, Joshi, N, Carley, SD. Top 10 (+1) tips to get started with in situ simulation in emergency and critical care departments. Emerg Med J. 2016;33:514-516.
10. Sorenson, JL, Lottrup, P, van der Vleuten, C, et al. Unannounced in situ simulation of obstetric emergencies: staff perceptions and organisational impact. Postgrad Med J. 2014;90:622-629.
11. Patterson, MD, Geis, GL, Falcone, RA, et al. In situ simulation: detection of safety threats and teamwork training in a high risk emergency department. BMJ Qual Saf. 2013;22:468-477.
12. Barbeito, A, Bonifacio, A, Holtschneider, M, et al. Durham Veterans Affairs Medical Center Patient Safety Center of Inquiry. In situ simulated cardiac arrest exercises to detect system vulnerabilities. Simul Healthc. 2015;10:154-162.
13. Guise, JM. Mobile in situ obstetric emergency simulation and teamwork training to improve maternal-fetal safety in hospitals. Jt Comm J Qual Patient Saf. 2010;36:443-453.
14. Paltved, C, Bjerregaard, AT, Krogh, K, et al. Designing in situ simulation in the emergency department: evaluating safety attitudes amongst physicians and nurses. Adv Simul. 2017;2:4.
15. Jacobs, LM, Burns, KJ. The Hartford Consensus: survey of the public and healthcare professionals on active shooter events in hospitals. J Am Coll Surg. 2017;225(3):435-442.
16. Jenkins, WA. EMS instructors teach scene safety. J Emerg Med Serv. 2011. http://www.jems.com/articles/print/volume-36/issue-5/training/ems-instructors-teach-scene-sa.html. Accessed August 20, 2017.
17. Wexler, B, Flamm, A. Lessons learned from an active shooter full-scale functional exercise in a newly constructed emergency department. Disaster Med Public Health Prep. 2017;11(5):522-525.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Disaster Medicine and Public Health Preparedness
  • ISSN: 1935-7893
  • EISSN: 1938-744X
  • URL: /core/journals/disaster-medicine-and-public-health-preparedness
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed