Hostname: page-component-7dd5485656-6kn8j Total loading time: 0 Render date: 2025-10-31T05:06:42.243Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  11 May 2018

Mark S. Mannenbach ,
Carol J. Fahje ,
Kharmene L. Sunga  and
Matthew D. Sztajnkrycer
Mark S. Mannenbach*
Affiliation:
Department of Emergency Medicine, Mayo Clinic, Rochester, MN
Carol J. Fahje
Affiliation:
Department of Emergency Medicine, Mayo Clinic, Rochester, MN
Kharmene L. Sunga
Affiliation:
Department of Emergency Medicine, Mayo Clinic, Rochester, MN
Matthew D. Sztajnkrycer
Affiliation:
Department of Emergency Medicine, Mayo Clinic, Rochester, MN
*
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).
Get access Rights & Permissions [Opens in a new window]

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. 2019;13:345–352)

Keywords

active shooteremergency departmentin situpreparednesssimulation

Information

Type
Concepts in Disaster Medicine
Information
Disaster Medicine and Public Health Preparedness , Volume 13 , Issue 2 , April 2019 , pp. 345 - 352
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

REFERENCES

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.Google Scholar
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.Google Scholar
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.Google Scholar
4. Keitel, A, Ringleb, M, Schwartges, I, et al. Endocrine and psychological stress responses in a simulated emergency situation. Psychoneuroendocrinology. 2011;36:98-108.Google Scholar
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.Google Scholar
6. Langhan, TS, Rigby, IJ, Walker, IW, et al. Simulation-based training in critical resuscitation procedures improves residents’ competence. CJEM. 2009;11:535-539.Google Scholar
7. Wang, EF. Simulation and adult learning. Dis Mon. 2011;57:664-678.Google Scholar
8. Zigmont, JJ, Kappus, LJ, Sudikoff, SN. Theoretical foundations of learning through simulation. Semin Perinatol. 2011;35:47-51.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar