What pediatricians need to know about active shooter incidents

Although they are still rare events, active shooter incidents—incidents in which a person is killing or attempting to kill people in a confined and populated area—are on the rise in the U.S., noted Adam Czynski, DO, during an OMED presentation Saturday, citing data from the Federal Bureau of Investigation.

Pediatricians would be well-served to educate themselves in the following areas regarding active shooter scenarios, Dr. Czynski noted:

• How to spot signs that their patients—or someone they know—might become violent and actions to take.
• How to respond if an active shooter attacks their practice or hospital.

Working with patients

Dr. Czynski recommended pediatricians ask their patients the following questions to try to uncover warnings that violence might occur:

• At school, have you heard of anyone who joked about bringing a gun to school or hurting people?
• Have you ever wanted to get revenge against someone?
• Do you have a gun in the house? (Note: In Florida, physicians are legally barred from asking patients about guns.)
• Is there anything that happens at school that bothers you on a daily basis?
• If a person has a problem at school, does the school take it seriously? If something bothered you, who could you tell that would take you seriously?

“It’s about asking questions to start a conversation,” Dr. Czynski said. “It’s not about accusing every person who comes in the office of being the next shooter. It’s about trying to find the link or the person who might know someone who’s at risk.”

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For this reason, pediatricians should ask patients which teacher or school employee is a trusted confidante; this person may be able to provide more information if a patient mentions an incident or warning sign.

Equally important is taking action when necessary, Dr. Czynski said, noting that school shooters often act out in part because they feel like no one is listening to them or helping them. This could mean, if a patient reports being bullied by a particular classmate, speaking to school administrators—with the patient’s permission—and encouraging them to rectify the problem.

If an active shooter attacks your hospital

Active shooters sometimes target hospitals or health care facilities, often because they are unhappy with the care that a family member received. Hospitals and clinics should conduct active shooter drills to train staff to be as prepared as possible, Dr. Czynski said.

In an active shooter scenario, people have three choices: To run, to hide or to fight the attacker.

Dr. Czynski implemented active shooter training at the Loma Linda University Children’s Hospital, where he works. Before the drills, nearly all participants say that if they were facing an active shooter, they would run. But after the drills, nearly all of them report that they hid instead. When he asked participants about this, many of them reported that they were frozen in fear.

Others express hesitation to run, viewing it as a cowardly act, Dr. Czynski noted. But runners are more likely to survive the attack than those who hide, and if one person runs, others will likely follow him or her.

“If the thought of running away and leaving people behind who might need help strikes you as a cowardly act, know that you will probably save more people by giving them the strength and the motivation to follow you,” he said.