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CODE SILVER: Plan for hospital active shooter event

The typical response time for police to arrive on the scene of an active shooter event is 5 to 7 minutes after the first shots are fired.  Hospitals should think through these crucial first minutes and train staff in passive and active countermeasures before law enforcement arrives.  Passive countermeasures include identification of sanctuary protect-in-place rooms that can be secured.  Employees should also be trained on active countermeasures that can be taken if a shooter enters the room.  This pragmatic article discusses these possible countermeasures.

Where Do Hospital Shootings Occur?

  • 29 percent in the emergency department
  • 23 percent in the parking lot
  • 19 percent in patient rooms

What is a “Zero Incidents Philosophy”?

In a companion article (Sawyer, 2015), the components of violence prevention are itemized, including warning signs.  This zero incidents plan includes a proactive domestic violence component.


Putnam, J., and Losefsky, W. (2015). The first five to seven minutes! Journal of Healthcare Protection Management, 31(2), 10-14; and, Sawyer, J.R. (2015). How to avoid having to “run-hide-fight.” Journal of Healthcare Protection Management, 31(2), 15-22.  This journal has a website, but articles are not directly for sale on it: http://www.iahss.org/?page=Journal  Posted by AHA Resource Center (312) 422-2003, rc@aha.org

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