Active Shooter Preparation & Training“It’s NOT A Shot In the Dark”May 30, 2009

Who We Are Claudia Witcher, RN, BS, LHRM, CCRAssistant Director, Medical & HealthAdministration Terry Wheeler, BS, MS-IRM, CISSPTechnology & Facilities Manager

Where we come from

Why we took a proactive role University Health Services has a high exposureprofile on campus, due to the nature of our closeinteraction with students and patients. 1 year after Virginia Tech, there was still nopolicy or procedure in place across our campusaddressing how to respond to such a crisis.

Partial List of fatal shootings onUS campuses in recent years—AUG. 1, 1966: Charles Whitman points a rifle from the observation deck of theUniversity of Texas at Austin’s tower and begins shooting in a homicidal rampagethat goes on for 96 minutes. Sixteen people are killed, 31 wounded.—MAY 4, 1970: Four students were killed and nine wounded by National Guardtroops called in to quell anti-war protests on the campus of Kent State Universityin Ohio.—NOV. 1, 1991: Gang Lu, 28, a graduate student in Physics from China,reportedly upset because he was passed over for an academic honor, opens firein two buildings on the University of Iowa campus. Five University of Iowaemployees killed, including four members of the Physics Department, and twoothers wounded. The student fatally shoots himself.

Partial List of fatal shootings onUS campuses in recent years—AUG.15, 1996: Fredrick Martin Davidson, 36, a graduate Engineering studentat San Diego State, is defending his thesis before a faculty committee when hepulls out a handgun and kills three professors.— APR 20, 1999: Two teenagers, Eric Harris and Dylan Klebold, open fire ontheir classmates at Columbine High School in Littleton, Colorado. 12 studentsand 1 teacher were killed before the teenagers committed suicide.

Partial List of fatal shootings onUS campuses in recent years— JAN. 16, 2002: Graduate student Peter Odighizuwa, 42, recently dismissedfrom Virginia's Appalachian School of Law, returns to campus and kills the dean,a professor and a student before being tackled by students. The attack alsowounds three female students.—OCT. 28, 2002: failing University of Arizona Nursing College student and GulfWar veteran Robert Flores, 40, walks into an instructor’s office and fatally shootsher. A few minutes later, armed with five guns, he enters one of his Nursingclassrooms and kills two more of his instructors before fatally shooting himself.— MAY 9, 2003: A 62-year-old man with two handguns and a bulletproof vestfires hundreds of rounds during a seven-hour shooting spree and standoff at aCase Western Reserve University building in Cleveland. One student is killedand two others are wounded. Biswanath Halder, who authorities say was upsetbecause he believed a student hacked into his website, is later sentenced to lifein prison.

Partial List of fatal shootings onUS campuses in recent years—SEPT. 2, 2006: Douglas W. Pennington, 49, kills himself and his two sonsduring a visit to the campus of Shepherd University in Shepherdstown, WestVirginia.—APR. 16, 2007: Cho Seung-Hui, 23, kills 2 people in a dorm, and 30 moretwo hours later in a classroom building at Virginia Tech in Blacksburg, VA,then kills himself in the deadliest mass shooting in modern US history. 15others were wounded.— FEB 8, 2008: Latina Williams, a 23 year old nursing student, opens fireduring an emergency medical technology class at Louisiana TechnicalCollege in Baton Rouge, killing Karsheika Graves and Taneshia Butler. Shethen kills herself.

Partial List of fatal shootings onUS campuses in recent years— FEB 14, 2008: Stephen Kazmierczak, a former graduate student at NorthernIllinois University in Dekalb opens fire in a lecture hall, killing five studentsand wounding 17 others. He then commits suicide.

Learning Objectives Understand / define the term “active shooter.” List necessary measures that can be employedto reduce the effectiveness of an active shooter. Understand Law Enforcement Response. Understand the key components of a lockdownpolicy.

The Active Shooter Defined An armed suspect orassailant who has useddeadly force on otherpersons and continuesto do so while havingunrestricted access toadditional victims. Threat is not containedand there is immediaterisk of death or injury.

Active Shooter Considered thegreatest terroristthreat on campuses. You need to beinformed of lawenforcementresponse plans soyou can takeprotective measures.

Mentality of Active Shooter Desire to kill without concern for their safety orthreat of capture. Normally has intended victims, and will searchthem out. Accepts targets of opportunity while searchingfor or after finding intended targets.

Mentality of Active Shooter Will continue to move throughout building orarea until stopped by law enforcement, suicide,or other intervention. This has necessitated a change in tactics by lawenforcement (Immediate Action RapidDeployment or Quick Action Deployment).

Shooters Intentions / Goals:To Kill and InjureLosses can be mitigated with communitypreparedness training and response duringactual event.

Considerations Unlike public school systems, University facilitiesdo not feature:Intercoms in classrooms / buildingsOne centralized administrative officeVisitor access points (open campus)Dense campus facility (large area)Immediate Campus wide EmergencyNotification System

Campus Mitigation Campus Protective Posture:Early Warning / Notification System?Campus training involvement?Building construction?Established escape routes?Identification / location of safe rooms?

Facility Mitigation Building / departmental Lockdown Policydevelopment:Well thought out?Multi-disciplinary approach?Simple / understandable?Practiced / rehearsed?Funded AND endorsed?

Law Enforcement Mitigation

Law Enforcement Mitigation Campus Police Training Status:Campus SWAT Team?Campus training involvement?Number of officers on shift / available? External Law Enforcement:Collective training with Campus Police?Nearest station / sub-station?Command / Control integration?

Law Enforcement Response

Law Enforcement Response Law Enforcement’s mission is to locate, containand stop the shooter. Once officers are at the scene and determinethat violence is actually, currently occurring, theyenter the building. They will not wait for a SWATteam. The shooter will generally not flee when lawenforcement enters the building. Respondingofficers become “new” targets.

Law Enforcement Response Remember, theshooters main goal isnot escape, but ratherto kill as many peopleas possible.

Law Enforcement Response Injured persons Initial responding officerswill not treat the injured orbegin evacuation until thethreat is neutralized. You may need to explainthis to others in anattempt to calm them. Fire / Rescue will respondas soon as it is safe to doso.

Law Enforcement Response Evacuation - when area is secure. Safety corridors will be established. This may betime consuming. You will be searched. You will be escorted out of the building by armedpolice officers. Follow their instructions at alltimes.

The Investigation The entire area will be treated as a crimescene. Once you evacuate, you will not bepermitted to retrieve items or access the crimescene. After evacuation you will be taken to a holdingarea for medical care, interviewing,counseling, etc.

Your Response Your actions willinfluence others. Stay Calm. Render 1st Aid untilhelp arrives. Assure others thatyou and the police areworking to protectthem.

Lockdown Policy Policy / Procedure Development Goals:Facility / site securityStaff, student, visitor safetyProactive – NOT ReactiveReduce staff anxietyTested and Re-tested: Effective & Efficient

Lockdown PolicyDefinition:“an emergency protocol to protect peopleinside your facility from a dangerous external orinternal event.”

Lockdown ProcedureEnables staff, students, visitors, and patients toquickly move to multiple safe locations in thebuilding and shelter in place until the threat hasbeen removed or resolved.

Lockdown FrameworkImmediate isolation protected posture.Lockable door – behind cover.History shows that when intruders come to alocked door, they keep moving – taking the pathof least resistance to locate unlocked doors orwindows where they can see people inside.

TriggersThere two types of events that might trigger alockdown: An external unsafe activity, condition, or eventon campus. An internal IMMEDIATE event or threat.

External Lockdown EventExternal Events:Bomb Threat (not in current building)Bio / Chemical Hazard / Bio TerrorismArmed Intruder on campus OR ExternalShooting Event (unresolved)

External Lockdown ResponseInitiated by Outside Entity: UniversityAdministration / Law EnforcementBarrier security – secure all exterior doorsimmediately.All staff, visitors, patients to move immediatelyaway from windows.Complete all in-progress patient care.Shut down elevator / secure internal doors.Move to safe areas or designated Safe Rooms.Length of time in lockdown posture: HOURS?

Internal Lockdown EventInternal Events:Staff have active view of intruder with weaponor explosive device.Shots fired.Robbery or hostage situation.

Internal Lockdown ResponseImmediate responseSecure first line barrier doorsGather patients / visitorsQuickly move to and secure Safe RoomsOpen lockdown packetCheck in (radio) with Operations CenterMaintain quiet & order; establish calm demeanorLength of time in Lockdown posture: 20 - 30minutes maximum

Initiation of Internal Lockdown1) When the trigger event occurs, observing partywill initiate the lockdown by broadcasting“LOCKDOWN LOCKDOWN LOCKDOWN” on2-way radios; both on Channel 2, and again onChannel 1.On completion, 2-way radios switched toChannel 1 and monitored.

Initiation of Lockdown2) Observing party (or designated staff member)will call Campus Police @ “123-4567” ASAP.This may or may not be the designated “911”number; depending on the nature of theemergency, 911 may be overwhelmed (ringbusy).Report details of incident / event.

What to Report? Your Name & Phone Number. Specific Location of incident or event:Building Name Room Number Injuries:Number of People InjuredTypes of injuries Additional details, such as

What to Report? Suspect InformationSpecific locationNumber of suspectsRace and GenderClothing color and stylePhysical featuresType of weaponsBackpack Do you recognize the shooter?What’s their name?

Initiation of Lockdown3) It is essential that each staff member andSupervisor assess their local areas for threats.IF SAFE LOCALLY, all Pods and departmentswill lock their 1st barrier doors immediately, andthen quickly move to Safe Room.IF NOT SAFE LOCALLY, immediately move todesignated Safe Room OR seek immediatecover / protection.

Initiation of Lockdown4) Move all staff, visitors, and patients toidentified Safe Room.Safe Room considerations:* must be immediately accessible.* large enough to contain functional groups ofstaff, visitors, and patients.* no windows; no exterior walls.* preferably “room within a suite” to give 2-deepbarrier locking doors.

1st Floor

2nd Floor

3rd Floor

Safe Room Shepherd Each Safe Room has primary and backupmembers designated as “Shepherds”. Shepherd is last person “in” Safe Room, andacts as the door gatekeeper. Ensure doorway access remains unobstructed.

Safe Room ShepherdResponsibilities Get your flock into the Safe Room & secure thedoor. Silence all cell phones. Remove envelope from lockdown package &review the authentication code word or phrase. Ensure 2-way radio is present, operating, andon channel 1. Take headcount by name – staff, patients,visitors. Quietly respond to command center by 2-wayradio when requested. Maintain calm and order.

During the Lockdown Ignore all door knocks or fire alarms. Ignore all verbal commands from outside yourSafe Room unless authentication code word /phrase is delivered by authorized administrativestaff. The authentication code word / phrase must beunique to your organization and available – oursis located in a dedicated envelope in thelockdown kit. A known administrative staff member will cometo each Safe Room and give the authenticationword or phrase and announce code clear whenthe danger has resolved.

Debriefing In an actual event, the Environment of Carecommittee will conduct a Health Centerdebriefing after release from Law Enforcement. Goals: help staff explore and manage strongemotions; take action against demeaning oraggressive attitudes, words, or behavior; monitorand settle emerging conflicts; correctmisinformation; make corrective actions in theplan as needed; connect staff to availableresources or support groups (NOVA, EAP, orother activities).

Drills Purpose: to familiarize occupants of the buildingwith the process, signals, and lockdownprocedures, and authentication for all clear whenan emergency occurs. Authority to call drills: Director, Medical Director,Chair-EOC. All persons in building must take part in a drill.

Responsibility of Administration Full charge of organizing and conducting drills inthe Health Center. Capability and familiarity to secure all buildingexits in a lock down event. Establish and operate incident command center.

Unsecured Areas If you find yourself trapped in an open area,immediately seek protection. Put a physical barrier between you and thesuspect. Consider “concealment” (can’t be seen)versus “cover” (protection). Consider your options:Escape or shelter in place.

Lock Down Packet Contents 1 large zip lock bag1 pen1 flashlightCover sheet – UCF Health Center LockdownSignage – Health Center is under LockdownLock Down PolicyLock Down Checklist / Attendance FormsHealth Center Phone List

Lock Down Packet Contents Green & Red Paper (to be used to identify injurystate of building to outside law enforcementobservation). Only in Admin (3rd Floor) and IT(2nd Floor) with exterior window placement. Envelope with “all clear” code phrase /codeword. List of staff member cell numbers. List of Administration staff who can give “allclear”.

Train and train some more In April 2008, the UCF Police Dept conducted a“near” off campus training exercise for 1stresponding groups of officers to an “activeshooter” scenario. Full instrumentation – video and military gradelaser engagement system / monitors. Empty 2 story multi-roomed office building. Armed shooter roaming building, targetingindividuals and targets of opportunity. Faculty, Staff, and students played the victimroles.

Health Center Training Lockdown Training for Staff – 4 Sessions(mandatory attendance) April 2008 3x Tabletop Sessions (May-June 2008) Active Shooter Drill – July 18,2008 Next Drill – Summer 2009

Active Shooter Drill Health Center closed for 2 hours for staffmeeting. Upper Administration & Campus Police advisedof drill. Many staff members experienced unexpectedlevels of anxiety. From start to finish (all clear) approximately 1215 minutes. Outdoor signage personnel at entrances. Full after action review / debriefing.

Drill – Lessons Learned No time to lock stairwell / external doors.Size of some Safe Rooms too small.Pathways / escape routes found not secure.Safe Room packets / procedures too “noisy” andflashlight problems.Safe Rooms were not quiet.Some Pod doors found unsecured.Police cancelled participation at last minute.Staff requesting additional training & drills.Policy / Plan requires revision(s).

Summary Active Shooter – take a leadership role. Follow Lockdown protocol – triggers, notify, report,secure, shelter, safeguard, authenticate all-clear. Calm, reassure, and quiet others; treat injureduntil aid arrives. Law enforcement will respond; their mission is toneutralize the threat. Evacuation – follow Law Enforcement commands. Follow up - medical care, interview, counseling. Drill – evaluate, refine, practice, repeat.

Our EOC Committee Sr. Nurse – ChairInformation Technology ManagerMedical DirectorPharmacy ManagerBuilding ManagerSenior Appointments StaffOffice ManagerProviderPatient AdvocateWellness – Sr. Training Specialist

Closing Comments We can not predict the origin of the next threat. Assailants in some recent incidents across thecountry were not students or employees. Victims are often unaware they were targets,until attacked. There are no “Cookie Cutter” plans – eachbuilding and campus is unique.

Questions ?Discussion /Comments / Suggestions ?

Contact Information Claudia Witcher, RN, BS, LHRM, CCRAssistant Director, Medical & Health AdministrationUniversity of Central Florida Health Services4000 Central Florida Blvd, Bldg 127, Suite 309MOrlando, FL [email protected] Terry Wheeler, BS, MS-IRM, CISSPTechnology & Facilities ManagerUniversity of Central Florida Health Services4000 Central Florida Blvd, Bldg 127, Suite 202EOrlando, FL [email protected]

Active Shooter Preparation & Training . Barrier security - secure all exterior doors immediately. All staff, visitors, patients to move immediately away from windows. Complete all in-progress patient care. Shut down elevator / secure internal doors. Move to safe areas or designated Safe Rooms.