Notes – High Threat Considerations/Active Shooter Scenario

High Threat Considerations/Active Shooter Scenario

Patient Safety Considerations

  1. Anticipate unique threats based on situation
  2. During high threat situations, provider safety should be considered in balancing the risks and benefits of patient treatment

Notes/Educational Pearls

Key Considerations

  1. In high threat situations, novel risk assessment should be considered. Provider and patient safety will need to be simultaneously considered
  2. During high threat situations, an integrated response with other public safety entities may be warranted
  3. Depending on the situation, a little risk may reap significant benefits to patient safety and outcome
  4. During these situations, maintaining communications and incident management concepts may be crucial to maximizing efficiency and mitigating dangers

Quality Improvement

Associated NEMSIS Protocol(s) (eProtocol.01)

None recommended

Key Documentation Elements

  • Traditional documentation may not be appropriate during Hot Zone/Direct Threat and Warm Zone/Indirect Threat care
  • Documentation of key intervention should be relayed:
    • Time of tourniquet application
    • GCS

References

  1. Callaway DW, Smith ER, Cain J, et al. The Committee for Tactical Emergency Casualty Care (C-TECC): evolution and application of TCCC guidelines to civilian high threat medicine. J Spec Oper Med. 2011;11(3):104–122.
  2. Hartford Consensus. Facs.org. https://www.facs.org/about-acs/hartford-consensus. Accessed August 22, 2017.
  3. TCCC-MP Guidelines and Curriculum. NAEMT.org. http://www.naemt.org/education/TCCC/guidelines_curriculum. Accessed August 22, 2017.
  4. TECC Guidelines. C-TECC.org. http://www.c-tecc.org/guidelines. Committee for Tactical Emergency Casualty Care. Accessed August 22, 2017.