Mass Shooting

[Bellisimo]

What would you guys suggest if there was some sort of mass shooting threatening the OR environment? Does your workplace have a plan in place for such an event? I feel like, in today's world, that we should all have some sort of plan in place if something like this were to happen.

[Rose_Queen, BSN, MSN, RN]

Do you mean a shooter within the department or a mass casualty incident?

We actually developed a plan for the first after an incident in which a non-employee found their way into the OR during an overnight trauma surgery with a gunshot wound. We never did learn whether the person was a family member as they claimed or if they were the shooter looking to finish the job. Within days, the OR became a locked unit and an active shooter code (similar to a code blue page) was developed.

For a mass casualty incident, it depends on the time of day and whether it's during the week or the weekend. If it's during day shift during the week, as scheduled cases finish, no new patients roll into the OR. Essentially, the entire OR goes into hold mode to open ORs for traumas. During off shifts and weekends, we have a disaster call list where OR management starts calling everyone who works in the OR to get additional staff in house beyond just the call staff. The first people to be called are those who live closest and are identified as immediate report staff (not forced, just get called first because they can get there the quickest). We also have a house wide mass casualty incident plan in place that provides additional staff and policies for the ER, trauma ICU, other procedural units, ancillary staff, etc.

We've actually used that plan twice while I've been working at my current job: once as a result of a multiple victim shooting (10 patients, although none ended up needing surgery or were transferred to a higher level of care) and once as a result of a school bus accident.

[RobtheORNurse]

Most ORs I visit are locked for security reasons such as this. You have to have a badge to swipe in order to open the door. Not fool proof but dramatically increases safety. My personal belief is that everyone should receive training in how to react to this type of situation. Contact your security department for concerns. They will probably have some really good training already prepared. If not, ask them if they could work with law enforcement to get this training. After training, have regular drills, just like fire drills to stay proficient. Knowledge is power.