If you hear gun shots, don’t dismiss it.

You have three choices, in descending order of efficacy.

1. Run. Your best option. Run like your life depends on it, because it does.

2. Hide. Find your best hiding place, turn off your phone, and be vewwy, vewwy quiet.

3. Fight. Experts used to suggest cooperating, but in fact, 70 percent of hostages end up dead. So you’re better off fighting.

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Knives are just as dangerous as guns. Maybe even more so, because most people are such terrible shots, they end up missing 80 to 90 percent of the time. But most people know what to do with a knife. You should take a self-defence course and practice disarming people regularly.

Don’t let down your guard. And don’t approach a patient with your stethoscope around your neck. One patient jumped up and choked a nurse with her own stethoscope. But if a patient does attack you, fight as hard as you can instead of worrying about protecting the patient.

Figure out what you’d do if someone walked through the door and started killing people. Have an action plan in place. The hospital is a prime target, because it’s full of defenceless people trapped in a building. Whatever your group decides to do, it’s best to act together, e.g. either you all run or you all fight, as a group. Probably there isn’t enough space to hide.

Would you stay behind with your patient? Would that serve a purpose, or would you all die that way? Decide in advance.

And if you’re on the receiving end of a mass casualty, have an action plan for that, too. Get a trauma surgeon involved in the triage. Decontaminate all casualties—dirty bombs can contain anything from Hepatitis-infected cadaver remains to radioactive waste. Try to use warm water to decontaminate, especially for pediatric patients. Take pictures and note identifying characteristics of the casualties so they can be united with their families as quickly as possible. You can even save the plastic shell of expired car seats to place babies in when you move them through the decontamination shower, because they’ll be slippery and difficult to hold.

Think about it. You have an average of 25 seconds to live when a active shooter enters the room. What are you going to do?

All information courtesy of an EM:RAP interview of paramedic Mike Clumpner, conducted by pediatrician Ilene Claudius. They have now released the podcast for everyone to hear. Listen to it. (https://soundcloud.com/the-captain-cortex-show/emrap-active-shooter-2015-release)

Originally published in the Medical Post