Active shooter protocols in OR?

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JobsFan said:
that is a disturbing trend worldwide.

removing guns doesn’t make us utopia, it’s just one less (major) problem.
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I dont know about world wide.. mostly just in US and Europe. I wouldn't say I'm always up to date with world news but I haven't heard much from Africa and Asia that is very different from the past
 
I was told specifically by Risk Mgmt at one facility not to fight and that I needed to save myself so I'd be able to help in event of mass injuries. Don't think I could do it though.

I'd probably still fight though. :poke:
 
GravelRider said:
I have had to take active shooter courses at two different hospitals. Both sort of encouraged patient abandonment. There is no concern for liability...unless you are the active shooter. Why lose two lives when you can possibly save at least one (your own)? Plus, you may be needed for helping in a mass casualty situation after the shooter has been neutralized. From a purely ethical/moral standpoint, the right thing to do is save yourself first. Don't you pay attention on flights when they tell you to secure your own oxygen mask first before helping others?
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Trust me. I totally believe you and buy into what the hospitals are saying. What I'm getting at is when it comes down to it, in a court room, in America, juries get real sympathetic for plantiffs which is why many suits are settled out of court. There probably in all likelihood would not be a case but if it did get to a courtroom I wouldn't feel confident as the physician.

Again, I like my idea of moving the machine in from of the door and moving the OR table in front of the machine in front of the door and buckling down in the OR.
 
Twiggidy said:
Trust me. I totally believe you and buy into what the hospitals are saying. What I'm getting at is when it comes down to it, in a court room, in America, juries get real sympathetic for plantiffs which is why many suits are settled out of court. There probably in all likelihood would not be a case but if it did get to a courtroom I wouldn't feel confident as the physician.

Again, I like my idea of moving the machine in from of the door and moving the OR table in front of the machine in front of the door and buckling down in the OR.
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Is there only one way in to your ORs? No entry/exit from the core?

Anyway, I’m sympathetic to your point, but one surefire way to avoid ending up in court is to get killed in the OR you refused to leave. Also, what if your patient is a meth head with a septic joint from IVDU? Still stickin’ around?

Jusged by 12 vs. carried by 6 and all that...I’m going home to my family.
 
Twiggidy said:
Trust me. I totally believe you and buy into what the hospitals are saying. What I'm getting at is when it comes down to it, in a court room, in America, juries get real sympathetic for plantiffs which is why many suits are settled out of court. There probably in all likelihood would not be a case but if it did get to a courtroom I wouldn't feel confident as the physician.

Again, I like my idea of moving the machine in from of the door and moving the OR table in front of the machine in front of the door and buckling down in the OR.
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Seriously dude. You would rather risk getting shot than possibly getting sued???
 
People hand you their lives daily on the consent form to me its only right that you would be willing to lay your life down protecting your patients. A honorable death is a honor of its own.
 
narcusprince said:
People hand you their lives daily on the consent form to me its only right that you would be willing to lay your life down protecting your patients. A honorable death is a honor of its own.
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Umm no. I will zealously safeguard the patient from suffering any harm related to my anesthetic. This is not that
 
NightNight said:
Is there only one way in to your ORs? No entry/exit from the core?

Anyway, I’m sympathetic to your point, but one surefire way to avoid ending up in court is to get killed in the OR you refused to leave. Also, what if your patient is a meth head with a septic joint from IVDU? Still stickin’ around?

Jusged by 12 vs. carried by 6 and all that...I’m going home to my family.
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If the shooter is saavy enough to find his way into the core because he knows I've blocked the main doors then it's likely my time to go. Patients put their lives in our hands when they go under and personally I don't think ends in a crisis. I wonder what the surgery forum would say about this scenario. Open ex lap belly and the crap goes down. Just bail with an open belly? It's one thing if I'm on OB babysitting epidurals. "Sorry ma'am. I gots to go." C-section would be interesting. There's only one door so put everything we can find in front of the door. But seriously, open belly, head, hip, etc in the OR.....i don't know man, I don't think I can peace out on a patient like that. But that's the smaill 10% of me that actually cares about his patients.
 
narcusprince said:
People hand you their lives daily on the consent form to me its only right that you would be willing to lay your life down protecting your patients. A honorable death is a honor of its own.
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Spoken like real military. I mean, that high school coach in FL could've bolted out of the school but he chose to stay and protect the kids.
 
Twiggidy said:
Spoken like real military. I mean, that high school coach in FL could've bolted out of the school but he chose to stay and protect the kids.
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I guess. But again, are you basing that decision on specific patients? You sticking around and risking your life for the meth head, or just the soccer mom?
 
NightNight said:
I guess. But again, are you basing that decision on specific patients? You sticking around and risking your life for the meth head, or just the soccer mom?
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It's definitely a moral decision. And you're right, maybe I'd say screw the meth head vs the venture capitalist's wife. Who knows? I hope I don't have to make that decision, but 90% of me says protect the patient no matter who they are. I'm sure the wife of that coach wishes he ran but that dude is considered a hero and probably for a few kids who aren't saints.
 
Twiggidy said:
Trust me. I totally believe you and buy into what the hospitals are saying. What I'm getting at is when it comes down to it, in a court room, in America, juries get real sympathetic for plantiffs which is why many suits are settled out of court. There probably in all likelihood would not be a case but if it did get to a courtroom I wouldn't feel confident as the physician.

Again, I like my idea of moving the machine in from of the door and moving the OR table in front of the machine in front of the door and buckling down in the OR.
Click to expand...

Just make sure the bullets don't hit the oxygen tanks...
 
Twiggidy said:
It's definitely a moral decision. And you're right, maybe I'd say screw the meth head vs the venture capitalist's wife. Who knows? I hope I don't have to make that decision, but 90% of me says protect the patient no matter who they are. I'm sure the wife of that coach wishes he ran but that dude is considered a hero and probably for a few kids who aren't saints.
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So you're willing to die over a boob job?
 
are you guys aware of the boiling frog?

it is so so f?$cked up that you consider this, and have a protocol ffs.

you have a serious problem with guns in your country. it’s tragic. stop minimising it. stop comparing it with other problems. wake the fu?.k up it’s crazy.
 
JobsFan said:
you have a serious problem with guns in your country. it’s tragic. stop minimising it. stop comparing it with other problems. wake the fu?.k up it’s crazy.
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To be fair, I don't even want to calculate my odds of dying in a mass shooting compared to something like cancer or hypertension or a stroke. I mean it's tragic, but it doesn't even register on the radar of public health concerns.

It's a problem, but something like distracted driving will probably kill 100x more people this year in the US.
 
Mman said:
To be fair, I don't even want to calculate my odds of dying in a mass shooting compared to something like cancer or hypertension or a stroke. I mean it's tragic, but it doesn't even register on the radar of public health concerns.

It's a problem, but something like distracted driving will probably kill 100x more people this year in the US.
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Your odds are not zero and the odds are certainly better than dying in a terrorist attack or being killed by ISIS. Your odds of dying in a tornado are pretty low, so should we just shrug off tornado preparedness?

5a860c28d0307219008b45d4-640-744.png


Source: How likely is gun violence to kill the average American? The odds may surprise you
 
JobsFan said:
are you guys aware of the boiling frog?

it is so so f?$cked up that you consider this, and have a protocol ffs.

you have a serious problem with guns in your country. it’s tragic. stop minimising it. stop comparing it with other problems. wake the fu?.k up it’s crazy.
Click to expand...

It's really not a problem. The number of people killed by random violent acts (with or without guns) is negligible. It makes for great news bits though.

Violent crime has been on an uninterrupted downward trajectory for decades.

Many other risks are far more significant.

The overwhelming majority of firearm murders are criminal vs criminal - that's not a gun problem, that's a problem of economics, poverty, and War On Drugs collateral damage.

Don't read too much into the fact that protocols and drills for this exist. We Americans wring our hands over lots of things sensible people in less excitable nations don't get worked up about.

I don't worry about random crime any more than I worry about a house fire. And by that I mean I have basic preparations for both, and that's all.

I would have thought an Aussie would be led angsty about this subject, surrounded as you are by freakishly deadly snakes, spiders, and kangaroos. 🙂
 
pgg said:
It's really not a problem. The number of people killed by random violent acts (with or without guns) is negligible. It makes for great news bits though.

Violent crime has been on an uninterrupted downward trajectory for decades.

Many other risks are far more significant.

The overwhelming majority of firearm murders are criminal vs criminal - that's not a gun problem, that's a problem of economics, poverty, and War On Drugs collateral damage.

Don't read too much into the fact that protocols and drills for this exist. We Americans wring our hands over lots of things sensible people in less excitable nations don't get worked up about.

I don't worry about random crime any more than I worry about a house fire. And by that I mean I have basic preparations for both, and that's all.

I would have thought an Aussie would be led angsty about this subject, surrounded as you are by freakishly deadly snakes, spiders, and kangaroos. 🙂
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Guys ... it is a problem ... you have protocols for what to do if you have an ‘active shooter’ in your hospital / OR ...
 
JobsFan said:
Guys ... it is a problem ... you have protocols for what to do if you have an ‘active shooter’ in your hospital / OR ...
Click to expand...
We have had 34 tornados hit schools in the last 100 years (and 50% of those were in Oklahoma) yet we still have tornado drills. My state hasn't had that happen since 1924, but we still have the drills.
 
GravelRider said:
Your odds are not zero and the odds are certainly better than dying in a terrorist attack or being killed by ISIS. Your odds of dying in a tornado are pretty low, so should we just shrug off tornado preparedness?

5a860c28d0307219008b45d4-640-744.png


Source: How likely is gun violence to kill the average American? The odds may surprise you
Click to expand...



I guess I'll put it behind my worries of chewing food and riding my bike through the neighborhood since I'm way more likely to die from either of those. Are mass shootings bad? Of course. But let's at least acknowledge the absolute rarity with which it is likely to happen to any one of us.
 
pgg said:
It's really not a problem. The number of people killed by random violent acts (with or without guns) is negligible. It makes for great news bits though.

Violent crime has been on an uninterrupted downward trajectory for decades.

Many other risks are far more significant.

The overwhelming majority of firearm murders are criminal vs criminal - that's not a gun problem, that's a problem of economics, poverty, and War On Drugs collateral damage.

Don't read too much into the fact that protocols and drills for this exist. We Americans wring our hands over lots of things sensible people in less excitable nations don't get worked up about.

I don't worry about random crime any more than I worry about a house fire. And by that I mean I have basic preparations for both, and that's all.

I would have thought an Aussie would be led angsty about this subject, surrounded as you are by freakishly deadly snakes, spiders, and kangaroos. 🙂
Click to expand...

If death by random violent acts is so negligible then why is self defense one of the reasons it's important to be able to own guns?
 
GravelRider said:
If death by random violent acts is so negligible then why is self defense one of the reasons it's important to be able to own guns?
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Same reason smoke alarms are important when the risk of death by fiery inferno is also very low.

I am glad you acknowledges that self defense is only ONE of the many reasons it's important to be able to own guns.
 
pgg said:
Same reason smoke alarms are important when the risk of death by fiery inferno is also very low.

I am glad you acknowledges that self defense is only ONE of the many reasons it's important to be able to own guns.
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What are the others?
 
GravelRider said:
What are the others?
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First would be to resist an oppressive govt

Then self defense against a random attacker

Then a bunch of reasons that are also important including “because freedom”, hunting, target shooting, because they are fun etc
 
The question is not "what are the odds of this thing happening related to other things?"

The question is, "can we get rid of these odds or make them even lower?"

Suppose you were playing Russian Roulette with a gun that had a 1 in 10M chance of killing you. Would you say, "well the odds are less than getting struck by lightning, I might as well keep doing it" or would you say "why don't I just stop playing this ******ed game?" (All numbers made up, obviously)

Strange that people in this specialty of all specialties don't understand that. (No offense @Mman, you're one of my favorite posters.)


Mman said:
I guess I'll put it behind my worries of chewing food and riding my bike through the neighborhood since I'm way more likely to die from either of those. Are mass shootings bad? Of course. But let's at least acknowledge the absolute rarity with which it is likely to happen to any one of us.
Click to expand...
 
WholeLottaGame7 said:
The question is not "what are the odds of this thing happening related to other things?"

The question is, "can we get rid of these odds or make them even lower?"
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No, that's the wrong question.

(It may feel "right" if the question is actually a deliberate lead to a particular answer you want to hear, but that's unhelpful at best and disingenuous at worst, and I'm sure you mean neither.)

A more correct question might be "How can we reduce the odds of murder with a firearm, considering the context of the individual civil right guaranteed by the 2nd Amendment of the Constitution, which may only be restricted if all three elements of strict scrutiny are met (1 compelling government interest, 2 narrowly tailored law, 3 least restrictive means possible)?"
 
WholeLottaGame7 said:
The question is not "what are the odds of this thing happening related to other things?"

The question is, "can we get rid of these odds or make them even lower?"

Suppose you were playing Russian Roulette with a gun that had a 1 in 10M chance of killing you. Would you say, "well the odds are less than getting struck by lightning, I might as well keep doing it" or would you say "why don't I just stop playing this ******ed game?" (All numbers made up, obviously)

Strange that people in this specialty of all specialties don't understand that. (No offense @Mman, you're one of my favorite posters.)
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The question becomes, will increasing restrictions actually result in improvements in the homicide rate. Since Australia enacted their fairly restrictive gun ban, their overall homicide rate has gone down approximately 37%. In roughly the same period of time, our homicide rate has gone down 45%.
 
pgg:
The overwhelming majority of firearm murders are criminal vs criminal

That's quite the value judgement, no?

HH
 
GravelRider said:
What are the others?
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Seriously?

You've posted in these threads before. I know you don't live under a rock on Mars. I know we've discussed this before. I know that you know there are a multitude of perfectly reasonable and laudable reasons to own a gun beyond self defense.

Even the most irrationally aggressive and grabbiest of gun grabbers will pay at least insincere lip service to hunting and target shooting, usually while mocking the notion of an armed citizenry being a harder target for government oppression. But they're at least AWARE that guns have uses beyond self defense.

Why are you pretending not to know about these applications?
 
Hamhock said:
pgg:
The overwhelming majority of firearm murders are criminal vs criminal

That's quite the value judgement, no?

HH
Click to expand...

Not at all. We're talking about the risk of dying from a random act of violence.

If you're not a criminal your odds are much, much lower. If we're going to rationally discuss reducing that risk, we should start with an honest admission that the risk to ordinary people is nearly zero.

That actual honest risk assessment affects the degree to which restrictions on civil rights are permissible.
 
WholeLottaGame7 said:
The question is not "what are the odds of this thing happening related to other things?"

The question is, "can we get rid of these odds or make them even lower?"
Click to expand...

To me that isn't the question I care about. Sure I'd like it be less likely for it to happen. I don't own a gun and don't play on ever buying one so I personally don't give a crap what they do with gun laws. But in the grand scheme of things I care about in my life and things that are likely to impact me in the future, it doesn't rate very highly. It's like me spending time worrying about the ability of tall buildings in San Francisco to withstand an earthquake. I'm sure it matters, just not to me very much since the odds of me ever being near San Fran during a major earthquake are pretty remote living 1000s of miles away.
 
pgg said:
Seriously?

You've posted in these threads before. I know you don't live under a rock on Mars. I know we've discussed this before. I know that you know there are a multitude of perfectly reasonable and laudable reasons to own a gun beyond self defense.

Even the most irrationally aggressive and grabbiest of gun grabbers will pay at least insincere lip service to hunting and target shooting, usually while mocking the notion of an armed citizenry being a harder target for government oppression. But they're at least AWARE that guns have uses beyond self defense.

Why are you pretending not to know about these applications?
Click to expand...

One of the reasons people buy guns is to kill another human not out of self defense, but for other reasons. It may be a relatively small number, but it is a reason that select individuals purchase guns. That reason is often left off lists of potential applications for guns. This a purely objective comment that is not meant to lean one way or another, but let's not leave it off the list for why one may want a gun.
 
pgg said:
Not at all. We're talking about the risk of dying from a random act of violence.

If you're not a criminal your odds are much, much lower. If we're going to rationally discuss reducing that risk, we should start with an honest admission that the risk to ordinary people is nearly zero.

That actual honest risk assessment affects the degree to which restrictions on civil rights are permissible.
Click to expand...

Interesting coming from an anesthesiologist. The difference between anesthesiologist directed care and unsupervised crna care is probably nearly zero, but we spend an awful lot of time and energy arguing otherwise.
 
GravelRider said:
One of the reasons people buy guns is to kill another human not out of self defense, but for other reasons. It may be a relatively small number, but it is a reason that select individuals purchase guns. That reason is often left off lists of potential applications for guns. This a purely objective comment that is not meant to lean one way or another, but let's not leave it off the list for why one may want a gun.
Click to expand...

Yes. That is an unlawful reason to buy a gun. And it's why the right can be restricted via background checks, waiting periods, court actions to prohibit individuals, to name a few, without running afoul of the Constitution.
 
GravelRider said:
Interesting coming from an anesthesiologist. The difference between anesthesiologist directed care and unsupervised crna care is probably nearly zero, but we spend an awful lot of time and energy arguing otherwise.
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I don't disagree.

I think people should be able to choose a health system that includes care directed by an anesthesiologist at cost $A or an independent CRNA at $B. Provided they are truthfully informed of the differences.
 
pgg said:
Same reason smoke alarms are important when the risk of death by fiery inferno is also very low.

I am glad you acknowledges that self defense is only ONE of the many reasons it's important to be able to own guns.
Click to expand...

I think that’s more of an insurance reason than preventing death. Just an opinion
 
ZzzPlz said:
Thunderwear? :naughty:
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You laugh, but I've used Thunderwear SmartCarry since 2009 near every day. Super deep concealment in everything from summer-time shorts to full suit and tie. Just have to get used to the... *ahem* proximity. Beware of generic brands not adequately covering the trigger guard... some anecdotes of spontaneous field ballectomy.
 
narcusprince said:
What are the chances an active shooter knows the OR better then you?
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I haven't looked up stats, but seems like lots of massacres were from inside threats or former employees/students who are familiar with the premises and layout. So I wouldn't count on a madman/madwoman's unfamiliarity with terrain.

Maybe from disgruntled family, but aren't those targeted attacks and not random massacres?
 
Physio Doc 2 Be said:
You guys think this constitutes a violation of the Oath of Geneva or the Hippocratic Oath (whichever you took) as using your knowledge to harm? I think an argument could be made that you are doing far greater good, but I could see it as being construed as a violation as well.
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IANAL, but I can't think of a legally binding "Oath" that waives your natural right (philosophical debate) or legal right (codified statute in all 50 states) to defend yourself. When presented with a deadly threat in the USA, you can use whatever implement of deadly force at your disposal, as long as you can 1) articulate and 2) authenticate (prove the veracity of your testimony) should LE and prosecutor push to charge you in court.

In the case of using spontaneous weapons from your environment, you'd have to frame your defense at all times to satisfy the Reasonable Person Test and explain how your use of force was authorized by all components of the Ability-Opportunity-Jeopardy triad being simultaneously satisfied.

But let's get real, if your MacGuyver ketamine dart successfully stops the bad guy with his boomstick and saves the day -- even if the attacker dies -- what are the chances of some whacko DA up for re-election trying to make an example out of you by making YOU the do-gooder health care professional into the bad guy? I don't think our country's that far gone. Yet.
 
GravelRider said:
Your odds are not zero and the odds are certainly better than dying in a terrorist attack or being killed by ISIS. Your odds of dying in a tornado are pretty low, so should we just shrug off tornado preparedness?

5a860c28d0307219008b45d4-640-744.png


Source: How likely is gun violence to kill the average American? The odds may surprise you
Click to expand...
The footnote in that infographic states "Gun deaths were counted as mass shootings when four or more victims were shot." This is an INCREDIBLY dishonest way to present the data and significantly overstates the frequency of active shooter scenarios. "Four or more victims were shot" (not even killed?) includes every single inner-city, gang related "business" activity in Chicago, DC, St. Louis, Baltimore, etc. just to massively pump up the figures. Safe to say most of us are nowhere near inner-city turf wars and gang rivalries.

Pro-tip: Since there's no universally accepted definition of "mass shooting," always check how it's defined.
Pro-tip: Same with seeing how "gun violence" is defined as often times suicides are lumped in with homicides/murders but then that data is pivoted in the next sentence with gun ownership figures to castigate law-abiding gun owners with criminals. It's a sneaky tactic and very easy to miss unless you know what to look for.

Edit: I spent this post on the "Mass shooting" statistic and totally missed the "1 in 315 Assault by Gun" figure. It doesn't define that at all. It wouldn't surprise me the least bit if that 1 in 315 figure included both suicides and justifiable homicides.
 
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