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Active Shooter Incident Planning: Emergency Plans and De-escalation

1. An active shooter incident is defined as one where an individual is actively engaged in killing or attempting to kill people in a confined and populated area.

A. True

B. False


2. Each of the following is mentioned as part of an effective plan for an active shooter incident except:

A. Having an evacuation policy and procedure in place

B. Training employees to identify people who may be on a trajectory to commit a violent act

C. Developing a method for reporting active shooter incidents and informing all those at or entering the health care facility

D. Arming key personnel at strategic locations in the health care facility

E. Providing information concerning local area emergency response agencies and hospitals, including internal contacts


3. Which statement correctly identifies observable pre-attack behavior indicators:

A. Development of a personal grievance

B. Contextually inappropriate and recent acquisition of weapons, escalation in weapons training or interest in explosives

C. Contextually inappropriate and intense interest with previous shootings or mass attacks

D. Experience of a significant real or perceived personal loss such as a death, divorce or job loss in the weeks or months leading up to the attach

E. All of the above are mentioned as observable pre-attack behaviors


4. Which of the following contradicts a mentioned training recommendation of the "Run, Hide, Fight" model in health care facility settings?

A. Train HCF employees to leave personal belongings behind and visualize physically accessible escape routes for disabled patients, avoiding escalators and elevators

B. If running is not a safe option or not possible due to (patient) mobility issues, train HCF employees to hide in a place where walls might be thicker and with few windows, locking and barricading doors

C. Train HCF employees if hiding to turn off lights, close and lock windows, close blinds or cover windows, silence electronic devices, remain silent, look for ad-hoc weapons and other avenues of escape

D. Train HCF employees not to hide along the wall closest to the exit, whether or not it is in view from the hallway, as this will increase the odds of being shot through the wall

E. Train HCF employees to try disrupting or incapacitating the shooter by using aggressive force and/or items in their environment such as chairs or fire extinguishers only as a last resort


5. Staff should be trained to understand and expect that law enforcement's first priority must be to find and evacuate those injured by the shooter(s); all other actions are secondary

A. True

B. False


6. All of the following are recommended as post-event assessment activities except: 

A. Accounting for all individuals at designated assembly points

B. Assessing the behavioral health of people at the scene and ensuring access to victim rousources, ensuring equal access to deaf, blind, hard of hearing and communication-disabled individuals

C. Notifying families of individuals affected by the active shooter - this is the sole responsibility of the Health Care Facility and should be done independent of law enforcement

D. Filling any critical personnel or operational gaps left in the organization as a result of the active shooter

E. Determining when to resume full services


7. Basic objectives of Psychological First Aid include which of the following?

A. Establishing a non-intrusive and compassionate human connection

B. Enhancing immediate and ongoing safety as well as physical and emotional comfort

C. Help survivors discuss their immediate needs and concerns, offer practical assistance addressing survivors' immediate needs and concerns

D. Connect survivors to social support networks as soon as possible

E. All are basic objectives of Psychological First Aid


8. HIPAA privacy rule includes which of the following "permissions" for disclosure of personal health information (PHI) during an emergency?

A. PHI can be reported to law enforcement to prevent or lessen a serious and imminent threat to the health or safety of an individual or the public

B. PHI can be rported to law enforcement that a 'covered entity' believes in good faith to be evidence of a crime that occurred on the premises

C. PHI can be reported to law enforcement when required by law to do so, such as reporting gunshots or stab wounds or for purposes of identifying or locating a suspect, fugitive, material witness or missing person

D. PHI can be released to comply with a court order or warrant, a subpoena, or summons issued by a judicial officer, or an administrative request from a law enforcement official

E. Each of the above is a permission granted by HIPAA privacy rule


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