Emergency Response: Active Shooter Training Tips

Emergency Response: Active Shooter Training Tips

Like many first responders, professionals in the medical field face the possibility of encountering an active shooter. It is important for providers to stay up-to-date on the recommended emergency response protocols for managing the event of an active shooter for the safety of staff, patients and potential passersby. Below, we’ll cover the three basic procedures for handling an active shooter situation as well as comprehensive list of resources for providers seeking additional emergency response training.

What is an Active Shooter?

Per the Department of Homeland Security’s Active Shooter Response manual, an active shooter is any individual actively engaged in the attempted killing of persons in a populated space. While most response guidelines are tailored to hostile intruders possessing a firearm or firearms, many response tactics are equally applicable to assailants with handheld weapons, tools or any other object capable of inflicting serious harm to another. In the majority of cases, active shooter scenarios are unexpected, occur and/or escalate quickly and often end within minutes.

While it is difficult to anticipate the occurrence of an active shooter scenario, by remembering several basic guidelines, a provider has the ability to substantially decrease the risk of harm.

Basic Guidelines: Evacuate, Shelter, Protect

  1. Evacuate

The first priority for a provider responding to an active shooter scenario is evacuation. It is important for staff on-site to periodically receive refresher training regarding emergency exits, escape paths or alternative routes of egress for staff and patients if a designated route is obstructed or otherwise unable to be used. Providers should be able to identify a specific escape route and, if applicable, alternative routes prior to a potential emergency scenario.

While providers should exercise care to inform patients or anyone who is a passersby of designated escape routes in an emergency scenario, it is vital that staff prioritize evacuation regardless of whether some people agree to follow. Additionally, providers should under no circumstance attempt to place themselves in a dangerous situation or increased risk of harm to reach and/or assist another person.

In an evacuation, leave all personal belongings behind, attempt to assist others if possible and safe to do so and contact 911 or emergency personnel as soon as possible. Do not attempt to move wounded people if evacuation to a safe location has not been achieved. Follow all instructions of any law enforcement officers or emergency personnel.

  1. Shelter

If evacuation to a safe location is not possible, find a place to hide where an assailant is less likely to find you. An ideal shelter location should be out of the assailant’s view and provide protection from potential weapons (for example, a room with a locked door, utility space or similar location with adequate protection from projectiles). Spaces with lockable doors are preferred; if this is not possible, a door may be barred with furniture. A proper shelter should not be extremely small or tight, but should allow the evacuee adequate room to move and react. When a suitable shelter has been located and secured as much as possible, ensure any evacuee(s) present remain still, quiet and mute any personal devices that could attract the assailant’s attention.

If it is safe to do so, attempt to assist others who may have difficulty entering or securing a shelter such as children, injured or the elderly. Do not attempt to move any incapacitated person or provide medical assistance unless you have completed an evacuation off the premises or have secured a shelter that is locked, safe and away from the assailant.

  1. Protect

If neither evacuation nor shelter are achievable, providers should be prepared for the possibility of disrupting or incapacitating the assailant. Note that attempting to fight an assailant is to be used only as a last resort and only when your life is in immediate danger.

If you must attempt to incapacitate the assailant, act as quickly and aggressively as possible. Throwing items or improvising weapons from nearby objects, yelling and, if applicable, acting in concerted effort with another person or person(s) are more likely to result in incapacitation of the assailant. If possible, attempt to separate the assailant’s weapon from the assailant.

If the assailant appears disabled or otherwise incapacitated, proceed to evacuation as quickly as possible: do not attempt to check on the assailant. If you encounter police or emergency personnel, put down any items or objects you may be holding, keep your hands visible at all times and follow all instructions given by emergency personnel.

Additional Resources:

In addition to the DHS Active Shooter Response Manual, DHS maintains a database of additional training materials, emergency planning documents such as booklets and posters and various templates for designing emergency response protocols.

DHS also offers several interactive and visual training aids, including a brief video detailing proper emergency response protocols.

  • FEMA Emergency Management Institute Interactive Course

FEMA offers an interactive web-based course featuring active shooter response training for non-law enforcement employees. Upon completion of the course, participants will learn which actions to take when confronted with an active shooter, recognize potential workplace violence indicators, how to prevent and prepare for potential active shooter incidents and how to properly manage the potential consequences of an active shooter incident.

  • Federal Bureau of Investigation: Run. Hide. Fight.

The FBI offers a comprehensive video series instructing participants in proper application of active shooter response protocols as well as several supplemental resources for emergency preparedness training. The videos and resources can be found here.

  • CHA Hospital Preparedness Program: Active Shooters

Provided by the federal hospital preparedness grant program, CHA offers ongoing support to California hospitals and health systems in disaster planning. Medical professionals can find active shooter response materials oriented towards provider facilities at CHA’s Active Shooter Response page.

  • University of Rochester: NY State Health Emergency Preparedness Coalition

The University of Rochester Medical Campus provides a comprehensive database of active shooter response training materials for use by medical professionals.


Experiencing an active shooter scenario is a possibility no provider wants to encounter. However, by staying up-to-date on the recommended response guidelines issued by public authorities, providing comprehensive training to staff and providers and ensuring your facility’s emergency scenario protocols are simple, clear and widely available, providers have the power to minimize the risk of harm to any employee, patient or bystander in the event of an emergency.

Advantage Healthcare Consulting, a division of Advantage Administration, can provide resources to help your practice learn the proper ways to respond to an emergency situation. As a Management Services Organization (MSO), we have providers in our member network that offer training and consulting at reduced rates for our members. If you’d like to learn more about enabling your staff to properly respond to the unexpected, contact us  to find out what resources are available.