1. Health Care, Education and Research Active Shooter Defense Actions you can take to save lives Patrick J. Hoy March 2015

2. Health Care, Education and Research Active Shooter Defense Training Goals Explore the mindset of the typical Active Shooter Share lessons learned / similarities from previous Active Shooter incidents Discuss tactics to employ against an Active Shooter Help you develop your individual plan of action!!

3. Health Care, Education and Research Active Shooter Definition The Department of Homeland Security defines an Active Shooter as: “An individual actively engaged in killing or attempting to kill people in a confined and populated area.” School / College / University Mall / Open Business / Church Theater / Entertainment Venue Hospital / Health Care Facility

4. Health Care, Education and Research Types of Previous Shooter Events Mercy killing - Ending terminal illness and suffering Loss of emotional control – Violence borne out of family grief / receiving bad news Gang violence overflowing into the Emergency Room Targeted killing – Revenge Active Shooter scenario – Random killing Combination of Targeted killing & Active Shooter - “Going Postal”

5. Health Care, Education and Research Mentality of the Active Shooter He has a desire is to kill without concern for his safety or threat of capture May have intended victims and will search them out Accepts targets of opportunity while searching for - or after finding - his intended victims Will continue to move about the building, randomly engaging targets until stopped by law enforcement or commits suicide

6. Health Care, Education and Research Similarities In Previous Active Shooter Incidents Work places and schools were the norms - disgruntled / fired workers, angry / vengeful students The shooter was acting out of rage, vengeance and / or mental disorder Many were well-planned, using multiple guns, excessive ammunition and some included IEDs Most incidents were perpetrated by one individual - 98% were male The shooter planned to move about, randomly shooting as many victims as possible, as quickly as possible

7. Health Care, Education and Research Similarities In Previous Active Shooter Incidents (Cont.) In 74% of the 2013 Active Shooter incidents, the shooter entered via the main entrance The majority of shooters were “insiders” – They were known by their victims Most “insiders” broadcast their attack in advance on their websites or other social media – “The thrill of the thought” Clue of potential problems - Unhappy individuals frequently discussing (even threatening) violence The shooter did not expect to survive the incident; most plan suicide or dying in a hail of police gunfire

8. Health Care, Education and Research Active Shooter Video On YouTube – “Run, Hide, Fight” Produced by the City of Houston, TX Grant funded from the Department of Homeland Security Excellent training and awareness video http://www.youtube.com/watch?v=5mzI_5aj4Vs&list=PLUr a6uw6CXK9SNLZeddcLIufDY5OfnMpU

9. Health Care, Education and Research Run, Hide, Fight Run Use out-of-the-way hallways and staircases Go out fire exits on the first floor Take others with you Go out the building and get a block away Call 911 when you are safe

10. Health Care, Education and Research Run, Hide, Fight Hide Find the rooms in your work area having locking doors Determine which doors will accommodate wheelchairs Take a flashlight Turn out the lights Quiet your cellphones Be quiet and calm

11. Health Care, Education and Research Sandy Hook School Floor Plan

12. Health Care, Education and Research Run, Hide, Fight Fight Attempt to incapacitate / distract / delay the shooter Act with physical aggression Improvise weapons Organize as a team Commit to your actions Take the shooter down!

13. Health Care, Education and Research Active Shooter Defense Tactics Break his concentration; make him duck Throw things at him (books, binders, coffee cups, a pot of hot coffee) Distract him from others closer to him If you are a safe distance, yell at him to distract him from closer targets Make him become defensive Organize as a team Attack him from multiple directions Overwhelm him with many objects thrown at him simultaneously Anything you can do to momentarily stop his shooting will create time for others and you to flee

14. Health Care, Education and Research Active Shooter Defense – Your Best Weapon A Fire Extinguisher Can be employed from a distance by aiming and “shooting” the agent Halon gas or dry chemical, makes no difference; both will disable him Aim for his face, don’t hold back!! May be able to dissuade him from coming into your area

15. Health Care, Education and Research Active Shooter Defense Tactics If possible, observe the type of weapon he is using: Assault Rifle Shooter Advantages - Many bullets, rapid fire, accurate, penetrates wooden doors Victim Advantages – Must be aimed, time to reload, two-handed operation Semi-Automatic Handgun Shooter Advantages – Many bullets, rapid fire, penetrates wooden doors Victim Advantages – Must be aimed, time to reload, accuracy degrades with increasing distance to the target, possibility of a bullet jam, the safety must be off Revolver Shooter Advantages – Fast, reliable operation, penetrates wooden doors Victim Advantages – Limited number of shots, very slow reloading Shotgun Shooter Advantages – Point and shoot, high killing power Victim Advantages – Limited magazine, very slow reloading, two-handed operation

16. Health Care, Education and Research The Three Phases of an Active Shooter Incident Phase I – The shooter is active and moving about looking for victims / targets Phase II – The Police arrive and begin looking for the shooter; weapons drawn and ready to fire Phase III – The Police begin evacuating the building and sorting out the events and individuals

17. Health Care, Education and Research Active Shooter Characteristics to Look For Bulky, Bulgy clothing out of character with the weather / environment Backpack or handbag that looks heavy and / or overloaded Cargo pants, especially if the pockets appear “stuffed” full Long, narrow packages that could conceal a rifle or shotgun Focused and determined facial expressions; like he is on a mission Weapons visible and carried in shoulder holsters or waist holsters

18. Health Care, Education and Research A Final Thought We may not be armed (no guns allowed on Billings Clinic property), … … but, we are not defenseless, … … if we plan ahead and know what to do if it happens here. Your actions can make a difference for your safety and survival

19. Health Care, Education and Research Active Shooter Defense Now, go be vigilant and ready! Questions? March 2015