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Active shooter incidents

Awareness and action

doi: 10.1097/
CE Connection

GENERAL PURPOSE: To provide guidance for nurses based on INCMCE recommendations, best practices, and lessons learned from the experiences of hospitals that have navigated an active shooter incident. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing-education activity, you should be able to: 1. Describe strategies used to prepare the community and hospital response to active shooter incidents. 2. Identify the role of nursing in active shooter preparedness and response.

  1. Which of the following meets the Mother Jones criteria for a mass shooting?
    1. A man enters the home of his ex-wife, shooting her and their four children.
    2. A teenage boy shoots six people at a local sporting event and all survive.
    3. During a bank robbery, a man shoots three customers and one security guard.
  2. To support community preparedness, all nurses should be able to perform all of the following except
    1. advanced trauma skills.
    2. hemorrhage control.
    3. identification of an MCI.
  3. The INCMCE framework for nursing competencies in response to MCIs includes
    1. two phases.
    2. three phases.
    3. four phases.
  4. Prevention and preparedness involve assessment of all of the following except
    1. collaborative efforts with community leaders.
    2. postevent debriefs.
    3. risk reduction strategies.
  5. Which of the following preparedness strategies should nurses promote through education within the community?
    1. effective hemorrhage control
    2. effective triage of victims
    3. identification of potential shooters
  6. Based on the THREAT acronym, in which zone should hemorrhage control be initiated?
    1. danger
    2. not secure
    3. safe
  7. What was the goal of the American College of Surgeons in preparing the Hartford Consensus?
    1. Improve collaboration between law enforcement and EMS.
    2. Improve survivability of mass shootings.
    3. Adopt the Run, Hide, Fight approach to survival.
  8. Which statement based on the Run, Hide, Fight concept is accurate?
    1. Defend yourself as a last resort when in immediate danger.
    2. Hiding in groups maximizes survival.
    3. Once hidden, call 911 to alert law enforcement.
  9. In addition to hemorrhage, immediate medical care includes the prevention of
    1. wound contamination.
    2. hypothermia.
    3. fear and anxiety.
  10. The benefits of disaster drills include all of the following except
    1. standardization of federal and local practices.
    2. evaluation of the current disaster plan.
    3. the ability to provide experience for responders.
  11. To help ensure community preparedness, disaster drills must be
    1. mandated for all trauma units.
    2. performed monthly.
    3. taken seriously by participants.
  12. The initial goal for hospitals following a surge of mass casualty victims is to increase
    1. capacity.
    2. personnel.
    3. supplies.
  13. Command center priority strategies to increase capacity include
    1. increasing essential personnel staffing.
    2. discharging all noninvolved ED patients.
    3. transferring stable inpatients to other area hospitals.
  14. The ED is well over capacity and more victims are arriving. Which of the following creates the best option to care for incoming patients?
    1. activating an overflow area within the hospital
    2. expediting bed assignment for inpatient admissions currently in the ED
    3. diverting nondisaster patients to other EDs
  15. While working to assist in the ED, a reporter asks you for an update on the status of several victims. As a nurse, you should
    1. provide information without giving the reporter any names.
    2. direct the reporter to the designated information officer.
    3. direct the reporter to the charge nurse.
  16. Which of the following creates a communication barrier during an active shooter incident?
    1. using only dedicated phone lines
    2. establishing a staging area for family members
    3. a lack of credible information regarding the number, timing, and severity of incoming patients
  17. Which of the following is a personnel barrier during an active shooter incident?
    1. rapid credentialing of surgeons
    2. sending hospital personnel directly to the incident scene
    3. temporary personnel who are unfamiliar with the environment
  18. According to the authors, nurses working in the inpatient setting can benefit from training on which of the following lifesaving techniques?
    1. triage protocols
    2. large-bore I.V. catheter insertion
    3. hemostatic dressing usage
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