Hey gang,

Happy (and safe) 4th to all.

I have a question for those of you in hospitals or other institutions/buildings frequented by the public.

In a Virginia Tech type situation, how does your business announce or handle a lockdown situation (or do they even have a plan for such).

I'm wanting ideas to approach my Emergency Management Team with for my hospital. The option of announcing a "lockdown" overhead is frowned upon for fear of inciting a panic and having more people fleeing into the line of fire.

There are a series of overhead paged codes that the facility has and has modified in order to be more in sync with the other area hospitals (make sure we're all speaking the same language), but doesn't cover that sort of incident.

We had a code page as well, and someone would trigger the fire doors. They'd close (not always locking), security would go around and manually lock doors. Pretty much, close the doors and wait for the cops. We didn't have armed guards in our hospital.

The hospital I work at has a "plan"...sort of...that works on paper. IF everything goes as planned, those not killed/wounded in the initial attack get to clean up. If anything goes wrong, those not killed hide in their units while the others bleed to death.

Sounds cynical, and it is, but I do realize that this sort of situation is a "struck by a lightning bolt while being attacked by a shark" probability event. Just about useless to plan for, save for allowing employees to legally carry the means to defend themselves, which ain't ever going to happen. At least not at my hospital...That would make too much sense.

So what's with this allowing employees business? If I feel the need, I do what I have to do. To the extent I am physically able, I try not to let the responsibility for my safety and welfare rest with others. I have a policy of "What they don't know won't get me in trouble" when it comes to discreetly carrying something with which to defend myself. Someone telling my kids it was against company policy just won't fix anything at my funeral.

I guess we all must decide at some point what is important in life. Some risks we must take in order to get by. I suppose if you chose a profession in which you are always going to face policies which put your fate into the hands of ignorant administrators, then you chose to give up the right to defend yourself while under their control in order to earn a living. Just as I took a big risk going to Iraq, or moving to New York, or heading to Orlando at the beginning of hurricane season so that I could make the big bucks that help keep both kids in college and the wife happy. So I guess I can't be too critical, as I am a sellout as well.

To me, when you say "VA Tech type situation," it conjures up a number of different possible lock down situations that could have occurred and that may apply in your case.

• Seal the building
  Seal all entrances so no one can enter or leave. For example, you know that the gunmen is outside or maybe shooting up people in the office building next to the hospital, but could be coming your way and you want to prevent them from entering the facility at all, or you want to prevent someone from going outside and possbily becoming a victim outside.
• Isolate the entire hospital into sections
  Lock down all the individual floors/wards/departments so that a gunmen can't wander through the whole facility. People in a locked down area should be safe from anyone trying to enter that area from another area. Useful when you don't know where the intruder is.
• Isolate only a particular section
  Maybe a gunmen holes up somewhere or you know where the person is, so you want to quickly lock down only that area while allowing people in surrounding areas to flee quickly.
• Lifting lock down quickly
  One thing that makes me nervous about any plan that involves locking people into an area involuntarily is what happens if people really need to get out. Say a fire breaks out during a lock down or maybe the gunmen is temporarily "stuck" in one area so that people could escape the immediate area. Any plan that relies on someone running around physically locking doors that can only be opened with a key or putting chains on makes me very nervous. Actually, come to think of it, Cho locked exits himself to keep his victims trapped.

Locking down a facility is a very complex thing to try and plan for since what seems prudent in one situation would be dangerous in others. In some emergencies, you want to keep people out, sometimes you want to keep everyone in (child abduction would be one case), sometimes you want to partition the facility but still allow some people out, etc. Good luck!

My only direct experience is with federal courthouses, nearly all of which have armed Marshalls and metal detectors at the entrances. All bags and packages are opened and examined, everyone goes through the metal detector. Some of the larger courthouses repeat this on every level as you step off the elevator. Some even do it at the entrance of every active courtroom.

A system like that creates a host of problems for a hospital, but guards and detectors at certain strategic points might be worth considering.

IMO it is more effective to keep the armed aggressor out than it is to control him once he and his weapon are already in.

Frank2135

Be it hospital, courthouse, school, whatever, an armed guard or two standing at a metal detector at the entrance will not stop, or even slow down, a group of armed badguys intent on taking the facility over. The guards will simply be the first to fall, and any innocents nearby will become hostages, to prevent any aggressive response by other guards within the facility. In my opinion it is just about impossible to keep determined badguys out of any public building. Therefore a plan must be in effect to prevent the BG's from taking over the whole building and everyone in it, limiting access to rooms and the people within. If the responding SWAT teams know that the BG's (and the original hostages) are in the hallways, their job will be a little easier. Tall order...

The codes as noted are pretty standard.

I’ve seen hospitals that can lock down areas or the entire hospital by hitting a panic button. As noted earlier it dumps the Mag hold opens on the doors and activates a lock

Usually these are set up to Isolate an area (Someone steals a baby, crazy in ED, etc) Vs keeping people out.

I sit on the EM Committee at our hospital and as others indicated earlier we have the typical overhead page codes (colors; code red, orange, yellow, etc.) and procedures indicating what we are supposed to do in each case. We do drill several of the codes, and we have activated some of them before, say for a violent individual in the emergency department.

We follow NIMS guidelines and set up the emergency command system/structure accordingly.

Greg

If you work in a facility like the hospital where my sister works, just kiss your a$$ goodbye. They probably have some kind of plan on paper, and my sister is dead-certain-sure that it has nothing to do with reality or common sense.

This place has annual "disaster drills", and the drills themselves are disasters.

They had a gas leak around the first of the year, and they refused to tell anyone what was going on, refused to call for fire/police assistance, and then lied about the whole thing when it was over.

Of course, I should talk.... I work for a Native American casino where management is even more stupid than the local hospital, if that is even humanly possible. The only advantage I have is that I work in an area with two doors and six pretty sturdy locks on the inside. OTOH, if we have a major earthquake, absolutely no one will come looking for us, because they will have forgotten that we even exist.

Sue

Thanks NH,

We have code "cheat sheets" as well that folks wear on their armbands, and since I work on a medical/psychiatric hybrid unit, I get to respond to the violent individual codes paged overhead.

In recent years, we had a hospital in the area that had one of it's nurses go in and kill his soon to be ex-wife before suiciding.

Fortunately, there were only two deaths with that incident.

I just worry that in any hospital there is this huge population of vulnerable people in a contained area and I'm wanting to have some mechanism in place for dealing with that.

I sit on the Emergency Team as a bedside nurse so I'm limited in what info I'm privy to and what effect I can have.

Also as the newbie on the team, I'm very aware of not wanting to step on too many toes in the process.

But I figured I'd stick my neck out see what info I could offer them.

My 2c....I deliver patients to hospitals all the time. I'd say about 75% of the time, the 'securtiy guards' are a joke. The few that actually have the physical ability to 'do something' are so few in number that it would be like trying to take on a mob on your own. When the ER staff are in the midst of 'hand to hand' (be it 'real H2H or just trying to put down the very strong and beligerant drunk), they are very happy to see the 'streetwise' medics who can help them as compared to the 'security team'.

If anything real DID happen in a hospital/institution.....I'd figure you are on your own. There are so many doors to be able to exit that they could never really lock them all down. Even if there were the 'electronic lockdown' capability....human (I'm too lazy) nature would have people doing things to bypass the locks for their normal everyday activities that when the real thing happened....many of the locks probably wouldn't work.....be prepared to take care of you and yours.....

That's what I like about my buddy the ER doctor. He used to be an active Seal before becoming a doctor, and is a firm believer in going to work everyday well armed, and fully capable.

He has a great, calming disposition normally. What I like is he doesn't get violent in a confrontaion. When he decides that something has to be done, he is thorough, quick, and usually pretty quiet about the whole thing, the end result being the beligerent is usually subdued and the authorities contacted to come deal with them.