Regan Elizabeth M, Cranmer Thomas, Hanaway Timothy
Emergency Department, Advocate Christ Medical Center, Oak Lawn, Illinois, USA.
Disaster Med Public Health Prep. 2021 Nov 22;17:e63. doi: 10.1017/dmp.2021.325.
While hospital-related shootings are not common, recent years have demonstrated an increasing trend, especially involving the emergency department (ED). Despite this increase, there remains a lack of effective training for providers for active shooter events. Existing trainings commonly lack active participation, departmental-specific plans, or feasibility.
Sixty-six emergency medicine physicians, nurses, and technicians participated in a two-phased multimodal active shooter training aimed to increase response knowledge and comfort. The initial training phase included a lecture on "Run-Hide-Fight" principles with departmental adaptations, followed by scenario-based discussion, and then safety walkthrough. Months later in the second phase, participants completed an active shooter simulation. An identical knowledge survey was collected before and after each phase along with descriptive analysis. Surveys were compared using paired t-test. Comfort levels were reported on a Likert scale and compared by paired t-test.
Paired t-tests confirmed a statistically significant difference in both active shooter knowledge and comfort levels. Participants showed retention of response knowledge and comfort with implementing response behaviors. Further descriptive analysis demonstrated effective fleeing and barricading, suggesting a real-life gain of knowledge and comfort.
A two-phased, multimodal training design for active shooter response was successful in increasing ED provider active shooter knowledge, comfort, retention, and effective response behaviors.
虽然与医院相关的枪击事件并不常见，但近年来呈上升趋势，尤其是涉及急诊科（ED）的事件。尽管有所增加，但针对医疗人员应对主动射击事件仍缺乏有效的培训。现有的培训通常缺乏积极参与、部门特定计划或可行性。
66名急诊医学医生、护士和技术人员参加了一个分两阶段的多模式主动射击培训，旨在提高应对知识和舒适度。初始培训阶段包括一场关于“逃跑-躲藏-反击”原则并结合部门情况进行调整的讲座，随后进行基于场景的讨论，然后是安全演练。数月后的第二阶段，参与者完成了一次主动射击模拟。在每个阶段前后收集相同的知识调查问卷并进行描述性分析。使用配对t检验对调查问卷进行比较。舒适度通过李克特量表报告，并通过配对t检验进行比较。
配对t检验证实，在主动射击知识和舒适度方面均存在统计学上的显著差异。参与者表现出对应对知识的保留以及对实施应对行为的舒适度。进一步的描述性分析表明逃跑和设置路障行为有效，这表明在现实生活中知识和舒适度有所提升。
针对主动射击事件的两阶段、多模式培训设计成功提高了急诊科医疗人员的主动射击知识、舒适度、知识保留率以及有效的应对行为。
