After the events of the last week, there is nothing else I can write about for my scary topic. My normal writing style won’t fit this serious topic, so let’s get right to important information we should know, balanced with pictures to remind us how it should be!

Imagine Peace Tower

Imagine Peace Tower in Iceland. Photo by Jonas Freydal Thorsteinsson.

First Some Facts

There is so much posted on this topic – be careful believing what you read! I checked original sources as much as possible, looking for strict definitions and statistical analysis, but I encourage you to do your own research.

Mother Jones tracked mass murder active shooting events from 1982 on. According to their Guide to Mass Shootings in America, there were at least 62 mass murder events in the United States in the last 30 years. They use a FBI definition for mass murder as someone who kills at least 4 people in a single incident, primarily in a single place – not to be confused with a serial murderer killing in separate incidents and locations. Half the active shooter cases occurred at schools or the workplace. Malls, military bases, and restaurants were other common locations. More than three-quarters of the guns were legally obtained and most were semi-automatic handguns and assault rifles. Most shooters used more than one weapon. Mother Jones has good summaries of the main shooting events of the past, gathered on one site.

Police Analysis

The New York Police Department did a detailed statistical analysis of active shooters from 1966-2010, with 202 cases meeting Homeland Security’s definition of an active shooter as “an individual actively engaged in killing or attempting to kill people in a confined and populated area”. Notice no mention about the number of victims – in fact, the median number of people killed was only two, as was the median number injured. Their findings were otherwise similar to Mother Jones, although NYPD felt classifying weapon type was too difficult. Only 8 out of 202 had a female attacker, and 98% had only one shooter. The age of the shooter depended on the location – school shootings tend to have young adult shooters, whereas middle age shooters are most common at other sites. There was a wide degree of tactical planning by shooters, from almost none to detailed surveillance and plans to trap victims.

Unpredictable By Nature

Peace Pagoda, England

The western hemisphere’s first Peace Pagoda, in Willen Lake, England. Photo by diamond geezer (real name unknown).

Active shooter episodes are unpredictable, with no pattern or method to the actual choice of victims, although 78% have a link to at least one of the victims, most often academic or professional. The scariest thing is the speed in which it all goes down. Most attacks are over within 10-15 minutes, and some even faster. In the Northern Illinois University shooting, the murderer killed 5, injured 21, and then killed himself, all in about 3 minutes.  Unfortunately, when a shooter goes “active”, those in weapon range depend primarily on luck to survive. Luck – and how fast police arrive! 40% of attacks end in the shooter’s suicide and 46% end by force, primarily by police. I couldn’t find statistics on bystander intervention outcomes (does anyone have these?), but successes seem few and far between.

What Actions Should You Take?

1. Always be aware of your environment and possible dangers, both for active shooters and for other disasters. Pay attention to hazardous construction, excessive crowds, local environmental risks, and unusual behaviors.

2. Plan evacuation routes (preferably more than one) for every building you enter. Your best chance at surviving a shooting is to get out, quickly and quietly. Encourage others to leave with you (QUIETLY), but don’t force them. Don’t bring anything with you. Don’t stop to help wounded – you might just increase the casualty count. Once out, call 911 as soon as you are safe.

3. If you can’t get out, find a hiding place where the killer is less likely to notice you. Lock or barricade the door. Keep out of sight, hiding behind or under large furniture (to block bullets), and be quiet. SILENCE CELL PHONES – EVEN VIBRATION! If window exit is possible, do so. Avoid long hallways and bathrooms – areas killers often check.

4. If stuck with the shooter and unable to evacuate or hide, stay calm (yeah, sure) and don’t draw attention. If not yet shooting, follow their instructions. Once shooting starts, make a personal choice. You can stay still and hope they don’t shoot you. You can run for an exit while zigzagging (a moving target is harder to hit). You can attack the shooter. Definitely dangerous, but no more so than doing nothing and dying anyway.

5. If you can’t get to a safe space to call 911, dial anyway and leave the call open, allowing the dispatcher to hear what’s happening.

Peace Pagoda, Massachusetts

Peace Pagoda, Massachusetts. Photo by Baer Tierkel.

6. When police arrive, follow instructions. Drop everything, raise your arms, and open your hands. Do not point, make sudden movements, or make noise. Police can not tell who is a victim and who is a threat, so don’t do anything to confuse them. (Follow these rules when evacuating on your own as well, in case police are already outside).

7. Move quickly according to instructions. Do not try to stop or talk to police. They must find and stop the shooter before anything else, including care for the wounded. Once in a safe zone, other rescuers will help you. Do not leave the area until released by police – you are a witness.

Want to Learn More?

For more information on how to prepare, respond, and recover from active shooting events, read the Department of Homeland Security Active Shooter brochure. Or go all out and take the on-line FEMA course IS-907 – Active Shooter:  What You Can Do. It’s free, takes about 45 minutes, and includes information for employers on reducing risk. You even earn continuing education credits!

In the end, there are crazy people out there, and weapons to do crazy things. Hopefully it will never happen to you or your loved ones, but ultimately, we can’t prevent these events. All we can do is think through in advance what our best actions might be.

Stay safe,

Sheila Sund, M.D.

Colorful Origami cranes

Origami cranes. Photo by Sheila Sund, cranes by Kenton Popovich.

  1. Sheila,
    Very well put. I certainly couldn’t do any better myself… so I’ll be re-posting on my blog.

    • disasterdoc says:

      Thank you for the compliment and the re-post. I decided that if we look past the emotional, social, and political issues raised by shootings, active shooter events act like many other unpreventable disasters. As such, we can do hazard analysis (focusing on facts from previous events), mitigation (particularly in schools and the workplace), and teach people how to respond – the equivalent of “drop, cover, and hold” for earthquakes. This won’t save everyone, but it may save some!

      • Interestingly enough, the current thought on how to respond to an active shooter is ‘Run, Hide, Fight’. It’s a little scary to think that we are encouraging people to literally fight for their lives, but it has been proven to be the most effective through past incidents.

        • disasterdoc says:

          Are you aware of statistics about outcomes when people fight back? The fighting recommendation makes sense, but I would love to have some data to back it up. I couldn’t find any on-line. Maybe the numbers are too small?

          • Not that I’m aware of, but they must have looked at information stemming from incidents like Aurora (it was actually released soon after the movie theater event) where civilians fought back and subdued the perp. Other similar situations have occurred throughout the country. I believe the video itself originated from the city of Houston, TX.

          • Here are some numbers and case examples that may be helpful in understanding outcomes for when people fight:

            • Well that’s certainly an encouraging statistic. I came across an article last night on myths of mass shootings… I posted the article on my blog.

            • disasterdoc says:

              My science background cringes a bit at their sources – media and Wikipedia – and method of analysis, so I’m not sure I trust the statistics. Despite this, their basic conclusion supports the official recommendation of fighting back. This recommendation is also logical. A primary factor in the number killed is time, so if bystanders are successful in stopping the shooter, it will be over faster than waiting for police. It is also possible that fighting back may interfere with whatever psychological mechanism is driving the shooter. You fight back with whatever means you have.

              People should still use the first two steps of run and hide whenever possible! Even if this is not an option, human psychology suggests most people will not be able to fight. I hope our society never reaches a point where those who don’t fight are considered failures or cowardly. No one knows how they will respond in these situations until they actually happen.

              • Although the sources are not as credible, the list of situations and outcomes could be researched further to get the facts straight and gain a better understanding. I agree, time may not be the best factor because bystanders have the advantage of ‘fighting’ before the police arrive. What factors would you use?

                I doubt that society will reach the point of viewing victims as cowards, but you never know. I say this because oftentimes, media will focus on the perpetrator, and victims seem to be forgotten unless a bystander interrupts. In that case, a victim becomes a hero but never as ‘important’ as the perpetrator.

                Running and hiding are important. It seems simple but we do need education on these. For different situations at home, school, public, and in the workplace, we need to know where and how we should run, hide, and even what to do after. If a hostile situation occurs where we need to fight, we need to be educated on this as well.

                • disasterdoc says:

                  The analysis is a criminology topic, and probably falls in the academic realm for a professor or graduate student, or possible FBI or Homeland Security (they have their share of analysts). For all I know, the studies may be out there. I just don’t know how to find criminology literature. This is the problem with citizens doing their own Internet research on any topic. We can only go so far with our knowledge and available data. Believe me, it is even more prevalent in medicine! We just need to remember our limitations in forming our opinions.

                  From the scientific perspective, here are some factors I would include in a study of bystander intervention in active shootings. 1) Definition of cases. The NYPD analysis used the Homeland Security definition which is based on intent of the shooter (armed, public venue, intent to kill many), instead of outcome. This ensures results are not biased to higher fatality or higher publicity cases (often one and the same). 2) List of cases obtained from police or FBI databases, not media reports, to ensure completeness. 3) Facts from after-action police reports, including forensics and eye witness interviews, to best understand what actually happened. Without this, it is hard to tell exactly how the shooter was attacked, if those who fought back were killed/injured and how, and if some victims were injured or killed by “friendly fire”. Media interviews of witnesses and law enforcement can’t be considered accurate. 4) Analysis of shooter vs fighting bystander actions, and difference in outcomes (for example, how often “heroes” are successful with head-on defense, vs being out of line of sight, and success of armed bystanders vs those who used whatever was on hand). 5) Information on characteristics of bystanders – how physically fit, experienced with fighting, experience with stress situations, etc. 6) Information on probable mental health diagnosis of the shooter. Different diagnoses might be more inclined to continue fighting, some to surrender, and some to suicide. 7) Most importantly, an unbiased researcher!

                  I’m ready to let this topic rest for now. I don’t have a lot of contact with law enforcement, but I will keep my eyes and ears open for more credible information from authorities in this field. If I find anything, I will blog on it.

                  In the meantime, I will teach the disaster preparedness approach to active shooting events – hazard analysis (review available facts), mitigation (learning risk factors, observing your environment, workplace and school planning, etc), and planning and practicing response (Run, Hide, Fight). No matter what your opinions, this should help everyone to be a little better prepared!

  2. Reblogged this on Tim Riecker and commented:
    There are a handful of bloggers in the public safety field who are posting about active shooters, obviously as a follow up to the horrific incident at Sandy Hook Elementary in Connecticut. Dr. Sheila Sund (The Disaster Doc) not only provides the current industry standard guidance in her post, but also provides some information on mass shootings.

  3. Albert F Limberg says:

    Your comments regarding attackinig the shooter and fighting back make more sense than most people realize . . . but if you are going to do that don’t give the bad guy enough time to think about it. It has to be done fast and effectively. My suggestion is don’t grab the gun hand . . . grab the GUN and make every attempt to control the muzzle. Twist, wring, break fingers and hurt the gun hand. I’ve though about this a lot and decided that if anyone wants to shoot me they are going to have to work for the opportunity.

    I know . . . some of your readers to tell me I’m crazy. But my counsel to them is, “Don’t waste your time!” My mind is made up so don’t even try to confuse me with what you think are facts.

    Women are counseled to fight back with rapists, especially if they are in fear for their lives. There’s little difference here. Any time someone points a gun at me I AM in fear for my life and will act accordingly. I’m not going without a struggle.

    • disasterdoc says:

      The most important thing is to quickly choose your action and stick to it. If you are going to play dead, do it well, even if the shooter comes over to you. If you are going to run, really go for it. If you are going to fight back, do it with gusto. If you choose to fight, although a strong physical attack is best, anything may be effective – throwing things (chairs or backpacks), charging, hitting, etc. There is some thought that fighting back might derail the shooter psychologically, not just physically.

      It isn’t realistic to think that everyone will have the emotional state, personality, or physical ability to fight, and that is OK. I think the most important thing is to work through situations like this in advance and practice them, just like any disaster. At least that way, you will have some choices on what to do, instead of just freezing.

  4. […] response was amazing, but unfortunately, (as stated in my earlier post on mass shooters – Scary Fact # 6: Active Shooters – What Should You Do?), these episodes evolve rapidly, with most victims killed or injured in just a few minutes – not […]

  5. Jaimi Glass says:

    Dr. Sund,
    I want to thank you for the preparedness presentation you did at Stoneybrook on June 23. You had great information and engaged the community in a relaxed way, yet got them interested in preparing for disasters. It’s not if, but when!

    Again, thank you so much and I hope to see you again 🙂

    Jaimi Glass

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