Grand Rounds Recap 4.17.24

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Active shooter incidents

  • Important to have situational awareness, which is generally defined as knowing what is going on around you 

  • Three main tactics for defense in an active shooter situation: Run, hide, and/or fight

    • Run - Evacuation is going to be based on specific circumstances: location of shooter and whether it can be accomplished safely. You need to try and alert people in plain language, keep hands visible at all times, and do not stop to ask responding law enforcement officers for help. 

    • Hide - If evacuation is not possible, find a place to hide where the shooter is less likely to find you and deny the shooter entry that is securable and barricade if possible. 

    • Fight - taking action when faced with imminent danger when you cannot evacuate or hide and you are close proximity to the shooter.

Mass casualty incident simulation

  • Communication is key

  • Having a set structure or system that is followed in the pre-hospital setting and receiving hospitals is key to successfully getting through patients

  • Reassessment is important for patients triage levels. Some patients can change from expectant to green or vice-versa.

Climate Change and DIsaster Medicine WITH Guest Lecturer Dr. Dresser

  •  Why do we care?

    • Climate change and global warming will not only increase the amount of heat related illnesses we see, but will also exacerbate many chronic problems that we face in the emergency department because of diminished access to care 

  • Disaster preparedness in the setting of climate change

    • Risk = (Hazard * Exposure * Vulnerability) / Capacity

    • This is important to understand as risk to an individual patient, or to an entire community, and how climate change affects this formula. 

    • Things like flooding, fires, hurricanes, can make access to care difficult for patients and can make patients present at later stages of their illness. We need to think beyond the acute event, because the health impact is much more prolonged due to societal disruption.

    • Read more about Dr. Dresser’s work here

Hazmat/Decontamination Update WITH Dr. Calhoun

1st receiver key points:

  • Ensure provider safety, even when it leads to patient care delay or even worsened patient condition, as contaminating providers will lead to poorer care for all those who follow

  • Keep contamination out of the ED, you must protect the function of the ED above everything

  • Self-referral patients are the hardest to comply with this, have intentional plans for flow of both types of patients