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You can’t turn on the news without seeing a report of violence against innocent civilians. It may be at a mall, workplace, school, public transport facility or on the street. It isn’t unreasonable to wonder if it will happen to you—and what you can do to prevent it. Having experience in EMS, your outlook and ability to help is different than an untrained civilian.

5 Tips for EMS Providers to Survive a Mass Shooting Incident

1. Be Alert for Signs of Escalating Violence

Not all violent incidents are terror-related. You may find yourself inadvertently in the middle of a gang fight or other dispute that results in gunfire. An awareness of your surroundings can give you a few extra seconds to observe, predict and react before the shooting erupts. Be alert for any discord, tension, raised voices or aggressive behavior. Only a small percentage of these will escalate into shooting but awareness is the key to prevention.

 2. Be Alert for Suspicious People

People who enter a public place intending to harm people can often be identified in advance. Look for clothing or body mannerisms that indicate a weapon may be hidden. Before a mass shooting at a mall in Nebraska in 2007, security guards allegedly noticed when a man entered the building appearing as if he was “concealing something balled up in a hooded sweatshirt,” according to the Omaha Police Chief at the time. That something was an AK-47 with two 30-round magazines. Gunfire erupted almost immediately. The shooter killed 8 and wounded 2.

People on a mission to kill may be hyper-focused in their actions, may have an affect ranging from a total lack of emotion to rage and are often concealing large or multiple weapons. This person would stand out as “not right” to someone who has been in the emergency services for any amount of time.

3. Create an Escape Plan

This brings us to point three: When you see elements in the first two points above, begin forming an escape route. The urgency in developing or using an escape route depends on the level of threat you observe. There will be times you notice something that makes you casually look for an exit. There will be other times you will immediately start moving in a safe direction. In most cases, a few steps toward safety is the difference between life and death.

Remember that most facilities have rear exits for employees and deliveries. These might be a quick way out—or at least a place to go, lock the door and look for cover.

4. Take Cover

In addition to a safe escape, taking cover is also a vital component of surviving. You might not have an immediate exit—or the path to the exit leaves you too exposed. In that case, getting behind something that stops bullets is crucial. It might be a giant planter or a support column. When you’re out in a public, take a look around for potential cover spots.

Ideally, a combination of escaping and cover is best. While the cover will stop bullets, this won’t help if a shooter moves toward you. Always look for the next safe place if yours is compromised.

5. The “Incident” is Bigger Than You Think

Public shootings are stressful and complex. They occur over vast spaces with multiple victims. This means that your decision-making before, during and immediately after the incident is key. Consider the following:

  • You may be with family members. You will also need to keep them safe.
  • As an emergency service provider, you will also want to help others. This is honorable, but risky. You may have the ability to shepherd a group of people to safety. You must balance your personal safety while doing so.
  • There may be multiple shooters or other threats in multiple locations. Remain observant.
  • Dispatchers will need a calm, observant person to talk to. Calmly call 911 when safe to do so and be a solid source of information/intelligence.


You may not be able to help with care for the victims immediately. Follow the instructions of police officers carefully. Officers won’t know if the shooter is still on the loose so you will likely be herded out in groups. When safe to do so, identify yourself to EMS Command and get in the game if you are physically and emotionally able and invited to do so.

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