Active Shooter Incidents in the Health care Setting-Implications for the Surgeon

The incidence of active shooter incidents in the U.S. continues to increase, with 48 incidents reported in 2023, representing a 60% increase from 2019. Such attacks typically occur in soft target forums, defined as having minimal to no defenses. Historically, this has included schools, offices, public areas, but increasingly includes health care facilities, such as hospitals and medical offices. All physicians play critical roles in the response to any mass-casualty incident, including active shooter events. The surgeon plays a particularly special role both in leadership and treatment given the unique medical skillset capable of rendering life-saving aid to victims of a mass-casualty incident.