The Active Shooter: Staying Alive

by Joe Alton, MD of, co-author, The Survival Medicine Handbook

The Active Shooter: Staying Alive

It’s hard to read the news without seeing reports of the latest shooting by terrorists or the deranged and disgruntled. Few believe that they could possibly wind up in the crosshairs of a gunman’s sight, but it can happen anytime, anywhere. What would be your response?

The natural response for most people is not to do anything. You’ve heard me talk about “normalcy bias” before. That’s the tendency for people to believe everything follows a pattern and that the day will proceed normally; they’re usually right. When a terrorist event breaks that pattern, however, the unprepared brain takes time to process the new situation. People will think that the sound of gunfire is fireworks, or anything less threatening than an assassin out to kill them.

Another thing most citizens believe is that law enforcement and homeland security are on the case. While these agencies do the best they can to counter situations like this, most mass shooting events end in a few minutes. There is little or no chance that help will be there at the moment you need it, so you should have a plan of action.

A person without a plan of action follows the herd. If fifty people around you drop to the floor, your natural tendency is to do the same. Cowering in fear under a table in plain view of the shooter isn’t a recipe for a good outcome. By having a plan, you will have a better chance of getting out of there in one piece.

You’re at the mall; what would your plan be if you heard gunfire nearby? What would you do first? Run? If so, where? If you couldn’t run, what would you do? These are things you should be thinking about, calmly and rationally, whenever you’re in an area where there are a lot of people. It may seem extreme to have to think of these things, but that’s what I call the “New Normal”.

With an active shooter, what you do in the first few seconds may determine your final outcome. Give yourself a head start by always knowing what’s happening around you. We call this situational awareness. Know where exits are. Know where the gunshots are coming from. Know who appears nervous or suspicious in your immediate area.

Sounds simple, doesn’t it? But in this era of people immersed in their smartphones, few are situationally aware and are easy targets for the active shooter.

Here’s an example: Have you ever seen a patron enter a restaurant through the door marked “employees only”, or a movie theatre through the fire exit? This is a person you’ll want to observe. In most cases, it means nothing. In rare instances, though, it could be someone that’s up to no good.

By the way, those same little-used exits might save your life: Most people will be trying to leave by the front door, just where the gunman expects them to go. Find an exit away from the direction of gunfire.

The Active Shooter: Staying Alive

Run, Hide, and Fight

If you find yourself in the middle of a terrorist event, you should remember these three words: Run, Hide, Fight. Just as “Stop, Drop, and Roll” can save the life of someone on fire, “Run, Hide, Fight” might save the life of someone under fire. This is the order of the actions that you should be taking in an active shooter scenario.


Most people will hide as their first course of action. You, however, should run away from the direction of gunfire as soon as you hear it, leaving through those exits you’ve been mentally marking. This will make it less likely you and the shooter will cross paths. Forget about collecting your stuff, it will only slow you down and, face it, it’s just stuff.

If you’re in the line of sight of the shooter, run away at an angle or zig zag to make yourself a more difficult target. I know it’s not a natural action you’d think of doing, but most shooters aren’t marksmen and will miss a moving target.

A good citizen would yell for others to follow and prevent others from entering the kill zone. Don’t try to move or otherwise help the wounded, however, despite your natural tendency to want to do so. You have to get out of there and becoming the next casualty does no one any good. Even the police will leave the injured for after the shooter has been neutralized.

(One very important note: If you see law enforcement, don’t run up and hug them. Get your hands in the air, fingers spread, where officers can see them. They need to know you’re not the threat. Follow any instructions given and leave in the directions the officers came from.)

Once you’re in a safe area, call 911 if rescuers have not yet arrived.


If there’s only one exit and the shooter is standing in front of it, running might not be an option. Your next choice is hiding.

You first want to get out of the shooter’s line of sight. We call this “concealment”, but it isn’t necessarily “cover”. If you’re concealed, you can’t be seen but a bullet might penetrate to hit you. If you have found cover, it means that you are both hidden and protected from projectiles hurled your way. Foliage is good concealment, but a thick tree trunk might be better cover.

In a building, hiding under a table in the same room as the shooter is a death sentence. Get into another room, preferably one with a door you can lock. If there is no lock, put together a barrier with desks and chairs. Turn off the lights, silence your cell phone, and stay quiet behind an additional barrier like a table or in a closet. If you can quietly alert authorities, do so. Don’t respond to voice commands unless you’re sure the danger is over; sometimes the gunman will try to lure you out of a safe place.

By accomplishing the above, you’ve just made yourself a harder target to acquire for the shooter, and he wants to do his damage as fast as possible. He’ll likely pass you by to find easier targets.


What if you can’t run, and there is no reasonable hiding place? You just might have to fight yourself out of there. This strategy isn’t always doomed to failure. You still might be able to subdue an attacker even if unarmed. Three young and unarmed men were able to do it to a shooter on a train in Paris. It’s a last resort, but it can end without a fatality as it did there.

If you don’t fight, the shooter will have a clear shot to your head and death is likely. If you fight, it might just be harder to be hit with a fatal shot.

Of course, it would be great if you knew martial arts, but any type of aggression against the gunman would disrupt their “flow” and possibly put you at an advantage. If you can, approach him from the side or rear, and go for his weapon. If you have help, all should attack at the same time from different directions while hurling objects that he has to dodge. This guy is probably not James Bond: he’ll be disconcerted and not be able to handle multiple threats at once.

If you’ve disrupted the shooter or, better, gotten the weapon out of his hands, inflict damage on him until he is dead or has stopped moving. Tough, I’ll admit, but these are tough times; commit to your actions.

Luckily, few people will find themselves in the midst of a terrorist attack like the one at San Bernardino, but I honestly believe that more are coming. Needing a plan for active shooter situations is galling to some, but it’s part of life in the New Normal. Those with a plan will have a better chance to survive this event and many other disasters in the uncertain future.


  1. Bobcat-Prepper says:

    I recently heard this appropriate quote:

    ” A window is just a doorway waiting to happen.”

    If the exit is blocked by the gunman, use a window. Most stores have large, door-sized windows that can be knocked out with large piece of merchandise or furniture nearby. Yes, it will make a lot of noise, but you will be gone by the time the gunman checks it out.

  2. Thomas The Tinker says:

    I always look for the employee exits and ‘stock room’ doors. At a mall there are always rear exits to every store that lead to a parking lot exit. As a CC permit-ee, I have decided that forting up at a hard angle will be my best tactic if I can’t remove myself…

    I’d love to Rambo with my 5 round revolver … but … no! I can center mass at 50′ with my LCR … I’ll defend the hard angle and wait for Los PoPos … No PoPos… stayputshutup.

  3. SurvivalGuy says:

    Remember if you are armed to stay down. If you shoot, do so in your own defense. When the police arrive, stay down, if they see you with a weapon, you will be shot as no one knows who the bad guy is.

  4. TY…. food 4 thought…. re: bombs…. drop/cover ears. Drop behind cover if possible. Shock waves can enter ear canals causing brain trauma. cover ears.

    Most grenades blow up & out from point of detonation. Getting low quicker than quickly increases survival/less injury chances.

    Drop w/o cover vs dive for cover? Depends on proximity (cover & flashpoint). Split second decision- depends on situation.

    God Bless!

    • Very good advice. Also add keep legs together, arms as close to side as possible and mouth open. Concussion will compress your body and mouth open allow air in lungs to exit. At least that’s what I remember from my basic medic training in the olden days (1968).

    • Secondary bombs are sometimes detonated as people flee from the first bomb, which causes casualties, but also “herds” people to an exit. Store windows are tougher than most think. The terrorist in Oregon (He was a muslime in training. His social media sites were quickly scrubbed) ordered people to get on the ground, putting them at a huge disadvantage concerning any counterattack. Such a situation must be quickly assessed.

      • Believer & Hildegard….. tyvm 4 adding…..I did leave out some important ideas…..

        If 1 goes to casino, one is prolly gonna lose. The smarter player will choose the game w/best odds & become adept @ shaving more odds in his/her favor.

        Msblindspot & nimble fingers brought up more ideas I neglected. TYVM all!

        Assessing situations/locations paramount! MOST IMPORTANT when s is hitting the fan!!!!!! Keep thinking/assessing, especially if beset upon…..

      • riverrider says:

        he also had a black flag in his backpack, and it wasn’t a jolly roger.

  5. riverrider says:

    a) never fight even odds. fight a pistol with a shotgun, shotgun with a rifle, rifle with a cannon.
    b) navy seal told me once, “never rush to your death”, meaning chill a second to observe, then move in deliberately but not rushing. hard to observe while running and observing is more important that forward speed.

  6. Agreed, I am always aware of exits, also cover. Are there large concrete planter’s , partition wall’s, or benches that would provide cover? Wall’s, clothing rack’s, merchandise racks to provide concealment? Know the differance! Concealment is not always cover! Cover will stop a bullet, concealment will only hide or mask your movement’s; cover can usually be concealment but not the other way around.

    Yes, break a window! Due to commercial glass thicknesses this may be darn near impossible but should at least be attempted. Get out of the area, you are no good to help if you are a casulty.
    Can’t get out? Can you get to a store room that has an exit to a loading dock? If an exit has an “Alarm Will Sound If Opened” sign on it, open it! Create confusion/distraction for the assailant if you can do so safely.

    If armed seek cover, draw weapon (but maybe not) and prepare to fight. If not able to engage, cover the withdrawl of unarmed folks if you know where the shooter may be, you do not want to herd folks towards the shooter. If with family, your first obligation is to them. Ensure their defense! Keep your head on a swivel, constantly check your surroundings.

    Hand to hand against an armed foe can certainly be done and should be as a last resort IMO, be prepared to deliver as much violence as you can muster. IIRC the Paris situation had a weapon malfunction (or magazine change) as the chance to act, these young men delivered violence, a great deal of it.

    Critical thinking, do you fight, withdraw, or just be a good witness and record events? Big decisions when the daily routine falls apart. How do you train?

    • Even if armed, I would engage only if necessary, or if the schmuck is changing mags or something. The attacker has planned the attack. You are at a disadvantage if you engage.

      Sadly, there is now often video of the attack in progress. So many people are so addicted to their itoys that their first reaction is to start recording.

    • That’s a great idea, ‘Create Confusion’. Most people under pressure cannot think about more than one thing at a time. The terrorist may leave a scene to investigate or at least allow a moment to escape.

  7. I was just talking about this with my DD and GS’. We talked about being aware. We talked about what was going on with the shootings. We talked about everyone in the car having an
    “exit strategy” when you go shopping; including a rally point that is not the car or in the main parking lot. Something like another business that is close.

    There is little you and I can do to stop these shooting without drastically changing our lifestyles; which means the terrorists win. But we must have a plan for NOT being a victim and constantly being aware of our surroundings.

  8. When ever I am out and about I always check out my surroundings. If I am out shopping I look for Emergency Exits and a place to Bunker up if the need were to arises. As a CC Permit Holder with very good training on Weapon’s I feel that Once I make my Family Safe That I would help other people to become Safe and do what ever I could to neutralize the Threat. The best thing or Advice that I could give would be to not Panic or give into fear. These things will get you killed. Keep a level head as best you can and Think. If you are in a movie Theater take the time to count the steps to the Emergency Exits and the Direction in the event the lights or out. Alway be aware of your surroundings and if you see something that does not look right say something to the proper people. I am by know means a Rambo but you best defense is common sense.

  9. the price of liberty is eternal vigilence…..

    when the battle is carried to the perpetrator(s)- terrorists & political handlers, they retreat & regroup. As Patton would say: stay on the G**D DA*******D offensive! Carry the battle to the politician! Don’t give them time to regroup.

    War has been declared on our freedoms, liberties, wallets & loved ones! Declared by slime! Do we wish to let them slime us? Our children, our grandchildren? Take all we have/are?

    I like Reagan’s words here- ‘there is no where else to run’….

    I don’t like Reagan……

    • Make the phone calls, write the letters, get others to do so, do NOT sink to there levels!

      Find candidates, BACK them!

    • Muslimes cave in the presence of even token resistance. ‘They’re ready to die!!’ is a myth. The two in Cali tried to get away. The ‘unstoppable’ ISIS is only unstoppable when engaging unarmed peasants. They crumble in the face of resistance. Note that within a few weeks of Russia entering the Syrian conflict, the ISIS ‘militants’ were cutting off their beards and trying to slip out dressed as women.

  10. I believe it might have been Patton who said fixed position are monuments to dead people. The farther away you can get from the shooting the better off you are. If you have a permit for concealed carry and aren’t doing so shame on you. My gun is like my MasterCard. I never leave home without it and of course during this time it might behoove us to contact our representatives and ask them to support a national carry permit so you can carry it anywhere

  11. I personally do not go to large malls anymore. Not out of fear of what might happen, but more of the convenience of other big box stores in strip malls or closer to home. I hate Mall traffic! But, it is wise to aware of your surroundings where ever you go. My grandfather told me once that if an enemy were looking to do the most damage, it would be a place like a college or pro football stadium on any given Saturday, or Sunday. I would like some input from the pack as to suggestions on how to handle something like that where you are pretty much crammed into a roll of seats, and everyone trying to reach the exits at the same time.

  12. MsBlindSpot says:

    Such a good article!! Matter-of-fact, simple and to-the-point. I can follow these directions…or at least try to…thank you.

    Several years ago, I began to ‘survey’ the stores and other places I go to most frequently, scoping out the logical and/or ‘forced’ paths to safety through and out of the places, and where to hide/shelter if necessary. I scan every place (every time) when I go in (while I’m wiping the cart) and as I travel through. I had a fellow follow me through quite a few aisles once and I kept his feet in my peripheral vision until I got to a more populated aisle, then I turned and said hello. He slunk off and I went to the customer help desk and reported him. May have been my imagination, but I don’t care.

    I hate to admit it, but I have also curtailed where I will go. I feel as though that’s “allowing the enemy to win”, but I’m old enough to want survival rather than bravado. So, I limit the public places I will go. This is a two-fold action: one, because of the present dangers; two, because of disease. (Call me paranoid, but people are not minding their health and hygiene as they should and don’t mind being out in public with serious illnesses. And with all the ‘new’ viruses and such that are spreading…no thanks.)

    I have also created a small EDC fanny pack that is expressly for if I have to shelter/hide inside a store or other place for any period of time, and I wear it when out and about, as well as carry my purse. I understand that in an active shooter situation, getting away is the ideal. But I’ve read that folks in several of the places where it’s happened have hidden…even been ordered by LE to do so…for up to several hours. Having a bit of water, some gum, a small 1st aid, etc can help with shock and keep energy up, for yourself and whomever you might end up sheltering/hiding with.

    Here’s what I have in mine:

    – small first aid box (bandaids, neosporin gel, razor blade, cough drops, medical mask and gloves, Package of Vit C powder)
    – medium-size pocket knife with attachments
    – 2 water pouches (
    – bandana
    – several “Wet Ones”
    – emergency blanket
    – whistle
    – pepper spray
    – 2 power bars
    – small notebook & pen
    – extra ID and $20
    – lip balm
    – eye drops
    – earplugs
    – hand lotion
    – matches
    – paracord
    – gum
    – small flashlight
    – “Motel” style door lock (

    Some of the items may seem unnecessary to such an emergency situation, but I’m thinking if it’s for hours, a little lotion rubbed on the hands of someone freaking out may distract them and soothe them; the eye drops may soothe if there’s dust; and under stress, lips dry out – a bit of lip balm could ease that, and throats can get dry, and the cough drops can help. Again…this is for if it’s HOURS of sheltering/hiding.

    All these items are in small/sample sizes and my fanny pack is small and unobtrusive as well. It fits under whatever shirt/jacket I might be wearing. It is for immediate emergencies only…nothing larger. I have the BIG stuff for that. If I can get to my vehicle (which I try to park in a “safe” place always), I’ll be in good shape.

    Thanks again for such a good article about this. I am sending to everyone worthy.

  13. Emergencies at Hotels also need to be considered. Maybe not for mass shootings but for fires. When I have an inside room I always know in which direction I will need to go to get to the stairs AND I know how many doorways I will have to crawl past, in the dark and the smoke, to get there.

    • That’s one reason I prefer cheap motels (the other being I’m cheap). They are usually only 2-stories & all the doors open to the outside.

  14. Hey check this out.

    It now makes sense why Obama had early release of criminals. They converted to Islam in prison.

    More soldiers!!! Get ready they are coming.

  15. nimble fingers says:

    Last month I found myself waiting in a big box store, near the lumber exit for an employee assist with a very large and heavy shelf unit. I continued to wait. As I waited, I glanced around at the 15 or so individuals waiting in line near me. To my surprise, I was being studied. Not by one, but by 2 different guys, about 30, whose wives were with them. Neither one of them looked away, but made eye-contact with me albeit very briefly, and THEN each one looked away, before I did. (I was a middle school teacher before retiring, and by long habit, I did not turn my gaze away. I kept my face steady and calm, just like always. I never gave in to a threatening student in my classroom or in the hall when on recess duty because that leads to nowhere good.) I continued glancing around and noticed that everyone else, all men, were just into buying their building materials and moving on out to work or to a project at home. I glanced several more times at these 2 young men, but they “seemed” involved in small talk with their wives and did not look at me again. I remember thinking they must have been US military, but not in uniform. They were alert, trim, vital, clothes pressed, no tats/beards, short hair but not too short….and even though I had been accessed by them, I knew they were the “good guys.” It was just a sense emanating from them and is something else I developed from teaching middle schoolers for 25+ years….I’m pretty quick on sizing people up. So, I just experienced on the receiving end, what it looks like to be evaluated. These 2 guys were aware of each person in their immediate surroundings. I began to think of the other 15, too, as in “which ones are OK and which ones should I be careful of?” because I think the 2 were accessing each person as to their level of threat or support if something happened. So, I followed their lead, and accessed each one of the others, too. In my analysis, the group was filled with hard-working day laborers, contractors, and retired types just doing what comes naturally with wood stuff. Just an average-Joe type group. I bring this up because I think that in addition to looking for exit doors and ways for finding concealment & containment, one should be alert to the people surrounding one in crowded or waiting places, in lines, in near-by cars, just anywhere folks are bunched up for a bit. I realize now that if there had been a person in that group that brought me unease, I would have moved away from him and put someone else between me and him….and then kept an eye on him.

    The article was very helpful. I am going to step up and be more aware of my surroundings now in a careful and deliberate way.

  16. I just looked up massacres in Canada since 1950 – the total comes to about 100 people…About the same number died in US mass shootings in the first 4 months of 2015. Granted the US population is about 10x that of Canada so you would expect there to be more – but this is quite a bit more! Different cultures in the two countries I suppose.

    Just thinking about having that active shooter conversation with my young children and trying to decide the best way to approach such a subject..

  17. That is known as Prislam.

  18. riverrider says:

    m.d., this post got the blog noticed on several sites i visit along the “fringe”. good work!

  19. Macssurvivalkits says:

    Great post! With solid information to follow. The active shooter in the Killeen, TX Lubys was successful because he drove his vehicle through the entrance effectively blocking any escape that way. Most people were unarmed as it was prior to CHL. I was not there but believe that people were unable to break windows and most had no choice but to freeze in place. Unfortunately, I expect more incidents like this in the very near future. Stay safe.

    • 1 of the survivors lost her parents in this horrific onslaught.

      She has become a real pro 2A activist.Has run for office.I don’t remember her name or if she has been successful in bid for ofc.

      She left her pistol in her glovebox in her car prior to entering restaurant. Did so to be compliant w/law @ that time.

      On a different note, my 3 mini citrus fruit trees have begun to flower- 1 has @ least 3 green & little & dimpled (sarc: ON) ’tissue masses’. I don’t know when they can be called ‘citrus fruit’. If they will be aborted & eaten or aborted & sold into captivity I’m guessing they remain cell or tissue masses…..

      (Sarc: off)

      • Macssurvivalkits says:

        Yes, she was a central person in getting Texas’ CHL law passed. Avoidable and terrible stuff.

  20. Whenever I go out to eat I always make sure I sit so my back is not to the door.

    “Be polite, be professional, but have a plan to kill everybody you meet. ”

    Gen James Mattis.

  21. Walk softly, carry Desert Eagle? A carrying society is a polite society.

Before commenting, please read my Comments Policy - thanks!