Ongoing Deadly Violence (PDV) Training Exercise at Södersjukhuset (Stockholm South General Hospital), Sweden, October 2024 Ellinor Linde Blidegård, Emergency Preparedness Coordinator

Summary: PDV (Ongoing Deadly Violence) refers to incidents where one or more attackers subject the public to life-threatening violence, often using simple means. These events are typically brief but result in many serious injuries. Saving lives and preserving health during ongoing deadly violence in a hospital environment requires effective, coordinated efforts based on a unified approach. It requires mental preparedness, and the involved parties have jointly planned, trained, and drilled their staff. Södersjukhuset is one of Sweden’s largest hospitals for acute care. A PDV exercise was conducted at the hospital on October 2, 2024. The goal was to prepare hospital staff to handle a violent incident within a healthcare setting. The exercise involved personnel from the information desk, pediatric emergency department, and hospital security, working in collaboration with police special squad teams and local officers. Before the exercise, each department developed specific action lists to prepare its staff. The exercise began with a realistic scenario: a couple who had lost their child acted violently in the pediatric department, using a knife and handgun, which created a simulated casualty scene with injured role players from knife and gunshot wounds. Staff responded according to the PDV plan, locked themselves in, and alerted the police and security guards. Within 14 minutes, the police had neutralized the perpetrators, and hospital staff initiated acute medical interventions. All injured role players were triaged and treated. After the exercise, a joint evaluation was held with all participants. The police deemed the exercise highly successful, and hospital staff felt strengthened in their professional roles and their ability to handle a PDV event. In addition, psychological debriefing sessions were arranged to process emotions and reflections. To conclude, the hospital’s readiness and coordination abilities are reinforced; however, the training of staff and updating of action plans for PDV events continue.