Acts of violence at schools across the country committed by gun-wielding students in recent years have all too frequently, as we know by now, resulted in multiple casualties and widespread community grieving. Two of the shooting rampages noted in this report that attracted national and international media attention--one at West-side Middle School, Jonesboro, AR, on March 24, 1998, and the other at Columbine High School, Littleton, CO, on April 20, 1999--illustrate the importance of hospital preparedness and quick implementation of emergency disaster plans. In both instances, officials say their administrative, clinical, and security personnel were well prepared to handle the physical and emotional trauma caused by the tragedies. Meanwhile, a leading criminologist warns that the trend toward school violence likely will continue and provides tips for hospitals and their security directors.