Three teenagers are fighting for their lives after a fellow student shot each in the head, as it emerged that a staff member attempted to stop the attack at a US high school.
Two girls, 14, and a boy, 15, were in critical condition in the hospital after Friday's bloodshed in the northwestern state of Washington that also left one student and the young shooter dead in yet another US school attack.
Another boy, 14, was in a serious condition after he was shot in the jaw. Both male students were reportedly cousins of Jaylen Fryberg, a popular first-year student at the Marysville-Pilchuck High School who opened fire in the school cafeteria.
Joanne Roberts, a doctor at Providence Regional Medical Centre in the city of Everett, 50km north of Seattle, said the girls had undergone surgery for head wounds.
"The next three days are going to be crucial," Roberts said, explaining the surgery aimed to relieve brain swelling.
Student Eric Cervantes told KIRO-TV that a staff member intercepted Fryberg - who shot himself in the neck during a brief tussle. The bullet killed Fryberg but it was unclear if it was intentional.
Snohomish County Sheriff's Office said detectives "were able to confirm that a cafeteria worker attempted to stop the shooter", while local media said the employee was a teacher.
"There's all these heroes in this type of a thing, even though it's a horrendous tragedy," Marysville Mayor Jon Nehring said.
Police are attempting to ascertain a motive. The student that died was a girl, though authorities did not immediately release her name.
Don Hatch, a grandfather of one of the wounded boys, told CNN affiliate KOMO that the shooter and the boys were related.
"All three of them are cousins, and they live right close to each other," he said.
Students gave graphic details of the moment Fryberg began his shooting spree.
"I could see Jaylen standing up with a gun, and he started shooting," Josiah Gould, 14, told The Seattle Times.
"They were sitting down and he was behind them shooting. After that I just ran."
A student identified as Austin told KING 5 television how the shooter was initially quiet.
"He was just sitting there. Everyone was talking. All of a sudden I see him stand up, pull something out of his pocket," Austin said.
Many in the community were baffled by the shooting.
Fryberg was a well-liked student who had played on the football team and had been named a homecoming prince just a week ago, local media reported.
Fryberg, a Native American, had left a series of tortured posts on Twitter, suggesting a teenager used to handling guns, and hinting that a failed romance may have led to the shooting.
One post on Instagram showed him brandishing a hunting rifle.
In his final post on Twitter on Thursday, Fryberg had stated: "It won't last...It'll never last...."
In August he had issued threats to an apparent love rival: "Your not gonna like what happens next."
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