AURORA, COLO. – When 41 of the 58 people wounded in the Aurora, Colo., movie theater shooting early on July 20 suddenly flooded the two nearest emergency departments, effective disaster plans, well-rehearsed mass-casualty drills, and teamwork kept both staffs on top of the situation.
By the time the sun came up later that Friday morning, the surgeries had finished, the wounds were cleaned and bandaged, and most physical traces of the bloody scene at both hospitals had been cleaned away. In testimony to the excellent care the wounded received, nearly a week later just 1 of 41 patients had died.
Dr. Frank R. Lansville
"The most astonishing thing was the number of people who came together in such a short period of time, and at such an hour. What sticks with me is the efficiency with which our staff was activated, and how we worked together," said Dr. Frank R. Lansville, medical director for emergency services at the Medical Center of Aurora, where 18 of the shooting victims received their care.
"The staff buzzed around like bees, but they were doing nothing but listening and doing their jobs. They figured out what to do. They instinctively picked out the highest-acuity patients, and then staggered [the patients] down from there," he said in an interview. "The patients are in the condition they are in today because of how the staff acted."
Of the 18 patients brought to the emergency department of the Medical Center of Aurora (about 3 miles south of the movie theater where the mass shooting occurred), all 18 were still alive by the middle of the following week, including 13 patients who received gunshot wounds, although 2 patients remained in intensive care.
Dr. Frank Lansville discusses his hospital's response to the crisis in this video.
Source: CBSNewsOnline
"We see a lot of very horrible trauma come in, but nothing like this, in terms of the sheer magnitude," said Dr. Comilla Sasson, the emergency physician who was one of two attendings on duty early that Friday morning at the University of Colorado Hospital at Aurora, about 3 miles north of the shooting, which received 23 of the patients.
"I don’t think there is any way the patients would all be alive today without this coordinated response. There was literally blood everywhere" during the hour when the patients arrived, between about 1:00 and 2:00 a.m. "What really boggles my mind is that we kept 22 patients alive," said Dr. Sasson, who likened the scene at her hospital to a war zone. Both she and her fellow emergency attending, Dr. Barbara Blok, worked like orchestra conductors, coordinating the actions of their four emergency medicine residents as well as the other care providers on their staff, Dr. Sasson said.
Dr. Gilbert Pineda
"It was very graphic, very dramatic, an overload of acuity, and a lot of sounds. One patient in the hallway was screaming with extreme pain," when Dr. Gilbert Pineda, medical director of emergency medical services at the Medical Center of Aurora, arrived a little after 1:00 a.m., having been awakened from sleep at home after just finishing a long shift. But despite the "frantic" activity he saw upon arriving, "every patient in the department was being cared for with one-on-one nursing. The nurses and techs were focused," Dr. Pineda recalled.
Dr. Lansville, Dr. Pineda, and Dr. Sasson credited both the frenzied but focused actions of their staffs and their facilities’ regular disaster drills as linchpins of the successful response at both locations.
"It was a surreal moment. We were all working on gut instinct," said Dr. Sasson. "We do monthly disaster drills, and [until now] many people used to say they were a waste of time, [and] when will we ever need this?" But having a well-rehearsed, carefully formulated disaster plan meant that "we were able to provide care and not think about the logistics," she said.
"You need to be prepared. You need these sorts of drills. I don’t think anyone will complain about drills ever again at our institution. The drills helped us tremendously," said Dr. Lansville.
Dr. Comilla Sasson
An additional challenge at both centers was that when the police cruisers, ambulances, and private vehicles started arriving with victims, both emergency departments were already at full capacity, with roughly 50 emergency beds occupied at each of the level II trauma centers. The incoming patients initially were put in hall beds, and at the University of Colorado many received their initial work-up and treatment in the ambulance bay or in a mobile unit set up nearby. At first, "we literally had no space available," Dr. Sasson said. She credited the speedy evacuation of the patients following their injuries as another important factor that led to good outcomes for many.