Rapid Mobilization Was Key to Successful Emergency Care after the Las Vegas Shooting

April 1, 2021
April 1, 2021

HealthStream recently spoke to Dr. Scott Scherr, Medical Director at Sunrise Hospital & Medical Center, Las Vegas, NV, who is also the regional medical director for TeamHealth. The hospital is just a few miles away from where the Route 91 Harvest Festival was in its third and final night.

Radio calls were the first sign to doctors, nurses, and staff at Sunrise that something major was happening. It had been a fairly routine night in the 52-bed emergency department, but even a slow night means plenty of activity at Sunrise, a Level II trauma center and the closest hospital to Las Vegas’s famed Strip—and the concert. The hospital gets about 165,000 adult and pediatric visits a year, and some 115,000 emergency department visits annually as well. Around 120 ambulances per day pull up. But even the busiest facility in Nevada couldn’t be fully prepared for what was coming, says Dr. Scherr.

Rapid Mobilization Key to Successful Intake

More than 100 physicians rushed to Sunrise to assist, as well as more than 200 nurses, clinicians, and support staff. Matching the frantic pace of patient care taking place in the ER and adjacent areas, the rest of the hospital also was highly active. In addition to the activity around new patient care, staff was working to discharge those patients who could be processed out in order to make room for the influx. Thanks to around 100 discharges, there was a bed for every incoming patient who needed one; no shooting victims were diverted to other facilities.

In short, everyone who could be there, was there— and playing a vital role.

“How did we get that response? There was a mass text, and phone calls were sent out to all people in the medical staff,” Dr. Scherr explains. “That got anesthesiologists, ICU doctors, hospitalist medicine, and emergency medicine docs to arrive.”

The Timing Was Fortuitous

And even though it was late in the evening, it was still early enough to mobilize a fair number of people more quickly than would have been likely in the early morning hours, he says. “If it was 2 a.m., it would have been difficult to mobilize the number of physicians and physician extenders as we did. All the nursing leaders called their staff members to bring them in. Some of them were at home watching the news and they didn’t even wait for a phone call—they just came in.”

Similarly, the Sunday-night time window also meant that the busy ER area wasn’t full to capacity, which meant there was room to maneuver the initial wave of patients while triage areas were being created for the additional ones arriving every minute.

“If it was a Monday or a Tuesday afternoon where the PACU space and both ERs would be completely full of medical patients or surgical patients, we wouldn’t have been able to expand the footprint of the ER,” Dr. Scherr says. “Basically, we expanded the footprint of the ER about four times. We quadrupled the space of the ER within 60 minutes.”

Emergency Drills Prepared Them for the Unexpected

While the Sunrise team wasn’t anticipating having to care for more than 200 patients in an hour, it nonetheless was ready for the unexpected. Multiple Casualty Incident (MCI) drills are conducted throughout the year, and past real-life responses have included a British Airways fire at McCarran International Airport, where more than 35 patients were treated.

“Every year, we actually have a planned surge model for New Year’s Eve because we’re the destination of choice for the paramedics on New Year’s Eve,” Dr. Scherr adds. “We’ve utilized the PACU space before, so we had all necessary office equipment and supplies over there to help us take care of those patients. But have we practiced taking care of 215 patients like we saw? No, but it’s just the Sunrise ‘next man up’ mentality to help our patients that really showed that night.”

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