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Abstract
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For Joseph Ibrahim, MD, the first wake-up call came last year at an Orlando Magic basketball game. The trauma medical director of Orlando Regional Medical Center (ORMC) was sitting in the stands at the Amway Center when he looked around at the crowd of thousands and imagined a mass casualty incident. “Being the only level I [Trauma] Center in this area, we’re responsible for every single person in here,” he recalled thinking to himself. It later struck him that Orlando—with its proximity to Disney World—was a prime target for a mass shooting or bombing.
Ibrahim’s fears were realized when the deadliest mass shooting in modern US history unfolded in the early morning hours of June 12 at Orlando’s Pulse nightclub, located 2 blocks from ORMC. But by then, the hospital’s trauma and emergency staff were prepared.
Three months before this real-life tragedy, ORMC staged its annual community-wide mass casualty drill. In prior years, the drills have simulated scenarios including a bombing, a rally that became violent, and an airplane crash. This year’s mock disaster—an active shooter incident at a local school with 500 injuries—included all of central Florida’s 15 hospitals, the Federal Bureau of Investigation (FBI), local law enforcement, emergency medical services (EMS), fire personnel, and ORMC’s Air Care Team, which provides transportation and in-flight stabilization for trauma patients. Ibrahim recently pushed to add trauma simulations on a more regular basis, and these smaller drills have been taking place 3 times a month.
As 44 injured patients streamed in during 2 waves on the night of the Pulse nightclub shooting, these and other preparations undertaken by the hospital for mass casualties paid off, Ibrahim said: “For the most part, the big needs—anesthesia, operating rooms [and other] space, blood, and people to care for [patients]—were taken care of, and I think it was in large part due to the drills that we had performed.”
Jay Kaplan, MD, vice chair of emergency services for Ochsner Health System in New Orleans and president of the American College of Emergency Physicians (ACEP), called the hospital’s response “amazing.” “Within a very short period of time they had 6 trauma surgeons [and] 8 emergency physicians caring for patients,” he said. Surgeons performed 28 operations on Sunday alone. Thirty-five patients survived and, as reported in the media, the 9 patients who did not survive died soon after reaching the hospital, indicating that they had arrived with fatal wounds. Ibrahim said that local EMS reached out to express gratitude for being included in the hospital’s drills. “I’ve had a lot of feedback saying they’re really happy that we did those drills because they knew how to step in and how to best help,” he said.
By all accounts, ORMC is an example of how trauma centers and communities should prepare for mass shootings and other intentional mass casualty events. The 2013 Boston Marathon bombing, after which only 3 of 264 patients died, has been cited as another well-coordinated and highly successful response....
Language: en |