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March 8, 2017
Surgeons share trauma care lessons from Orlando shooting
By Dan Scanlan
ORLANDO, Fla. — As horrific as the Pulse nightclub slaughter was on June 12 in Orlando, lives were saved.
Three blocks away, Orlando Regional Medical Center staff had practiced a mass casualty drill just weeks ahead of the real thing, hospital officials told 600 doctors, nurses and educators Tuesday in Ponte Vedra Beach.
When 35 gunshot victims showed up in the first half hour, the training helped surgeons, nurses and administrators do what was necessary for them to survive, Chief Surgical Quality Officer Michael Cheatham said. So the trauma surgeon issued a challenge to the medical professionals before him — are their hospitals prepared?
“If you don’t have a plan or are unfamiliar with your hospital plan, you have something to do when you get back home. Because unfortunately with the world we live in, this type of an event is occurring with increasing frequency,” Cheatham said. “It is not a question of if you will be affected by a mass casualty event. It is a question of when. Make sure you have a plan and have practiced and drilled it.”
Even being prepared, the experience still caused about 1,200 staff who worked through those weeks with the wounded to seek counseling offered by the hospital.
Bringing staff who handled the Pulse massacre to this week’s Human Patient Simulation Network conference at the Sawgrass Marriott showed health care experts that training becomes “Practice with a purpose,” CAE Healthcare President Robert Amyot said. His Montreal-based corporation works with medical experts in simulation training and sponsored the conference.
“There are lots of lessons learned from their experience and we wanted to learn from that,” Amyot said. “… One thing that struck me was that they are talking about drills that before the tragedy a lot of people saw as maybe unnecessary, a waste of time or too frequent. But now their perspective is really different. Now they feel these drills made them better the day of the tragedy.”
Pulse was packed with about 300 people when gunman Omar Mateen opened fire in a 2 a.m. rampage that left 49 victims dead and 53 wounded in what became the worst mass shooting in modern U.S. history. Mateen was ultimately shot and killed by police.
Clinical nurse Steve McMichen told the audience they faced many challenges that day. One was that Orlando Regional was so close to the club that many victims were brought in before Orange County’s alert was even sent to any city hospital.
“There were bystanders actually carrying patients into the hospital,” McMichen said.
Cheatham said he had to run a gauntlet of police blockades to get to the hospital, presenting a problem for the 471 doctors and nurses called in to care for the victims. When he got in, Cheatham said he joined other surgeons to take care of the first of 71 surgeries done on victims. But he realized the chaos “was controlled” because staff knew what to do.
“We fell back on our training. We fell back on the drills,” Cheatham said. “And we were able to apply what we had learned in those drills to care for all these victims.”
All six operating rooms were used as doctors were joined by teams from two area hospitals so no victim would have to be moved. In the end, all 35 victims brought in alive were treated and released.
The mass casualty drill really prepared them for the worst, emergency preparedness manager Eric Alberts said.
“That fuels the fire to want to do more because it is no longer something that is on a piece of paper,” he said. “This stuff matters and even administrative persons can help saves lives.”
The hospital’s 51-page “After-Action” analysis does have 66 areas of improvement, they said. More training was needed, so Orlando Regional now does four trauma drills a month. While the hospital didn’t charge victims for medical services, the emergency cost it $5.5 million in unplanned costs.
“There is really no script for this type of incident. When you plan for an exercise, you don’t consider the big incident to be no more than a half mile from the hospital,” Alberts said. “But think outside the box and think of what’s just outside your hospital.”
Cheatham said they have presented about 120 similar sessions to medical professionals across the country since the shooting, and 100 more are planned. When their presentation was done, the names and faces of those who died were shown during a moment of silence.