Controlled Chaos at Las Vegas Hospital Trauma Center After Attack

By: Guest Author | Posted on: Oct 03, 2017

This article was originally published on nytimes.com by SHERI FINK View the original article by clicking here.

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On Sunday night, Toni Mullan drove 110 miles an hour on side streets from home to get back to University Medical Center of Southern Nevada, where she had just worked a 12-hour shift as a clinical supervisor in the trauma resuscitation department. Her car was smoking as she pulled into a three-hour parking spot close to the trauma center. Ms. Mullan, 54, left her hazard lights blinking as she shut the car door and raced inside.

Around a dozen patients had already arrived from the shooting scene at a music festival on the Las Vegas Strip. Two were dead and two had been “black tagged” — fully assessed and found to have injuries that were not survivable. Ms. Mullan’s daughter, Antoinette Cannon, 29, a trauma nurse who also works at the hospital, was standing out front with a physician assistant, taking injured patients out of vehicles as they drove up to the hospital and quickly assessing whose conditions were the most precarious.

“The minute I got there, I looked at the situation and said ‘How am I going to utilize my resources?’ ” Ms. Mullan, a registered nurse, said in a telephone interview Monday morning. By daybreak, 104 patients had arrived.

University Medical Center is the only level-one trauma center in Nevada and one of only a few free-standing trauma units in the nation. That means it is fully staffed with surgeons and trauma nurses day and night to handle injuries and mass casualties, from vehicle crashes that bring in 10 patients at a time to a 2015 episode in which a woman drove onto the Las Vegas Strip, sending 17 patients to the medical center. Last week, there had been 15 trauma cases in one night.

But even with 11 trauma bays, three operating rooms, a CT scanner, a trauma intensive care unit and a pediatric intensive care unit all under one roof, the trauma center had never faced a torrent like this. For two or three hours, the patients came nonstop. The radio at the clerk’s desk blared with transmissions from paramedics. With the frequency overburdened, other paramedics resorted to calling in patients by phone. Many patients simply arrived in cars or, in one instance, several in the back of a truck.

To an outsider, “it would look like a disaster zone, a chaotic scene, very chaotic,” Ms. Mullan said. “If a nonmedical person were to be sitting there watching this, they would think nothing was being accomplished.”

But in fact much was being done. It had been a busy day, which meant some of the day shift was still present and stayed to work alongside the night shift. Pagers went off with a be-beep be-beep each time a severe trauma case was identified. Patients, most of them with gunshot wounds, were doubled up two stretchers to a trauma bay. At one point, beepers screeched as five trauma cases were clocked in at the same time. “We couldn’t hear each other talk, it was that crazy,” Ms. Mullan said.

The injured also poured into other area hospitals. At Sunrise Hospital & Medical Center, within walking distance of the concert, 90 patients arrived in the first hours and by noon on Monday the total had reached 180. Of those, 124 “met the criteria for trauma activation,” said Dr. Jeffrey Murawsky, the hospital’s chief medical officer.

They included patients with single and multiple gunshot wounds to the head, face, chest, body, arms and, in one case, a finger. By Monday afternoon, sixteen patients had died, some on arrival and others after being treated.

Patients were sorted in the lobby of the emergency room on a scale of one to five, with one being the most critical, a system used daily. On Monday afternoon, operating teams at Sunrise were still at work. More than 50 patients had undergone surgery.


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