Hailey Tran
On October 1, 2017, hospitals in Las Vegas were confronted with the deadliest mass shooting in modern American history. A gunman opened fire on a crowd of thousands at a country music festival, resulting in an unprecedented influx of patients with gunshot wounds. Hospitals across the city were inundated, with almost 600 patients flooding in, 58 of whom would ultimately succumb to their injuries. In the face of this crisis, the medical community demonstrated remarkable resilience and bravery, with hundreds of doctors, nurses, and support staff rallying to provide emergency care. This response, characterized by effective communication and coordination, exemplifies the dedication and humanity of those who worked tirelessly to save lives.
| Characteristics | Values |
|---|---|
| Number of patients treated at Sunrise Hospital | 214 |
| Number of doctors at Sunrise Hospital | 100+ |
| Number of other staff at Sunrise Hospital | 200+ |
| Number of patients across hospitals in Las Vegas | 500+ |
| Number of deaths | 58 |
| Number of patients in critical condition | 12 |
| Number of patients at the University Medical Center of Southern Nevada | 104 |
| Number of deaths at the University Medical Center of Southern Nevada | 4 |
| Number of patients who remained in the hospital | 45 |
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What You'll Learn
Hundreds of patients injured
On October 1, hospitals in Las Vegas were confronted with the worst mass shooting in US history when a gunman opened fire on a large crowd at a music festival on the Las Vegas Strip. Fifty-eight people were killed, and more than 500 were injured, many with severe gunshot wounds. Hospitals across Las Vegas were inundated as hundreds of injured people arrived at their doors by ambulance and private car.
Sunrise Hospital and Medical Center, a level II trauma centre located just a few miles from the festival, first received notice of a mass casualty event at 10:20 pm. The hospital's chief medical officer, Jeff Murawsky, explained that they "mobilized staff and supplies within the ED, operating room, inpatient units, and in [our] pharmacy and supply warehouse".
The hospital was faced with an unprecedented number of gunshot wounds, and staff had to react quickly. More than 100 doctors and 200 other staff were brought in, along with five chaplains. Transporters pushed patients inside, where they met doctors and nurses preparing to treat them. Environmental Services staff worked to clean up bloodied bedsheets and trails of blood.
The scale of the incident was overwhelming, with one doctor, Menes, describing how he found himself back-to-back with two other doctors, all intubating patients in a trauma bay built for one. Another doctor, Scherer, described how they treated 214 patients that night and was amazed by the capacity of the patients and their families to remain generous and understanding despite the horrific circumstances.
In the days and weeks following the shooting, hospitals continued to receive patients suffering from secondary effects, including skull fractures and injuries sustained from the stampede. They also saw an influx of people experiencing PTSD and anxiety related to the event.
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Hospitals inundated
On the evening of October 1, hospitals in Las Vegas were inundated with patients injured in the worst mass shooting in US history. A gunman opened fire on a large crowd of 22,000 fans at the outdoor Route 91 Harvest Festival, killing 58 people and injuring more than 500, many with severe gunshot wounds. Hospitals across the city were flooded with almost 600 patients, an unprecedented number of gunshot wounds for American hospitals to handle.
Sunrise Hospital and Medical Center, a level II trauma center located just a few miles from the festival, was the closest trauma center to the Las Vegas Strip. The hospital received 199 patients in six hours, with doctors, nurses, and other staff treating hundreds of injured patients. More than 100 doctors and 200 other staff were brought in to help, along with five chaplains. The hospital's chief medical officer, Jeff Murawsky, described how they mobilized staff and supplies within the ED, operating room, inpatient units, and pharmacy and supply warehouse.
The scale of the incident was overwhelming, with one doctor, Menes, describing how he found himself back-to-back with two other doctors, intubating three patients in a trauma bay built for one. Another doctor, Bowerman, tried to save a young woman who had been shot in the head, but despite their efforts, she passed away. The staff at Sunrise Hospital worked tirelessly to save as many lives as possible, with one nurse describing the amazing capacity of the patients to be generous and understanding, even in the midst of the chaos.
In the days following the shooting, hospitals continued to receive patients with secondary effects, including skull fractures and injuries sustained from the stampede. They also saw an influx of people suffering from PTSD and anxiety triggered by the traumatic event. The emotional fallout from the shooting extended to hospital staff as well, who were deeply affected by the tragedy.
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Staff's collective attention shifted to the ER
The staff's collective attention shifted to the ER as transporters pushed patients inside, where they met doctors and nurses carrying spare gloves and IV bags. The hospital quickly bypassed standard registration processes, moving to a system used in mass casualty situations to capture an alias on every patient treated. Dr Kevin Menes, the attending in charge of the ED that night, had previously supported a local SWAT team, and his experience helped him think ahead about how to mobilize his department in the event of a mass casualty incident.
Menes instructed the secretaries to get every operating room open and called in every scrub tech, nurse, perfusionist, anesthesiologist, and surgeon. He told the trauma nurses to keep all treatment areas clear and to keep an eye out for crashing patients. They were also instructed to make sure that all patients had bilateral 14-18 gauge IVs ready. The hospital also initiated its "code triage," in which staff from upstairs would come down to help by bringing down gurneys and spare manpower.
The surgery team performed 28 damage control surgeries in six hours and 67 surgeries in the first 24 hours. They had dispositioned almost all 215 patients by about 5 o'clock in the morning, just a little over seven hours after the ordeal began. That’s about 30 GSWs per hour.
Even a day or two after the incident, patients from the shooting continued to present to the ED. “We were getting transfers later on, and people eventually turned up who had injuries sustained from the stampede,” Obert notes. “People were stomped on and people hit their heads and had skull fractures, so there were some secondary effects from [the mass shooting]. And then we started getting influxes of people with degrees of PTSD [post-traumatic stress disorder] and anxiety.”
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Hospitals prepared to build capacity
Hospitals across Las Vegas were inundated on the evening of Sunday, October 1, 2017, when a gunman opened fire on a large crowd of thousands of people at a country music festival on the Strip. Almost 600 patients flooded into hospitals across the city, with 58 dying and more than 500 injured, many with severe gunshot wounds.
Sunrise Hospital and Medical Center, a level II trauma center located just a few miles from the festival, received more than 200 patients with penetrating gunshot wounds. The hospital's chief medical officer, Jeff Murawsky, explained that they mobilized staff and supplies within the ED, operating room, inpatient units, and in their pharmacy and supply warehouse.
The University Medical Center of Southern Nevada, the state's only comprehensive trauma center, received 104 patients, with four dying and 12 remaining in critical condition. Hospitals across the city called in reinforcements to handle the influx of patients, with hundreds of doctors, nurses, and support personnel reporting to work to assist the hundreds of patients lined up in ambulance bays and hallways.
The Southern Nevada Health District, which covers Las Vegas and Clark County, has a 65-page trauma system plan that outlines how emergency responders and hospitals should communicate, collaborate, and divide responsibilities in mass casualty situations. Ian Weston, executive director of the American Trauma Society, affirms that "hospitals are prepared to build capacity." They determine how many patients they can accommodate, even considering how many can fit into hallways temporarily. They prioritize the most critical patients for surgery, stabilize others in the ER, and treat some in the lobby.
The hospitals' ability to build capacity and quickly mobilize resources and staff undoubtedly contributed to saving numerous lives that night.
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Sunrise Hospital's emergency room
On the night of October 1, 2017, the Sunrise Hospital and Medical Center in Las Vegas received more than 200 patients with penetrating gunshot wounds. The hospital, located just a few miles from the Route 91 Harvest Festival, is the closest trauma centre to the Las Vegas Strip.
Dr Kevin Menes, the attending physician in charge of the emergency room that night, had previous experience supporting a local SWAT team and had thought about how he would handle a mass casualty incident. Menes chose to work the weekend night shifts in Sunrise Hospital’s emergency room because they offered the greatest opportunity to save lives.
As patients began arriving by the truckload, many in private vehicles, Menes sprang into action. He told the secretaries that he needed every operating room open and every nurse, scrub tech, perfusionist, anesthesiologist, and surgeon to get to the hospital right away. He instructed the trauma nurses to keep an eye out for crashing patients and to make sure that all patients had bilateral 14-18 gauge IVs ready. The hospital's "code triage" was also initiated, with staff from other departments coming downstairs to help.
The surgery team performed 28 damage control surgeries in the first six hours and 67 surgeries in the first 24 hours. By about 5 am, just over seven hours after the incident began, the team had dispositioned almost all 215 patients.
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Frequently asked questions
Almost 600 patients with gunshot wounds flooded into hospitals across the city, with 58 people dying.
Sunrise Hospital received over 200 patients, with 199 patients treated in six hours.
Hospitals across Las Vegas called in hundreds of doctors, nurses, and support staff to help handle the patients. Sunrise Hospital brought in more than 100 doctors and 200 other staff members.
