After Orlando shooting, hospitals treat 'relentless' stream of wounded, seek to comfort families

'This is something we have been planning for over 20 years,' health system says

This story has been updated

Orlando Regional Medical Center (ORMC) admitted more than 40 patients and set up an information center for families waiting to hear the condition of their loved ones in the wake of the mass shooting on Sunday, the deadliest in U.S. history.

Officials have identified Omar Mateen as the man who opened fire in a gay nightclub early Sunday morning, killing 49 and injuring more than 50 others. Mateen was also killed by police.

A 'relentless' stream of patients

The most severely injured patients were transported to ORMC, a Level I trauma center, while those with less-severe injuries were transferred elsewhere. Florida Hospital Orlando treated 11 victims, according to the Orlando Sentinel.

Early Sunday morning, ORMC doctors and nurses received a page notifying them of a mass-casualty event—even as the shooting itself continued.

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The first victims arrived after 2 a.m. ET. The trauma surgeon at the hospital initially called in two more surgeons, and then brought in a total of six because of the volume of victims, according to health care network Orlando Health. All  six surgeons were in the hospital and operating within an hour of the first patient's arrival.

Most patients were taken to the ICU or a critical step-down unit, while others were taken directly to an OR. The hospital admitted 44 patients, while nine victims "either arrived deceased or succumbed to their injuries."

The stream of patients "was relentless," an ORMC staff member tells People Magazine. "It was like everyone showed up all at once, and then more people kept coming. Like, one minute we were waiting, and the next minute, it was chaos."

The situation has been difficult for all involved, including hospital staff. "I went into the staff room because I needed a minute, and there were two other nurses crying," the staff member says. "I think everyone took a minute at some point last night and let out the emotions."

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Michael Cheatham, ORMC's chief surgical quality officer, said on Sunday that "many of the gunshot wounds were fairly severe ... Our operating room has been quite busy all day long with those injuries."

He added, "Now it's a matter of stabilizing the patients and identifying non-life threatening injuries and, most importantly, unit[ing] victims with their families."

The hospital and hospital grounds barred visitors on Sunday "out of consideration for patient, staff, & family safety," according to Orlando Health. ORMC set up a family information center at a nearby hotel.

As of Sunday afternoon, OPMC had identified all patients at the hospital and was "working on reuniting patients with their families." The hospital also lifted its lockdown at about 4 p.m. ET on Sunday.

The mayor of Orlando on Sunday said that the White House had waived the Health Insurance Portability and Accountability Act (HIPAA) in order to allow hospital staff to communicate with families, according to The Atlantic's Matt Ford. However, HHS Assistant Secretary for Public Affairs Kevin Griffis said no waiver was granted, adding that "HIPAA gives health care [professionals the] ability to disclose limited health care info in appropriate circumstances."

What it takes to respond to a Brussels-type attack

As of 10:30 a.m. ET Monday, Orlando Health said six victims had been discharged and 29 remained, while no additional patients had died.

Orlando Health stresses that responding to a mass shooting "is something that we train for regularly," adding, "This is something we have been planning for over 20 years, and unfortunately it occurred." ORMC conducts weekly trauma simulations and also periodically carries out "large-scale, city-wide simulations," Orlando Health says.

Community responds to call for blood donations—although some can't donate

The blood-donation foundation OneBlood on Sunday said there was "an urgent need for O Negative, O Positive, and AB Plasma blood donors," and the Orlando community has responded.

Hundreds of people lined up to give blood at OneBlood donation centers on Sunday. The response was so great that the organization asked those with blood types other than those most in-demand to hold off on donating "until we can assess what else we need."

The fact that the shooting took place at a gay nightclub also put a spotlight on the restrictions that FDA places on blood donations from men who have sex with men (MSM), Jennifer Kay reports for the Associated Press.

In December, FDA released a final rule that eased a decades-old policy that prohibited MSM from donating blood. The new policy allows MSM to donate blood if they have abstained from sex with another man for at least one year.

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Several people reported on social media that OneBlood was accepting all blood donations from MSM, AP reports. However, OneBlood says such reports are false. A OneBlood spokesperson tells the Washington Post that no MSM—not even those eligible under the revised FDA guidelines—have been able to donate blood at the group's centers:

OneBlood's system, he says, will not be updated until later this year to allow MSM to donate blood if they have abstained from sex with another man for at least one year.

Some activists have renewed calls for FDA to change its blood-donation policy for MSM amid Sunday's tragedy. Some have also called for legislative action to reduce gun violence. Sen. Richard Blumenthal (D-Conn.) says in a statement, "The Senate's inaction on commonsense gun violence prevention makes it complicit in this public health crisis."

Democratic and Republican lawmakers also called for taking additional steps to combat terrorism (Ehrenfreund/Eunjung Cha, "Wonkblog," Washington Post, 6/12; Kay, AP/ABC News, 6/12; Alvarez/Perez-Pena, New York Times, 6/13; Mueller, New York Times, 6/13; Miller, Orlando Sentinel, 6/12; Cherney/Hayes, Orlando Sentinel, 6/13; Helling/Truesdell, People Magazine, 6/12; Orlando Health tweets, accessed 6/13; Ford tweet, 6/12; HHS website, accessed 6/13; Blumenthal statement, 6/12).

How hospitals can prepare for mass-casualty events

Hospitals must be prepared for myriad disasters that can stress health care systems to the breaking point and disrupt delivery of vital health care services.

The Advisory Board has compiled step-by-step procedures for various threats your facility may encounter—though we hope you'll never need to use them.

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