'Gut-wrenching': Inside Texas hospitals' response to Sunday's mass shooting

After a gunman opened fire at a Texas church on Sunday, University Hospital in San Antonio was "as ready [as] you can possibly be" to treat the wounded, ultimately receiving nine victims, according to Brian Eastridge, chief of trauma and emergency surgery, Jacob Beltran writes for the San Antonio Express-News.

How to reduce avoidable visits—in the ED and beyond

Background

The shooting occurred Sunday morning at a Baptist church in Sutherland Springs, Texas. According to officials, the alleged shooter, Devin Kelley, used an assault rifle to open fire at the church, killing at least 26 people and wounding at least 16 others.

Another armed individual reportedly engaged with and began firing at Kelley as he exited the church, causing Kelley to flee the scene in his vehicle. Law enforcement authorities said Kelley later was found dead in his vehicle following a pursuit. Officials said it was unclear whether Kelley had shot himself or was shot by another individual.

Multiple hospitals received victims of the shooting, including Connally Memorial Medical Center and Brooke Army Medical Center. In total, University Hospital received four children and five adults injured in the shooting, including four who were critically injured. Each of those patients arrived within 20 minutes of each other, according to Eastridge.

How the hospital prepared

According to Beltran, University Hospital was uniquely prepared to treat victims as it was in the midst of its annual credentialing review by the American College of Surgeons. As a result, the hospital had the verification and review team on campus on Sunday.

"We had seven trauma surgeons here when we got the original call about massive casualties from an active shooter," said Eastridge. He added, "In 45 minutes, we were up to the capacity to run 14 operating rooms and had a … triple-staffed ED."

Reflecting on the experience, Eastridge said he was reminded of his time as a surgeon in the U.S. Army. "These types of wounds we saw are very similar to the types of wounds we saw in deployed conditions," he said. "These are high-velocity rounds, so when they travel through tissue they … create a temporary cavity, and it causes a lot of tissue damage."

As of Monday afternoon, the hospital had treated and released three adults and one child injured in the shooting. Another four patients remain at the hospital as of Monday afternoon, with conditions ranging from serious to critical. The ninth victim treated at the hospital, a child, died during surgery, despite what Eastridge described as "heroic" efforts from providers. "Seeing an injured kid, particularly an injured child in your community, it's gut-wrenching," said Eastridge (Beltran, San Antonio Express-News, 11/6).

Members ask: How can our hospital prepare for disasters?

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.

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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