How Vanderbilt University Medical Center sprang into action after Tuesday's school shooting

Responding to its first school shooting since its designation as a trauma center 30 years prior, Vanderbilt University Medical Center (VUMC) last week admitted six students wounded at Marshall County High School, Shelby Livingston writes for Modern Healthcare.

A first for Vanderbilt Medical

On Tuesday, a 15-year-old male student at Marshall County High School opened fire in a common area, killing two students and wounding another 18. VUMC treated six of the victims, five of whom were flown by air ambulance to VUMC, which—at about 120 miles away from the school—was the closest Level 1 trauma center to Marshall County High School. The sixth victim was later transported by ground.

While the staff at VUMC had not previously treated victims of a school shooting, they have trained for such scenarios with multiple mass casualty drills and were prepared to care for Tuesday's victims, Livingston reports. Patients coming in were triaged by a team of trauma surgeons, emergency medicine doctors, nurses, and other health care providers.

Oscar Guillamondegui, the medical director of trauma ICU for VUMC, said, "At any given time, when we're told that there are multiple individuals [who] have been involved in trauma, I think at baseline we're ready to manage that. The team can grow to as many people as needed to manage those traumas."

Of the six patients VUMC treated, one passed away from a gunshot wound to the head. Three others have been discharged, and the final two, as of Thursday, remained hospitalized in stable condition. They were expected to be discharged between Sunday and Tuesday.

The emotional toll

According to Rick Miller, director of VUMC's trauma center, once the patients are cared for and stable, the trauma can take a serious emotional toll on staff. He said that doctors "have to cut [their] emotions off when [they] are trying to save somebody's life." He added, "When everything is said and done, and all the patients are doing OK, then we sit back and that's when it's tough on us."

After the patients were cared for, VUMC held a de-briefing to talk with staff and psychologists were available for those who needed them. "It's about resilience," Guillamondegui said. "We tend to downplay the things that we do, and we don't bring (our emotions) to the forefront, and then that ends up becoming what is considered a defense mechanism and I think it's an unhealthy one. We are becoming more aware of what wellness is in our profession and in doing so I am the first to open up" (Livingston, Modern Healthcare, 1/24; Neysa Alund, Tennessean, 1/25).

From shootings to hurricanes: How can your 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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