When staff at Littleton Adventist Hospital in Colorado treated victims of a mass shooting at STEM School Highlands Ranch on Tuesday, for some, the situation was one they'd confronted not just in training but in real life— two other times, Claudia Koerner reports for BuzzFeed News.

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School shooting leaves 1 dead, 8 injured

On Tuesday, 18-year-old Devon Erickson and 16 year-old Alec McKinney, whose legal name is Maya Elizabeth McKinney, allegedly opened fire at STEM School Highlands Ranch, a charter school near Denver, not far from Columbine High School. One 18-year-old student was shot and killed when he tried to stop the shooter. Eight others were injured in the incident. The shooters were unharmed.

Five victims were taken to Littleton Hospital. Two were in serious condition. USA Today reported Thursday that a hospital spokesperson said three had been discharged.

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Two other victims who were in stable condition were taken to Sky Ridge Medical Center.

Children's Hospital Colorado received one victim at its Highlands Ranch campus. That patient has been treated and released.

How Littleton Hospital responded

Littleton hospital trains for mass casualty events twice a year.

When Tuesday's shooting happened, staff were notified to expect multiple victims, Koener reports. The hospital set up a command center and went on lockdown, regulating who went in and out of the facility.

According to Mark Elliott, an emergency physician at Littleton Hospital, trauma surgeons, anesthesiologists, a neurosurgeon, and other staff were ready to receive patients within 15 minutes.

The emotional toll school shootings have on staff

Tuesday marked the third time some staff at Littleton hospital received patients who were victims of a school shooting. The first time was in 1999, when the hospital treated victims of the Columbine High School shooting. The second time was in 2013, when the hospital treated a 17-year-old shot at Arapahoe High School, who later died.

Other members of the staff have treated patients from multiple school shootings as well. For some, victims have been from the schools their own children attend.

Elliott, an emergency physician of 30 years who treated victims from Columbine, said while school shootings are handled the same as other mass casualty events, they take an especially large toll on staff's wellbeing. "It changes things incredibly just from an emotional standpoint," Elliott said. "There's that feeling of, 'Why again? Why do we have to go through this again?'"

Of the incident, Elliott said, "We are rather resilient, and it makes staff just perform at their most superb level." He added, "The staff [on Tuesday] was just incredible."

But he added that when it comes to school shootings, "physicians, nurses, and all the ancillary staff can become second victims."

Littleton Hospital has set up ways to support medical staff. On Thursday, the staff was scheduled to have a formal debriefing on Tuesday's events. Staff also have been trying to check in with each other, via a private staff Facebook group and in person, Elliott said.

Hospital staff will continue to train for future shootings, Koerner reports. Elliott added families and students should also prepare as best they can. 

"It's sad that that's the reality we have now," Elliott said. "Parents need to hug their kids" (Koener, Buzzfeed News, 5/8; Gooch, Becker's Hospital Review, 5/8; Healy/Stack, New York Times, 5/7; Schmelzer et al., Denver Post, 5/9; Hughes et al., USA Today, 5/8).

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