Las Vegas Sun

December 13, 2017

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Hospitals: ‘No training on earth that will prepare you for this’

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Yasmina Chavez

Scenes from outside University Medical Center in Las Vegas following a mass shooting on the Las Vegas Strip on October 1, 2017.

Hospital staffers routinely deal with people with traumatic injuries, but when they arrived in large numbers after Sunday’s mass shooting on the Las Vegas Strip, even the most seasoned professionals could not be prepared for what they saw.

“It was like a war zone,” said Mason VanHouweling, chief executive officer of University Medical Center. “Patients showing up in trucks and cars. Patients were on top of each other. Ambulances, taxis, you name it — we were just pulling patients out, trying to get them the quickest care possible and save their lives.”

VanHouweling, who was at home when he got the initial call, sped over to UMC as quickly as he could. “I jumped in my car. I may have broken a few speeding laws coming from my home but was here and watched our staff perform remarkably,” he said.

VanHouweling helped coordinate the response to treat the large number of patients.

“It was a long night, long morning, just trying to reconnect people with their families and caring for all the patients,” VanHouweling said. “We had to turn other parts of the hospital that would not normally be patient care areas for emergency type of situations.”

Similarly, Rayla Allen, a trauma nurse at Sunrise Hospital, was also at home on Sunday night. She received a call from her director shortly after the shooting, telling her to call as many people as she could to head to the hospital.

“I got in my car and I began to call people, waking some of them out of bed, and we all got the hospital at the same time,” Allen said. “When we walked in, there was a large Metro presence. There are were gurneys and staff members out in our ambulance bay waiting for the next ambulance to come through.”

She said she’ll never forget what she saw.

“There were blood trails from the ambulance bay into the hospital corridors and into the units,” Allen said. “You could see all the providers and nurses jumping from station to another, ‘I need an IV here. I need a chest tube here.'”

Once the news broke about the shooting, VanHouweling said he didn't have to ask for his staff to come in to help. About 300 staff members showed up on their own accord after they saw the news.

“We didn’t have to call people: They just came,” he said. “It really helped. It was truly a team effort.”

Of the 104 patients UMC took in, all who showed up with a pulse have survived so far. Four victims died en route to UMC before they could receive medical care.

The medical team at UMC moved quickly and had every patient who came to the hospital in a bed by 2 a.m. Monday, said Dr. John Fildes, UMC trauma center's medical director.

“I can’t say enough good about the staff, every single person,” Fildes said. “Our disaster plan was executed flawlessly.”

At Sunrise, Allen said almost every patient who came in had a gunshot wound of some sort.

“Those who needed OR went to OR; those who were stable waited,” she recalled. “It was crazy. No one is ready for anything of this magnitude. There is no training on earth that will prepare you for this.”

Of the 199 patients that were admitted to Sunrise, 16 died. There are still 45 victims in Sunrise care, with 23 of those in critical condition.

Sixty patients are still at UMC, with the list of critical condition victims dropping from 12 on Tuesday to six on Wednesday.

“They’re moving in the right direction,” Fildes said. “We’ll continue to manage and care for the patients and hopefully get many of them discharged soon and get them back home. We had patients from all over — Texas, Arizona, California, Northern Nevada and here in Las Vegas.”

After being at UMC for 21 years, Fildes said he thought he has seen it all. He was wrong.

“Nothing like his,” he said. “Everything that you know about that’s happened here, I’ve been here, but this is the biggest one.”

After working for the better part of three days tending to the victims and counting, Allen said that a pair of occurrences will stick with her for the rest of her life.

“The bloodied floors don’t belong in a hospital,” she said. “Then having armed SWAT protecting your doors. Those two things don’t belong in an emergency room.”

UNLV School of Medicine

The UNLV School of Medicine has also played a vital role in the response. The school sent 76 residents and fellows to assist the hundreds of victims, most going to UMC.

There were 30 emergency medical residents, 28 general surgery residents, eight orthopedic residents, three plastic surgery residents, three surgical critical care (fellows) and three acute care (fellows) used from UNLV.

Fildes, who also serves as the chairman of the department of surgery at the UNLV School of Medicine, said the UNLV students augmented the hospital’s response.

“On any given night if you were to come and visit us at the trauma center, we would have a dozen or so victims of car crashes, gunshots or stab wounds,” he said. “But to have over 100 at once, you have to have the ability to amplify your staff."