How Hospitals Are Preparing for Crises Like the Orlando Shooting

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Trauma centers in major cities are accustomed to seeing surges of gunshot patients (especially during the summer—research shows a correlation between heat and higher amounts of violence), and hospital staffs are adept at triaging the flow, opening up beds, and finding extra hands. But is it possible to prepare for the carnage and chaos that we’ve seen in places like Orlando, San Bernardino, and Newtown? They’re trying.

ORMC, along with many other major trauma centers, hold periodic large-scale disaster simulations to prep for scenarios like school shootings, disease outbreaks, bombings, and plane crashes. Professional actors or volunteers—all with different “injuries”—are hired, ambulances and helicopters are deployed, and emergency workers and doctors triage the patients at the scene and in the hospital, sending them through fake bloodwork, x-rays, lab testing, and operations to see if the “surge” plan works.

Photograph by BRENDAN SMIALOWSKI/Getty Images

At Stroger Hospital in Chicago, trauma center docs often see upwards of five to 10 gunshot victims in a night, and these drills have helped prepare them for the worst.

“We can have up to 20 surgeons available within 20 minutes, and our one or two operating rooms typically open can expand to 20,” says trauma surgeon Faran Bokhari, M.D., chairman of Stroger Hospital’s Trauma Department. When victims come in, they’re quickly labeled red (threat to loss of life or limb), yellow (moderately injured), or green (slightly injured) and rushed into various treatment bays. Gunshot victims that have pierced a major organ or artery hit the OR first, where docs perform speedy surgeries before moving on to the next victim. “Part of training is to build stamina—most of us can stand for 24 to 30 hours without stopping,” says Bokhari.

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When the Pulse nightclub shooting victims started streaming into ORMC, Smith had started his shift 20 hours earlier, at 6 a.m. The plan he and the other surgeons had trained for went “as well as we could have hoped,” he says, but loads of challenges still exist. The emergency alert system that was sent out didn’t reach everyone (docs still use pagers, and when they’re not on call those pagers might be cast aside, which is why Smith was calling personal cell phones).

What’s more, families of victims are often left hopelessly waiting for word. “These trauma patients were all ‘doe patients’ (unknown identity) so we can get their labs and bloodwork and care for them quicker, but it creates confusion,” says Smith. “As a system we need to find ways to identify people and get in touch with families sooner.”