Sandy Hook Elementary. Marjory Stoneman Douglas High School. The Las Vegas Strip. Tree of Life Synagogue. They’re all shorthand for mass casualty events that seem to get more frequent as time passes.
They also require hospitals to spring into action, and Kansas City area doctors and nurses are taking note. While it’s impossible to foresee every scenario, local doctors and hospitals are preparing for the unthinkable — whether it’s a mass shooting, hazardous chemical release or weather disaster such as a tornado.
“While you hope that all the preparation that you do for these types of things will never be necessary, to not prepare sets you up for a real problem,” said Mark Sinclair, a Children’s Mercy Hospital orthopedic surgeon who has a significant interest in pediatric trauma.
Sinclair started doing research several years ago to speak to a national orthopedic organization about pediatric considerations in mass casualty situations. He said that research made him realize, “We need to get our act together. We need to be prepared for all of these potential hazards whether they be mass shootings or natural disasters.”
Good preparation
That type of preparation is now occurring in the Kansas City metro area, said Robert Winfield, division chief for trauma, acute care surgery and critical care at the University of Kansas Health System.
“The regional preparation that occurs in Kansas City is outstanding,” he said. “The coordination between the trauma center and between the other facilities in the area, we drill together. We really, I think, are about as prepared as any community can be for a major mass casualty event.”
Winfield and Sinclair both recently spoke with KCUR’s Up To Date.
The Mid-American Regional Council has worked on mass casualty incident plans since the 1970s, and its most recent one dates from April 2015. It coordinates 39 emergency medical agencies and 30 hospitals within a 10-county metro area.
Kansas City’s Level 1 trauma hospitals include the University of Kansas Hospital, St. Luke’s, Truman Medical Center, Research Medical Center and Children’s Mercy. But Winfield noted that if such an incident occurs, “Every hospital in the community becomes a trauma center, and everyone has to be prepared to respond as a community to an event like that.”
The main difference between a mass shooting and other disasters, he said, is that a shooting “tends to involve a lot more surgical casualties” than a building collapse or weather calamity.
Disaster strategies
Disaster preparation steps include:
Coursework. Winfield said KU teaches the American College of Surgeons disaster management and emergency preparedness course, designed for health care providers but also available to laypeople.
Drills. Winfield and Sinclair said they do tabletop drills where they talk through different scenarios. They also do full-scale practice drills. Sinclair said Children’s Mercy plans a drill in a few weeks simulating a mass shooting.
Hemorrhage control. With shootings, Sinclair said, hemorrhage is the cause of death that’s most preventable if the bleeding can be stopped quickly. Regional coordination and a transportation plan are also important to get trauma patients where they need to go as quickly as possible.
Hazard vulnerability analysis. All hospitals must assess potential hazards, and weather disasters top the list in Kansas and Missouri. For example, a Joplin hospital took a direct hit from a tornado in 2011. Winfield and Sinclair said that illustrates the need for proper evacuation plans and other contingencies, including ensuring adequate supply stockpiles.
Debriefing. It’s important to study events after the fact, to improve response the next time. It’s also important, Winfield said, to address the stress these events inflict on medical responders. “It’s a long-term healing process,” he said.
The public’s role. People with first aid and emergency training can be very helpful in a disaster. But having well-meaning people show up unannounced at a hospital is not welcome. “The more people that show up at the hospital,” Winfield said, “they just create more chaos and it’s more difficult to control.”
Mark Sinclair, pediatric orthopedic surgeon at Children’s Mercy Hospital, and Robert Winfield, division chief for trauma, acute care surgery and critical care at the University of Kansas Health System, spoke with KCUR 89.3 on a recent edition of Up To Date.
Lynn Horsley is a freelance journalist and was a veteran reporter for The Kansas City Star. Follow her on Twitter @LynnHorsley