Pittsburgh area hospitals have never dealt with an all-at-once influx of patients anywhere near the 500-plus people injured in Sunday night’s shooting massacre in Las Vegas.
Medical officials say they’ve never practiced for a tragedy of such magnitude, either, but they’re confident that the necessary procedures, personnel and resources are in place to handle that nightmarish scenario.
“We would not be panicked into a coma,” said Bill Smith, UPMC senior director of emergency preparedness. “We — the entire region, not just UPMC — would have the ability to manage it.”
Nine UPMC hospitals in Allegheny County have emergency departments, including specialized trauma centers at UPMC Presbyterian, UPMC Mercy and UPMC Children’s hospitals to deal with life-threatening injuries such as shootings. The Allegheny Health Network has three emergency departments in the county, including trauma units at Allegheny General Hospital and Forbes Regional, and several independent hospitals also have emergency rooms.
Representatives of the two health systems say preparedness plans are established with both the city and county for government emergency management coordinators to oversee communications and triage of patients during any mass casualty incident. The goal is to make sure no one hospital is immediately overwhelmed just because it’s closest.
In a large shooting spree of the kind southwestern Pennsylvania has never experienced, they would expect the trauma centers to be called upon for the most critical cases, but other emergency departments would be used for injuries less likely to be fatal.
Hospitals have their own individual emergency disaster plans that include drills for handling calamities, officials with the two major health systems said. Part of the response plan involves flipping other areas of the hospital, such as recovery rooms, into overflow emergency treatment centers as needed. Staff members are also identified for readiness to move into emergency work they may not routinely do but are qualified to handle.
The system should work so long as communication is good among emergency management officials and all of the hospitals involved, which could also include those outside Allegheny County for a major event, said Allan Philp, AHN director of trauma surgery.
“Any time you’re dealing with mass casualties like [the Las Vegas shootings or Boston Marathon bombings], the initial triage in the field is probably the most critical. That’s what allows the next step, the trauma center, to continue to function efficiently and effectively,” Dr. Philp said. He added that hospitals have to be prepared also to handle walk-in patients arriving on their own with injuries, as occurred in Las Vegas.
In normal operations, the three local AHN hospitals have a combined 90 emergency department rooms, but their officials said many more patients than that can be treated in a crisis since they don’t all need rooms and other areas of the hospitals can be used. UPMC, with more facilities, could handle a higher number of patients, although its officials had no estimate to supply.
“We have plans that envision dealing with a sudden influx of a large number of people in a mass casualty incident. Do we scope that to 500? Honestly, no, because you can’t scope for 500, but we scope for a mass number and move forward to handle it as needed,” Mr. Smith said.
Area hospitals have never had do deal at one time with dozens of shooting victims, let alone hundreds. This century has seen several horrific shooting sprees, however, with the largest number of injuries occurring in 2009 when three people were killed and nine were wounded at the LA Fitness Center in Collier.
For sheer volume of casualties, that was topped by the 24 injured people taken to six area hospitals in 2014 after a stabbing spree at Franklin Regional High School. On that day, Forbes Regional and UPMC East quickly set up emergency command posts and called in additional staff. UPMC Presbyterian postponed several scheduled surgeries to be sure it could treat stabbing victims.
Allegheny General Hospital used 120 volunteers last year in simulating what might occur from a concert bombing at nearby Stage AE, with that number of patients flooding its doors.
“That number stressed us almost to the point of failure, but if it were divided by six or seven or eight hospitals, it becomes more manageable,” said Gary Ciampanelli, AGH director of employee safety.
Gary Rotstein: grotstein@post-gazette.com or 412-263-1255.
First Published: October 2, 2017, 9:29 p.m.