AURORA | The calls started at 1 a.m. on July 20, with grim tidings about a mass shooting at an Aurora movie theater.
The emergency room at the University of Colorado Hospital was already packed, according to Dr. Comilla Sasson, an attending emergency department physician at the University of Colorado Hospital. Sasson had started her shift at 11 p.m.
“We had an emergency department full of people, and we got a phone call that alerted us that there had been a shooting in the area,” said Sasson, who also works as an assistant professor of emergency medicine at the University of Colorado School of Medicine. “We went into disaster mode. We had disaster protocols in place for what they call mass casualty events.”
That protocol involved a pool of resources that included surgeons, nurses, interns and even custodial staff, Susson said. The following hours would see the arrival of more than 20 victims of the rampage at the Century 16 theater, patients that ranged in age from three months to 45 years.
The influx at the University of Colorado Hospital was part of a bigger plan to address mass casualty care, an approach that stretched across six hospitals in the metro area. According to Richard Zane, the new chairman of the Department of Emergency Medicine at the University of Colorado School of Medicine, that approach meant drawing on resources at neighboring facilities like Denver Health, Swedish Medical Center and the Medical Center of Aurora. It meant properly marshaling resources to provide specific care to specific patients. It meant learning from monthly drills designed to recreate the kind of chaos and unpredictability of a mass casualty event.
“What’s very important from the perspective of disasters is that it wasn’t as though we were inventing new things that day. The general concept of mass casualty care is consistent,” said Zane, who started his role as the new chairman in April and who came to the University of Colorado School of Medicine after a 14-year stint at the Brigham and Women’s Hospital in Boston. ” Every month, the hospital has a drill of some kind on disasters. The drills are quite variable. Sometimes, it’s numbers and numbers of patients presenting at the same time. Sometimes drills are all of the sudden you’ve lost all of your computers.
“Emergency preparedness, mass casualty care, disaster, it’s all part of the common vernacular,” Zane added.
But that didn’t mean that the crews were fully prepared for the sheer volume and severity of the injuries.
“I’ve not ever had to deal with this number of penetrating, severely injured patients at the same time, nor have most doctors,” Zane said.
First responders decided between six hospitals in the metro area for patients depending on injury, age and other factors. Of all the hospitals and medical centers, UCH took in the most. Of the 23 patients that arrived at the emergency department in ambulances, police cruisers and even private vehicles, 13 have been treated and released.
One of the patients was dead on arrival, officials said.
“I think the response of the University of Colorado Hospital was nothing short of heroic,” Zane said.
For Susson and the rest of the UCH responders, that sudden influx put their emergency training to an unprecedented test.
“I’ve worked in a level one trauma center in Atlanta, I’ve worked in Michigan, I’ve worked in Chicago. This is by far the largest number of patients I’ve seen come in at one time,” Sasson said. “We train as emergency department physicians for the worst of the worst … I think all of us hope that it never actually happens to us.”
Next door, physicians at the Children’s Hospital Colorado were under similar pressure. The hospital treated five patients ranging in age from 18 to 31. The youngest mortality reported in the attack was Veronica Moser-Sullivan, 6.
According to Dr. Guy Upshaw, an emergency room physician at Children’s, many of the injuries were from a shotgun attack.
“Most of the injuries we saw appeared to be from buckshot, and one patient had what looked like a high-velocity wound to the tibia of the lower leg,” Upshaw said. “It (was) controlled chaos. We train for such situations and events frequently. In this case, it was even more controlled than usual because patients were fairly even in space when they came in, 10 to 15 minutes apart.”
Upshaw added that the first patient arrived in a private automobile.
“That was the first inkling that we got that there had been a shooting,” Upshaw said. “They said that someone came in with some sort of device that produced smoke. He said he thought it was some kind of stunt as part of the movie. Then when they started hearing shots, they realized it was not a joke.”
At both hospitals, the physicians’ quick work and rapid response time earned praise from all corners, including President Barack Obama. Obama paid tribute to doctors, nurses and first responders during a visit to the University of Colorado Hospital on July 22.
“I also had a chance, fortunately, to visit some folks who are going to be OK, thanks to the extraordinary efforts of the staff at this hospital. And I just want to thank everybody who’s worked tirelessly here to deal with this tragedy,” Obama said.