When a gunman opened fire on Akron birthday party attendees on June 2, injuring 27 and killing one, the medical staff at a Summa Health's Akron Campus Emergency Room had to mobilize.
It was after midnight, more than half of the victims were being brought by private car to the closest emergency room, Summa's, and there weren't enough nurses, surgeons and other essential medical personnel to treat such a rush of wounded.
So the hospital sounded the alarm. And the healers responded.
Here's how Summa's Emergency Medical Service Director Dr. Doug Gallo explained the night to Ideastream Public Media's Taylor Wizner.
GALLO: It was a little after 1 in the morning. I'd been on a string of nights ... so I was already awake and I got a blast text message that went out to all of our entire [Emergency Department] team that said there was what was called a "code yellow" involving multiple victims and that this wasn't a drill.
At first it was seven victims, then it was 14, and the count kept going up. We wound up with about double or triple the number of [staff] we normally have working at that time of the night, extra nurses, extra trauma surgeons, extra trauma surgery residents. One of [the residents] was literally walking out the door and then saw what was happening and turned around and came back in.
WIZNER: What was the E.R. capacity like that night? Were you full?
GALLO: Akron City ED (Emergency Department) is a Level 1 Trauma Center. On a nice late spring, early summer Saturday night, we were already at capacity. We [were] technically on EMS diversion (when emergency rooms temporarily close to incoming ambulance traffic) at the moment that page went out, so we were already full and then some.
Part of the reason that the ED got slammed so hard and so quickly was because everybody [who was shot] who could move got in a private vehicle. The closest facility to the shooting location was us. Four or five people all shot, all bleeding, all arriving at once in several clusters of that. There was very little notice, maybe one to two minutes, that this was about to happen.
"They will not be unscathed."Dr. Doug Gallo, ER physician at Summa Health Akron Emergency Department
One of the smartest moves that was made that night was our local city EMS agency, Akron Fire, realized what was going on with the ambulatory patients who jumped in vehicles. And when [Akron Fire] arrived on scene, they spread the patients with some of them going to Akron General. We are disproportionately over resourced for a city of our size to have two level one trauma centers within a mile of each other, and it really came in handy that evening.
WIZNER: I've heard the environment of a Trauma ED can sometimes be described as controlled chaos. If that's the baseline, how do you manage a potentially mass casualty event?
GALLO: There were a dozen people with bullets in the legs, arms, face, chest, buttocks, everything. Mostly low caliber weapons, thankfully. We physically cohorted everyone in a wing of the ED typically used for boarding patients who are awaiting inpatient admission.
And so one of the smartest innovations that was made was the simple low-tech solutions. So we had an eight-and-a-half-by-11 piece of paper that was taped to the wall next to every room that was literally check boxes for antibiotics, tetanus update, X-ray, CAT scan. Have they had laceration repair? It was simple, low tech. You didn't have to log in to a computer to do it.
And when you have 15 people with very similar injuries who are all screaming and many are drunk, they start to run together very quickly. And keeping track of all those people is one of the biggest challenges, and one of the biggest ways that [mass casualty incidents] go wrong. And it didn't that night because the team was so well organized.
WIZNER: For the 14 patients you treated who survived the mass shooting, what will their recovery be like?
GALLO: Some patients, it can morph into kind of long term paranoia and even PTSD. 'Oh my gosh, my town isn't safe.' I've seen people turn insular, turn angry, fearful, mean. I've seen that happen all too often. But I'm hopeful that we've got a pretty tight-knit community here in Akron. There's a lot of social support out there. There were a lot of families immediately at the hospital looking to take care of their loved ones. I'm sure they'll rally together. They will not be unscathed, certainly. But hopefully with enough community support, they can heal and start moving on. But that may take months for some of them.
