S
unrise Hospital & Medical Center is just a few miles
away from where the Route 91 Harvest Festival was
in its third and final night. The event was wrapping up
with headliner Jason Aldean, and thousands of country
music fans were enjoying the show. Then, just after 10
p.m., the shooter opened fire from the 32nd floor of
the adjacent Mandalay Bay hotel. Within moments the
terrified concertgoers were running in every direction,
or helping those who’d been hit try to find cover. Police
and emergency services personnel began offering first
aid to victims while also trying to control the crowds,
and they began to radio for reinforcements.
Those radio calls were the first sign to doctors,
nurses, and staff at Sunrise that something major
was happening. It had been a fairly routine night in
the 52-bed emergency department, but even a slow
night means plenty of activity at Sunrise, a Level II
trauma center and the closest hospital to Las Vegas’s
famed Strip—and the concert. The hospital gets about
165,000 adult and pediatric visits a year, and some
115,000 emergency department visits annually as well.
Around 120 ambulances per day pull up. But even the
busiest facility in Nevada couldn’t be fully prepared for
what was coming, says Dr. Scott Scherr, the hospital’s
medical director and also the regional medical director
for TeamHealth.
“I was at home when my phone started going off,” Dr.
Scherr says. “I was listening to the radio on the way in,
to news, and they said two confirmed dead with
multiple injuries. I was expecting to see some patients,
but not the number of patients we ended up seeing
that night. When I arrived, and walked towards the
ambulance bay, there were already private vehicles,
trucks, Ubers, and taxis lined up, with people pulling
the patients out the backs.”
The ambulances then began to arrive, some with as
many as five or six patients inside. Hospital staff, after
getting word of mass casualties headed their way, had
mobilized all available gurneys and wheelchairs out
front to receive them.
As medical director, Dr. Scherr would be in constant
communication with the physicians in the ER and
elsewhere, running point on every logistical need
from supplies to X-rays and transport.
Around 10: 27 p.m., he and his colleagues
began lifesaving efforts that would last
into the early morning hours.
Triage categories and process
enhanced patient flow
The emergency room physicians had
created a triage system so that victims
could be assessed based on the location
and severity of wound, an essential first
step when treating what would be
hundreds of gunshot victims. Dr. Scherr
assisted in those efforts and also
trafficked the victim flow so that
physicians could begin to treat patients
and prep those who needed surgery.
“I managed my physicians as well
as the trauma surgeons,” he says.
“We cordoned off our ER into
different sections based on the
MCI Triage Criteria.”
ABOUT DR. SCOTT SCHERR
Scott Scherr, MD, is emergency
department director at Las Vegas-
based Sunrise Hospital & Medical
Center and regional medical director
of Knoxville, Tenn.-based
TeamHealth. He and his staff
treated more than 200 of the 500
people injured in the worst mass
casualty event in U.S. history.
That meant Station One held:
• Black Tag: patients that had no signs
of life—they were dead on arrival.
• Red Tag: patient has seconds, to
minutes, to live; unstable vital signs along
with fatal or high-mortality gunshot wounds.
While Station Two supported:
• Yellow Tag: patients with an hour to live.
“We started resuscitating them, doing procedures in
those areas, and then that expanded because we had
more of those Yellow Tags,” Dr. Scherr says. “We
would put two to three gurneys inside each ER bay,
and then we expanded it into Station 4, which just
runs along the ER.”
The medical teams also were caring for Green Tag
patients, those with gunshot wounds to the extremities.
Those were moved into vertical-treatment areas, and
when those areas reached capacity, patients were
relocated into the adjacent pediatric emergency
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