Training, Drills Pivotal in Mounting Response to Orlando Shooting.

Emergency providers at Orlando Regional Medical Center in Orlando. FL, faced multiple challenges in responding to the worst mass shooting in U.S. history. As the scene of the shooting was only three blocks away from the hospital, there was little time to prepare when notified that victims would begin arriving shortly after 2 a.m. on June 12. Also, fears of a gunman near the hospital briefly put the ED on lock down. However, using the incident command system, the hospital was able to mobilize quickly, receiving 44 patients, nine of whom died shortly after arrival. Administrators note that recent training exercises geared toward a mass shooting event facilitated the response and probably saved lives. Patients arrived at the hospital in two waves, with the initial surge occurring right after the hooting took place around 2 a.m., and the second surge occurring about three hours later. At one point, more than 90 patients were in the ED, more than half for reasons unrelated to the shooting. Clinicians contended with a much higher than usual noise level while treating patients, making it hard to hear reports from EMS personnel. Also, treatment had to commence prior to identification for some patients who arrived unconscious or unable to speak. While surgeons and other key specialists were called into the hospital to address identified needs, administrators actually called hospital personnel to tell them not to come in unless they were notified. This prevented added management hurdles.