In summary, the best laid plans need to be practiced over and over again. You need a robust system for reaching team members in times of mass casualty. Many team members no longer have land-line phones, their cell phones are turned off at night or they do not always answer cell phones or have them near at night. You need a method to get back-up supplies if there are multiple injuries of the same nature. For example, crushing chest injuries require more chest tube trays than you would normally have on hand. You need to prepare for an influx of family that requires support, especially if there are many victims and identification is difficult. Lastly, supporting your teams for days and even weeks afterward is essential to the overall health of your organization.

One unexpected outcome of the Pulse disaster was pride in our shared teamwork and in how the hospital handled the event and the number of lives we were able to save. Even those not working on the night of the shooting were proud that we could serve our community in this manner. We always thought we could do it and now we know we can do it.

Besides our concern for the patients and their family members, there was support for the team members who had direct involvement with the event and the horrific nature and volumes of injuries that presented to the ED that night. No one felt they were alone in this …..we all needed support from each other.