At the time we were notified about the shooting, the trauma surgeon on call started calling in additional attending surgeons to aid in the care of the victims. Concurrently, the senior resident on call began calling additional residents. Residents of all PGY levels were called and responded immediately and without question. These responding residents presented to the emergency room and immediately began to evaluate and treat victims. The senior resident on call, with guidance from the on-call attending, began to assign groups of patients to specific residents. Additional residents were sent to the operating rooms, triage areas and the ICU. Many of them were fulfilling jobs that were outside their routine responsibilities in a trauma situation.
Residents were involved in all aspects of care from triage and emergency procedures in the emergency room, working in the operating room with faculty, providing ongoing resuscitation in the ICU, even helping with patient transport. We believe that their trauma training was essential to the impact that they made as valuable members of the team.
Throughout the night and the following days, our residents worked tirelessly with the faculty to ensure that the victims of this tragedy were triaged, treated and identified. The influx of surgical trainees was essential in our early response and allowed for a broader allocation of surgical resources. While not all residents were called in to help that night, nearly all of our residents provided care to the victims throughout their hospital stay.
The variables that affected the residents’ responses are numerous. Trauma training, disaster preparedness, prior exposure, leadership, compassion, confidence, dedication, availability of and allocation of resources, hospital support, patient ownership, the list goes on and on. Some of these variables — such as training and preparedness — can be quantified, some cannot. It is also important to recognize the effect the residents had on the outcome is one part of this discussion, recognizing the effect the mass casualty had on them is equally important. In our review of this mass shooting and the role our residents and residency program played we found that we were very prepared for some aspects of mass casualty response and were unprepared for others.