Upon the call of the mass casualty incident, the supervisor reported to the ED to assess the event and determine what staffing resources would be needed. Luckily, the supervisor on that night had recently switched from day to night shift and had regularly participated in the mass casualty drills. He was knowledgeable in the mass casualty process and well aware of what was required from our department to ensure that proper resources were available to support the incident. Upon notification of at least 20 gunshot victims, it was evident that staff would need to be pulled from the critical care areas to provide care for the victims. Unfortunately, we did not have 2 supervisors on that night, which made coordination efforts more challenging. The supervisor immediately called all available staff to the ED and prepared them for what was incoming.


Within minutes, patients began to arrive in droves. There was no report received from EMS, so expecting the worst became the standard. Each patient was immediately assessed to determine the need for airway stabilization and ventilatory support. All hands were on deck as therapists provided CPR, intubations and transports to the OR for the most critically injured victims. Supplies were quickly depleted and additional therapists were used to retrieve more supplies to restock and prepare for the next wave of victims. This continued until the last Pulse patient came through the door.


For our department, this incident didn’t just last a few hours, but continued for days, weeks and months. Our therapists provided respiratory care and support to these patients from the moment they entered our Emergency Department until the day they left our hospital. Ventilatory and oxygenation support, hemodynamic monitoring, lung expansion therapy, chest drainage monitoring and, yes, emotional support were the services we provided to the victims of the Pulse tragedy.