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New guidelines prep providers on effective care responses to mass shootings

by John R. Fischer, Senior Reporter | July 27, 2022
Emergency Medicine
A group of specialists with experience providing care in mass shootings came up with recommendations to help providers respond to these events effectively.
As mass shootings increase nationwide, researchers are looking at ways medical systems can be better prepared to respond to these events.

Gathering together EMS, emergency medicine and surgical specialists who provided care in the immediate aftermath of mass shootings, the Uniformed Services University of Health Sciences (USU) National Center for Disaster Medicine and Public Health held a conference in September 2021 to discuss what healthcare providers should do when faced with these tragedies.

Participants had responded to shootings in Las Vegas, Sutherland Springs and El Paso, Texas; Orlando and Parkland, Florida; and Dayton, Ohio, all of which resulted in 15 casualties or injured individuals. Together, they devised eight recommendations recorded in a paper, Mass Shootings in America: Consensus Recommendations for Healthcare Response.

They suggested:
  • Readiness training that reenacts real events to prepare entire community systems
  • Public education, web-based programs to teach people which hospitals to send mass shooting patients to for care
  • A staged and iterative triage process for at the scene and in the ED to prioritize operative care
  • Teaching prehospital staff effective communication skills for at the scene and in hospitals
  • A system for tracking patients from point-of-injury through subsequent care
  • Immediate access to alternative methods for documenting patient care and entering orders
  • Fast, organized ways of alerting and bringing together family members and providing assistance
  • Implementing mental health services for responding clinicians

Clinicians completed a two-part pre-conference survey and broke into subgroups based on their specialties to come up with recommendations. The study authors finalized similar suggestions among all three.

Eleven additional ones were made, including anatomic considerations for mass shooting triage. “The location of the bullet holes on a patient is important in getting the patient the right care as quickly as possible. This change could be a pretty easy recommendation for hospitals to implement,” said study author Dr. Craig Goolsby, vice chair of USU’s Department of Military and Emergency Medicine, and the science director of NCDMPH, in a statement.

Since mass shootings are unlikely to affect a given community on any particular day, the authors see the recommendations as a way of preparing prehospital and health systems in the event of a mass shooting.

The recommendations were published as an “article in press” in the Journal of the American College of Surgeons.

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