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Regional Health System Response to the Virginia Tech Mass Casualty Incident

Published online by Cambridge University Press:  08 April 2013

Lisa Kaplowitz ,
Morris Reece ,
Jody Henry Hershey ,
Carol M. Gilbert  and
Italo Subbarao
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Abstract

Background: On April 16, 2007 a mass shooting occurred on the campus of Virginia Polytechnic Institute and State University (Virginia Tech). Due to both distance and weather, air transport of the injured directly to a level 1 trauma center was not possible. The injured received all of their care or were initially stabilized at 3 primary hospitals that either had a level 3 trauma center designation or no trauma center designation.

Methods: This article is a retrospective analysis of the regional health system (prehospital, hospital, regional hospital emergency operations center, and public health local and state) response. Data records from all of the regional responding emergency medical services, hospitals, and coordinating services were reviewed and analyzed. Records for all 26 patients were reviewed and analyzed using triage designations, injury severity scores (ISS), and critical mortality.

Results: Twenty-five of the 26 patients were triaged in the field. Excluding 1 patient (asthma), the average ISS for victims presenting was 8.2. Twelve patients had an ISS of ≥9, and 5 had an ISS score of ≥15. Ten of the 26 patients (38%) required urgent intervention and surgery in the first 24 hours. The overall regional health system mortality of victims received was 3.8% (1 death [excluding 1 dead on arrival {DOA}]/ 26 victims from scene). The regional health system critical mortality rate (excluding 1 victim who was DOA) was 20% (1/5).

Discussion: The outcomes of the Virginia Tech mass casualty incident, as evidenced by the low overall regional health system mortality of victims received at 3.8% (1/26) and low critical mortality rate (excluding 1 victim who was DOA) of 20%, coupled with a need to treat a significant amount of moderately injured victims 46% (12/26 with ISS ≥9) gives credence to the successful response. The successful response occurred as a consequence of regional collaborative planning, training, and exercising, which resulted not only in increased expertise and improved communications but also in essential relationships and a sense of trust forged among all of the responders. (Disaster Med Public Health Preparedness. 2007;1(Suppl 1):S9–S13)

Keywords

Virginia Techmass casualty incidenthealth system responsetraumacritical mortalitytriage
Type
Original Research and Critical Analysis
Information
Disaster Medicine and Public Health Preparedness , Volume 1 , Issue S1 , September 2007 , pp. S9 - S13
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2007

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References

REFERENCES

1. Holley J. Students recount shootings. Washington Post. April 16, 2007. http://www.washingtonpost.com/wp-dyn/content/article/2007/04/16/AR2007041600826.html. Accessed July 20, 2007.Google Scholar
2.Baker, SP, O'Neill, B, Haddon, W, Long, WB.The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14: 187–196.Google Scholar
3.Frykberg, ER, Tepas, JJ.Terrorist bombings. Lessons learned from Belfast to Beirut. Ann Surg. 1998 569–576.Google Scholar
4.Frykberg, ER.Medical management of disasters of mass casualties from terrorist bombings: how can we cope? J Trauma. 2002;53: 201–202.CrossRefGoogle ScholarPubMed
5.http://www.citmt.org/start/overview.htm. Accessed June 6, 2007.Google Scholar
6.Peleg, K, Aharonson-Daniel, L, Stein, M, et alGunshot and explosion injuries: characteristics, outcomes, and implications for care of terror-related injuries in Israel. Ann Surg. 2004;239: 311–317.CrossRefGoogle ScholarPubMed
7.Biancolini, CA, DelBosco, CG, Jorge, MA.Argentine Jewish community institution bomb explosion. J Trauma. 1999;47: 728–732.Google Scholar
8.Cushman, JG, Pachter, HL, Beaton, HL.Two New York City hospitals' surgical response to the September 11, 2001, terrorist attack in New York City. J Trauma. 2003;54: 147–155.Google Scholar
9.Aylwin, CJ, König, TC, Brennan, NW, et alReduction in critical mortality in urban casualty incidents: analysis of triage, surge, and resource use after the London bombings on July 7, 2005. Lancet. 2006;368: 2219–2225.CrossRefGoogle Scholar
10.Peral-Gutierrez de Ceballos, J, Turégano-Fuentes, F, Pérez-Diaz, D, et alCasualties treated at the closest hospital in the Madrid, March 11, terrorist bombings. Crit Care. 2005;9: 104–111.Google Scholar
11. Centers for Disease Control and Prevention. In a Moment's Notice: Surge Capacity in Terrorist Bombings. CDC Web site. http://www.bt.cdc.gov/masscasualties/surgecapacity.asp. Accessed July 20, 2007.Google Scholar