Aug 29, 2019

Respiratory Emergency Preparedness: Las Vegas

Keith Varnes

On October 1, 2017, a lone gunman shot hundreds of people attending a concert in Las Vegas. This isn’t a discussion on gun control or mental health – this is a discussion on being prepared to react to any incident with a high volume of casualties. Are you ready to use your skills in respiratory to respond to mass casualty events? 

Are you really ready?

My hospital occasionally conducts a disaster drill or has us take online modules about mass casualty events, but I never fully grasped the enormity of the situation until I read the article How One Las Vegas ED Saved Hundreds of Lives After the Worst Mass Shooting in U.S. History in Emergency Physicians Monthly by Kevin Menes, MD, Judith Tintinalli, MD, MS and Logan Plaster.  

I work at an urban trauma center and gunshot victims are a routine occurrence. The most I have had to deal with simultaneously is three, where a person driving on the freeway was shooting at people randomly. That was stressful enough. The medical staff at Sunrise Hospital in Las Vegas treated 231 victims with many walking out on their own before treatment. 

How to Prepare

The way many departments react to mass casualty events is to pull as many people to the ED as possible from the other areas, call in everyone, pull vents out of storage, and to teach anyone you can find how to use an AMBU bag.  The most important thing to do is set up a command center. Someone needs to be in charge.

After reading the article above, you should be looking for and solving choke points in patient care. Should you start I.V.s before you need them? What happens when you run out of vents? Do you have enough chest tubes? What other resources are available in your area that you could draw on? The Center for Disease Control has a Strategic National Stockpile (SNS) of ventilators. How do you access it? How long does that take? What kind are they? Do you know how to use them? Respiratory therapists are the main source of ventilator knowledge at most facilities. If you aren’t knowledgeable about these vents, who is? These are just some of the questions you should be asking now before an event like this shows up at your door. It may not be a matter of if, but when. 


I encourage you to read the articles we have referenced and linked to below. See which ideas they used might benefit your hospital. Most importantly, check out the section of the article called Controlled Chaos: MCI Lessons Learned to discover the 6 lessons the physicians learned during this tragic experience.

Learn More

To better prepare yourself for incidents like these, take our class Emergency Preparedness for Mass Casualty Events for live credit, or you can take the self-directed version here. This course has been written specifically for respiratory therapists and counts for two AARC approved CRCE hours.

Use discount code BEPREPARED for 15% off either version of our Respiratory Emergency Preparedness class.

Keith Varnes

Keith Varnes, RRT-NPS, RRT-ACCS, AE-C, is the company founder, President, and chief visionary of Respiratory Associates. He creates content for our Live and Real-Time Live Broadcast continuing education courses. He has been in the respiratory field since 1983 enjoying a diverse career including DME, software development, agency staffing, and working at a level 1 trauma center. He is also an ACLS and PALS instructor.

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