Global & Disaster Medicine

Archive for the ‘Mass shooting’ Category

Crimea: A student went on a rampage and at least 17 people were killed and 40 injured in a school shooting



10/16/1991: George Jo Hennard drives his truck through a window in Luby’s Cafeteria in Kileen, Texas, and then opens fire on a lunch crowd of over 100 people, killing 23 and injuring 20 more.

History Channel


The Pulse and Preventable Deaths

E. Reed Smith, Geoff Shapiro & Babak Sarani (2018) Fatal Wounding Pattern and Causes of Potentially Preventable Death Following the Pulse Night Club Shooting Event, Prehospital Emergency Care, DOI: 10.1080/10903127.2018.1459980


“Background: Mortality following shooting is related to time to provision of initial and definitive care. An understanding of the wounding pattern, opportunities for rescue, and incidence of possibly preventable death is needed to achieve the goal of zero preventable deaths following trauma. Methods: A retrospective study of autopsy reports for all victims involved in the Pulse Nightclub Shooting was performed. The site of injury, probable site of fatal injury, and presence of potentially survivable injury (defined as survival if prehospital care is provided within 10 minutes and trauma center care within 60 minutes of injury) was determined independently by each author. Wounds were considered fatal if they involved penetration of the heart, injury to any non-extremity major blood vessel, or bihemispheric, mid-brain, or brainstem injury. Results: There were an average of 6.9 wounds per patient. Ninety percent had a gunshot to an extremity, 78% to the chest, 47% to the abdomen/pelvis, and 39% to the head. Sixteen patients (32%) had potentially survivable wounds, 9 (56%) of whom had torso injuries. Four patients had extremity injuries, 2 involved femoral vessels and 2 involved the axilla. No patients had documented tourniquets or wound packing prior to arrival to the hospital. One patient had an isolated C6 injury and 2 victims had unihemispheric gunshots to the head. Conclusions: A comprehensive strategy starting with civilian providers to provide care at the point of wounding along with a coordinated public safety approach to rapidly evacuate the wounded may increase survival in future events.

Florence, South Carolina: 7 law enforcement officers were shot, one fatally, during a standoff Wednesday.


1 year ago today: Las Vegas

Hospitals & Mass Shootings: What to do…….

Beckwith Hospital Review

“…..Here are four key concepts hospital officials are focusing on when preparing to treat mass shooting victims:
1. Expand the emergency department’s capacity quickly. After a gunman opened fire on a crowd of concertgoers in Las Vegas last year, a Federal Emergency Management Agency report found local civilians significantly helped in transporting victims from the shooting area……Hospital staff placed victims in hallways and in available rooms outside the ED, including the pediatric ED and post-anesthesia care unit.
2. Mobilize physicians, nurses and first responders. After learning how severe the Las Vegas attack was, Sunrise officials contacted dozens of additional physicians and nurses to respond to the facility. Before shooting victims arrived, the ED had four physicians and several nurse practitioners/physician assistants ready.
Within hours, over 100 physicians and about 200 nurses, NPs and other support staff were ready to treat victims…. Hospital officials also brought paramedics and emergency medical technicians from local fire departments to help assess patients.
3. Create a triage system to promptly evaluate incoming victims. When responding to a mass shooting, it is critical to determine which patients need to immediately go to the operating room and who can wait…..
Putting a physician exclusively on triage duty and assessing victims using the START method, or “simple triage and rapid treatment,” could be effective in mass shooting responses…..
4. Stop patients’ bleeding as soon as possible. Nurses, support staff and civilians can save patients using tourniquets, applying direct pressure to a wound or packing it with gauze or other material…..Teaching civilians how to help stop bleeding is common during mass casualty incidents, and the ACOEP hopes to see it become a routine part of medical providers’ response, Dr. Davis said. “This is a major aspect of ACOEP’s MCI training,” she said. “We have to train physicians to teach bystanders effectively and quickly how to provide care.”…….”

9/16/2013: a 34-year-old man goes on a rampage at the Navy Yard in Washington, D.C., killing 12 people and wounding several others over the course of 1 hour before he is killed.

History Channel


Mexico City: Men dressed as mariachi musicians killed 4 and wounded 9 in Garibaldi Plaza.



Active shooting in Cincinnati; alleged perpetrator killed; multiple wounded and several killed.

Jacksonville: 2 dead and 11 wounded, before the gunman killed himself at a video game tournament. Why?


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