Chase Knickerbocker1, Mario F Gomez2, Jose Lozada2, Jonathan Zadeh3, Eugene Costantini4, Ivan Puente5. 1. Resident, General Surgery, Mount Sinai Medical Center, Miami, Florida. 2. Associate Professor of Surgery, Herbert Wertheim School of Medicine, Florida International University; Broward Health Medical Center, Fort Lauderdale, Florida. 3. Mount Sinai Medical Center, Resident of General Surgery, Miami, Florida. 4. Broward Health Medical Center, Fort Lauderdale, Florida. 5. Director of Trauma Services, Broward Health Medical Center, Fort Lauderdale, Florida.
Abstract
BACKGROUND: Civilian mass shooting events (CMSE) are occurring with increased frequency. Unfortunately, our knowledge of how to respond to these events is largely based on military experience and medical examiner data. While this translational knowledge has improved our basic response to such events, it is critical that we have a better under-standing of the wound patterns observed and the resources utilized in civilian mass shootings. This will allow us to better prepare our systems for future events. METHODS: Patients from two consecutive CMSEs presented to the same level 1 trauma center in Fort Lauderdale, Florida. The patients received by this center were studied for their wound patterns as well as the care they received while in the hospital. This included wound patterns and severity, subspecialty interventions, and hospitalization requirements. RESULTS: Both events produced a total of 19 victims who were brought to the center as trauma activations. The events had a combined fatality rate of 55 percent. Fifty-five percent of patients also had at least one wound to an extrem-ity, two with major vascular injuries who had field tourniquets applied. Sixty-three percent required an orthopedic interven-tion and 32 percent required intensive care unit (ICU) admission, half of these with prolonged ventilator support. CONCLUSIONS: Given the number of extremity wounds in these events, we should continue the efforts championed by the stop the bleed campaign. The variety and quantity of specialties involved in the care of these patients also highlights the importance of a multidisciplinary approach to preparation and implementation of care in mass shooting events.
BACKGROUND: Civilian mass shooting events (CMSE) are occurring with increased frequency. Unfortunately, our knowledge of how to respond to these events is largely based on military experience and medical examiner data. While this translational knowledge has improved our basic response to such events, it is critical that we have a better under-standing of the wound patterns observed and the resources utilized in civilian mass shootings. This will allow us to better prepare our systems for future events. METHODS:Patients from two consecutive CMSEs presented to the same level 1 trauma center in Fort Lauderdale, Florida. The patients received by this center were studied for their wound patterns as well as the care they received while in the hospital. This included wound patterns and severity, subspecialty interventions, and hospitalization requirements. RESULTS: Both events produced a total of 19 victims who were brought to the center as trauma activations. The events had a combined fatality rate of 55 percent. Fifty-five percent of patients also had at least one wound to an extrem-ity, two with major vascular injuries who had field tourniquets applied. Sixty-three percent required an orthopedic interven-tion and 32 percent required intensive care unit (ICU) admission, half of these with prolonged ventilator support. CONCLUSIONS: Given the number of extremity wounds in these events, we should continue the efforts championed by the stop the bleed campaign. The variety and quantity of specialties involved in the care of these patients also highlights the importance of a multidisciplinary approach to preparation and implementation of care in mass shooting events.
Authors: Matthew P Czaja; Chadd K Kraus; Su Phyo; Patrick Olivieri; Dalier R Mederos; Ivan Puente; Salman Mohammed; Ross P Berkeley; David Slattery; Thomas H Gildea; Claire Hardman; Brandi Palmer; Melissa L Whitmill; Una Aluyen; Jeffery M Pinnow; Amanda Young; Carly D Eastin; Nurani M Kester; Kaitlyn R Works; Andrew N Pfeffer; Aleksander W Keller; Adam Tobias; Benjamin Li; Brian Yorkgitis; Soheil Saadat; Mark I Langdorf Journal: JAMA Netw Open Date: 2022-05-02