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. 2020 Mar;88(3):372-378.
doi: 10.1097/TA.0000000000002574.

Injury characteristics of the Pulse Nightclub shooting: Lessons for mass casualty incident preparation

Chadwick P Smith  1 , Michael L Cheatham, Karen Safcsak, Heidi Emrani, Joseph A Ibrahim, Michael Gregg, William S Eubanks, Matthew W Lube, William S Havron, Marc S Levy
Affiliations

Injury characteristics of the Pulse Nightclub shooting: Lessons for mass casualty incident preparation

Chadwick P Smith et al. J Trauma Acute Care Surg. 2020 Mar.

Abstract

Background: On the morning of June 12, 2016, an armed assailant entered the Pulse Nightclub in Orlando, Florida, and initiated an assault that killed 49 people and injured 53. The regional Level I trauma center and two community hospitals responded to this mass casualty incident. A detailed analysis was performed to guide hospitals who strive to prepare for future similar events.

Methods: A retrospective review of all victim charts and/or autopsy reports was performed to identify victim presentation patterns, injuries sustained, and surgical resources required. Patients were stratified into three groups: survivors who received care at the regional Level I trauma center, survivors who received care at one of two local community hospitals, and decedents.

Results: Of the 102 victims, 40 died at the scene and 9 died upon arrival to the Level I trauma center. The remaining 53 victims received definitive medical care and survived. Twenty-nine victims were admitted to the trauma center and five victims to a community hospital. The remaining 19 victims were treated and discharged that day. Decedents sustained significantly more bullet impacts than survivors (4 ± 3 vs. 2 ± 1; p = 0.008) and body regions injured (3 ± 1 vs. 2 ± 1; p = 0.0002). Gunshots to the head, chest, and abdominal body regions were significantly more common among decedents than survivors (p < 0.0001). Eighty-two percent of admitted patients required surgery in the first 24 hours. Essential resources in the first 24 hours included trauma surgeons, emergency room physicians, orthopedic/hand surgeons, anesthesiologists, vascular surgeons, interventional radiologists, intensivists, and hospitalists.

Conclusion: Mass shooting events are associated with high mortality. Survivors commonly sustain multiple, life-threatening ballistic injuries requiring emergent surgery and extensive hospital resources. Given the increasing frequency of mass shootings, all hospitals must have a coordinated plan to respond to a mass casualty event.

Level of evidence: Epidemiological Study, level V.

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References

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