Critical incident Review - Vegas Attack: Handling a Mass Casualty Incident – Dr. Kevin Menes
Aug 23, 2023
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Dr. Kevin Menes, an emergency room physician and tactical team doctor, shares his firsthand experiences and lessons learned from the active sniper attack in Las Vegas. He emphasizes the importance of preparation and training for all responding organizations. The podcast discusses the critical role of trauma surgeons in saving lives, the challenges faced during a mass casualty incident, and the process of treating gunshot wounds to extremities. Dr. Menes highlights the need for efficient communication, clear categorization of patients, and continuous preparation in handling such incidents.
The success in handling mass casualty events depends on prioritizing immediate transport to the hospital for patients with torso or head wounds, even if they are not yet stabilized.
Effective collaboration between different agencies, including law enforcement, first responders, and hospitals, is crucial for handling mass casualty events. Regular drills and joint training sessions are necessary for proactive preparation.
Continuous learning and improvement are crucial in enhancing emergency response efforts for mass casualty incidents. Early interventions, effective triage systems, and sufficient resources play a significant role in saving lives.
Deep dives
Initial chaos and triage
In the podcast episode, the speaker describes the chaotic scene during the mass shooting in Las Vegas on October 1, 2017. The emergency room physician and tactical team doctor, Dr. Kevin Minnis, reveals that he had to quickly triage and treat the numerous victims who were brought to the hospital. He implemented a system of dividing the patients based on severity: red, orange, yellow, and green. With limited resources and an overwhelming number of patients, Dr. Minnis and his team worked tirelessly to stabilize and resuscitate the critically injured.
Overwhelmed resources and creative solutions
As the influx of patients continued, the resources in the ER became overwhelmed. Shortages of drugs and blood supplies posed significant challenges. However, Dr. Minnis and his team, including the ER pharmacist, found creative solutions. They distributed drugs rapidly and organized makeshift blood transfusions to ensure that they could continue to resuscitate and stabilize the patients. The podcast episode highlights the resourcefulness and adaptability of the medical team as they dealt with the unprecedented circumstances.
Collaboration and quick decision making
Throughout the podcast episode, Dr. Minnis emphasizes the importance of collaboration and quick decision making in a high-pressure situation. He recalls how the ER staff, including nurses and respiratory therapists, provided crucial assistance and worked together seamlessly to treat the victims. Their decisive actions, such as simultaneously intubating multiple patients and employing innovative techniques for ventilation, played a vital role in rapidly stabilizing and resuscitating the injured.
Lessons learned and the need for preparedness
The podcast episode concludes with Dr. Minnis reflecting on the lessons learned from the Las Vegas shooting. He emphasizes the importance of preparedness for mass casualty incidents and the need for ongoing training and planning for all responding organizations. Dr. Minnis highlights the critical role of early interventions, effective triage systems, and sufficient resources in saving lives during such events. His experiences underscore the significance of continuous learning and improvement to enhance emergency response efforts.
The Importance of Scoop and Run in Mass Casualty Situations
In mass casualty situations, it is crucial to prioritize patients with torso or head wounds for immediate transport to the hospital, even if they are not yet stabilized. This approach, known as 'scoop and run,' can significantly increase the chances of survival for these patients. By getting them to the hospital quickly, the time saved may outweigh the benefits of stabilizing them in the field. While tactical medicine often emphasizes on-field stabilization, the unique circumstances of a mass casualty event may necessitate a different approach.
The Need for Collaboration and Preparation in Mass Casualty Events
The success of handling mass casualty events depends on effective collaboration between different agencies, including law enforcement, first responders, and hospitals. It is essential for these agencies to come together and work out strategies and solutions through regular drills and joint training sessions. By proactively addressing potential challenges and developing coordinated plans, agencies can enhance their preparedness and response capabilities during high-stress situations. Waiting until a crisis occurs to address these issues is not sufficient; ongoing collaboration and preparation are critical components of successful mass casualty response.
My guest today is Dr. Kevin Menes. Kevin is an emergency room physician and tactical team doctor who led a team that managed to treat and save hundreds of patients following the active sniper attack in Las Vegas on October 1, 2017. Kevin’s insights into the Las Vegas attack are unique and offer us clear lessons learned in preparing for mass casualty. Too often active shooter preparation ends at the tactical level and fails to consider the effect on all involved agencies. This discussion with Kevin clearly shows that saving lives after a mass killing event is dependent upon the preparation and training for all of the responding organizations.
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