How Summa Akron Municipal Hospital responded to the influx of gunshot victims

Lina Portman4 weeks ago

0 4 minutes read

Here's how one emergency service responded.
Dr. Rathna Shenoy and Dr. Douglas Gallo were called to work in the emergency room at Summa Akron Municipal Hospital right after the June 2 mass shooting.
In total, area hospitals treated approximately 27 victims, including 27-year-old LaTeris Cook who died.

Dr. Rathna Shenoy had just put her son to bed when she received a call early Sunday, just after midnight. As patients flooded in with gunshot wounds, Summa Akron Municipal Hospital called a code yellow for a mass casualty event.

As one of the trauma surgeons, Shenoy was on call for disaster scenarios like the mass shooting in East Akron that left 27-year-old LaTeris Cook dead and 26 others injured.

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The emergency department, already full at the time with cases unrelated to the shooting, gave way to the wave of victims, she explained. At first, Shenoy thought everything was under control, but as the number of patients increased from seven to 12 and peaked at 15, she knew her colleagues needed all the help they could get.

“I would say that in my five years [as a trauma surgeon], probably in my entire career, it was probably the most chaotic night for me,” said Shenoy, who has worked with Summa for a decade. “But when I say chaotic, it's coordinated chaos. It could have been much worse.”

Emergency service medical and administrative personnel train to deal with mass casualty events in hopes of not needing to put those skills to use, but Shenoy said preparation has allowed him, as well as his colleagues, to keep their cool.

“It's about how prepared your system is to handle the number of patients coming in, and I think we've done a phenomenal job,” she said. “We saved lives.”

What happened to the other victims of the shooting?

The official count of gunshot victims has been revised several times, with Akron police citing confusion in how patients were counted when they showed up at multiple hospitals. As of Wednesday, the total number of people injured by gunshots stood at 27.

Of those, 15 went to Summa Akron Municipal Hospital, nine were taken to Cleveland Clinic Akron General and the rest were transferred to other area hospitals, police said.

No one had been arrested in the case as of Thursday afternoon.

Inside an emergency department during a mass casualty event

Like Shenoy, Dr. Douglas Gallo was at home about to go to bed when the call came. They were two of many doctors, nurses, medical residents and administrators who answered the call.

“I jokingly call it a dysfunctional family,” Gallo said of Summa’s emergency department. “You don’t let your friends fight this fight alone.”

The majority of their patients were self-transported or taken to the hospital in private vehicles, without using an ambulance, Gallo said. In some cases, it may be quicker and easier to self-transport if the patient is able to do so.

“You see that with a lot of mass casualty events,” he said.

Once patients arrived, they were triaged or sorted according to their severity and order of arrival. As a Level 1 trauma center, Summa Akron Municipal Hospital could accommodate the most seriously injured patients.

Gallo said he has seen patients with gunshot wounds to their arms, legs and torso. Some were scratches. Two patients are in critical condition, including one who underwent surgery and whose condition continues to improve, they said. The second critical patient was Cook, who was pronounced dead at the hospital early Sunday.

Treating gunshot victims is a balancing act, Gallo said. He helped nurses care for wounds, manage blood pressure and monitor people needing clotting medications.

“You don't want to over-resuscitate them in an attempt to improve their blood pressure, [because that] “You have problems with clotting factors and bleeding,” he explained. In other words, aggressive treatments can help correct one problem while making others worse.

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Patients need constant monitoring because they may appear stable, but within an hour their condition can collapse.

“It can be misleading. Like you're looking at the tip of the iceberg,” Gallo said.

While Gallo worked, Shenoy ensured that each patient was properly triaged. She double-checked that each patient had undergone imaging of their injuries, that their vital signs were stabilized and that they did not need further intervention.

Of the 15 patients, 13 were not operated on, she said.

“Not every patient who sustains a gunshot wound needs surgery, but they may have certain injuries that require intervention,” Shenoy said.

These interventions included wound washing, imaging, removal of impact-related injuries like broken bones, and pain management.

Controlling what could have been a chaotic situation

Gallo, Shenoy and their colleagues undergo monthly disaster training and quarterly exercises to prepare for mass casualty events like this.

On Sunday, Shenoy said this training helped them turn what could have been a chaotic night into a smooth operation, allowing them to save lives.

“I think when you step back and it's all over, you realize you have an impact on these patients,” she said. “It’s the worst day of their lives and the families can’t see them because we’re in lockdown.”

Lina Portman

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