United States Fire Administration - The Nevada Hospital Association released a case study on the medical response to the Las Vegas, Nevada, Harvest Festival shooting. The purpose of this case study is to provide hospitals and public health agencies points of discussion to further their emergency management and mass casualty planning.
A Day Like No Other: A Case Study of the Las Vegas Mass Shooting covers an incredible amount of detail on several topics, reviewing triage, staffing, safety and security, communications, surge plans, mortuary care, and mental health and wellness. Any hospital or EMS agency writing or reworking its mass casualty response plan should review this case study. These are a few take-aways from this case study:
- Injured and deceased people were spread over four square miles around the venue, a very large area for EMS to manage.
- The majority of injured (approximately 800) self-transported, using phone mapping apps to find the closest hospital. This should be a planning consideration for events and venues as well as hospitals.
- Hospitals had no notice of the shooting before the injured started arriving.
- The influx of families and friends — and the issues they created — were not planned for. A Family Assistance Center wasn’t established until the next day.
- Infection control and contamination was a serious concern due to the amount of blood being spread everywhere. Environmental cleaning was continuous. Ensure you have enough staff and supplies to handle such an incident.
- Hospitals interpreted the Health Insurance Portability and Accountability Act (HIPAA) differently, creating confusion. Review HIPAA policy with a mass casualty incident in mind.
- One hospital used a military-type triage system that worked quite well; however, triage was problematic at best in most locations.
One added problem was that the festival used Radio Frequency Identification Device (RFID) armbands containing ticket and credit card information, and many attendees did not carry identification. This increased confusion as hospitals could not tell anyone, law enforcement or family members, who they were treating because they didn’t know.