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How Orlando Regional Medical Center met the challenge after the shooting

by Thomas Dworetzky, Contributing Reporter | June 16, 2016
Emergency Medicine Risk Management
Orlando Regional Medical Center
via Wikimedia Commons
“This is not a drill,” Dr. Michael Cheatham frantically told colleagues as he called them in after their full shifts were done, while home or on vacation.

As the wounded from the popular Pulse nightclub poured by “ambulance-loads” into the Orlando Regional Medical Center’s ER in the early morning hours Sunday, everyone answered Cheatham, the center's chief surgical quality officer, recounted at a press conference this week, “I'll be right there.”

A testimony to the staff's dedication shows in the large number of wounded who have survived. Of the 44 victims who arrived at the center, nine had fatal injuries and died before they could be helped. Of the others, 27 were hospitalized, with about half a dozen in intensive care. But after the initial tragic deaths, all were still alive as of 48 hours ago, according to Vox.

Another reason that survival rates were so good, ironically, is what has been learned from the tragedy of the battlefield.

“Advances in trauma care have accelerated over the past decade, spurred by the unprecedented burden of injury resulting from the wars in Afghanistan and Iraq,” according to a new consensus study and webinar from the National Academies of Sciences due for release June 17.

"During the height of the wars, we were treating injury patterns at a rate that was 10 to 100 times [that which] you would treat in any given city," Col. Todd Rasmussen, a physician who was in both wars, observed to Vox.

One key discovery from war's carnage was that an old technique, fallen into disfavor, could significantly boost survival in victims.

According to a 2016 paper in the Journal of Trauma and Acute Care Surgery on which he was lead author, “Military providers identified the significance of rapid, compressible hemorrhage as a cause of potentially preventable death,” adding that, although tourniquets were not new, their use had largely been abandoned before September 11, 2001. Faced with an unprecedented burden of massive extremity injury, vascular trauma and hemorrhage from explosive devices and high-velocity gunshot wounds, the military reappraised its stance and rapidly re-engineered, tested and deployed tourniquets and hemostatic bandages.”

Just as important, these tools were put into a kit carried by all war-fighters, giving all the ability to control bleeding. Studies backed up the importance of early and rapid bleeding control. Ultimately this led to Homeland Security's “Stop the Bleed” campaign in 2015, which spreads the word about bleeding control, urging bystanders to compress wounds before health care professionals arrive at shooting scenes.

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