Within about 30 minutes of an emergency report of a school shooting Oct. 27 at Santa Cruz High School, more than 100 medical providers from across Santa Cruz County reported to Dignity Health Dominican Hospital’s emergency room last week, hospital authorities said. Law enforcement officials later learned the call was a hoax. (Dominican Hospital — Contributed)
SANTA CRUZ — While a massive law enforcement presence converged on the Santa Cruz High School campus last week for what turned out to be a hoax school shooting report, a similar response played out at an emergency room 4 miles away.
With a clear mind and a weekend’s break between the emotional and chaotic Oct. 27 false alert, Dominican Hospital officials looked back at the highs and lows of preparing for what they believed would be a mass casualty event involving the city’s own children and their teachers.
“Within about 30 minutes, we had over 100 providers who had reported to the emergency room, ready to serve any patients/victims that came to our hospital,” Dominican Hospital President Dr. Nanette Mickiewicz told the Sentinel in an interview Tuesday. “I think the most impressive situation is we quickly set up for ourselves an organized trauma center, using our existing resources, including our physicians and staff. Everyone just fell right into their appropriate role to support each other and the patients.”
Unlike medical centers such as Natividad in Salinas or Santa Clara Valley, Dominican Hospital is not one of the state’s 81 designated “trauma centers,” according to the California Emergency Medical Services Authority. Instead, the hospital often serves as a pass-through to the out-of-county centers, or is bypassed entirely when patients are airlifted from landing zones elsewhere in the county. Trauma, according to the state, results from motor vehicle collisions, falls, burns, stabbing and gunshot wounds or other blunt or penetrating forces.
“It was really interesting because we hadn’t had a full type of ‘drill’ such as this in the past and so we really went through the entire scenario, expecting to see patients and wounded,” Mickiewicz said. “So we had doctors from throughout the community. We had surgeons from both Dominican and Sutter/Palo Alto Medical Foundation. We had multiple team members, staff members, who heard the news in the community and reported to work.”
Sutter Surgical Center and Watsonville Community Hospital sent word that they, too, stood ready should there be a need for additional care, said Dominican’s disaster coordinator, Paul Angelo, on Monday.
“Luckily, many of our doctors and some of our staff members have worked at trauma centers and so they stepped into leadership roles and made sure, as we were going through the process, that it was organized like a trauma center,” Mickiewicz added.
Rolling out ‘surge’ response
Shortly after 9:30 a.m., the hospital emergency department received its first alert from an ambulance crew on its way to the high school that a reported school incident was unfolding, Angelo said, describing how the prior Thursday morning unfolded. Shortly after, Santa Cruz County officials confirmed the response effort, he said. Hospital officials then gathered at a command center to direct enactment of a “surge plan” that began moving patients out of the emergency room and into the main hospital in order to make space, rolling out extra trauma carts stocked with tourniquets and dressings and alerting security staff to direct parking lot traffic, Angelo said. Later, surgeries that were not immediately necessary were postponed to free up surgical staff and space, he said. An air ambulance landed on Dominican’s helipad, ready and waiting to transport a victim to a trauma center, he said.
At the same time, the hospital paged all of its staff through an internal messaging tool, letting them know that a major incident was occurring. The response was so large that hospital officials needed to gather everyone together outside with a bullhorn in order to update them that the crisis was over, officials said.
“We did get reports a little earlier than that that were on scene and they couldn’t hear gunfire, couldn’t find any victims, but they weren’t sure if people fled the scene in private autos,” Angelo said. “So, we actually started preparing in the front of the ER, not just the ambulance entrance, just in case this was a smaller incident and people had already started self-transporting to the hospital.”
False alert takes its toll
Though unofficial word that the call may not have been accurate began filtering in within about the first half hour, Angelo said the hospital was faster — in part because of recent efforts to drill for “mass incidents,” whether they be school shootings or a devastating earthquake. Hospital officials opted to hold ready for several hours, until law enforcement had completed its top-to-bottom search of the high school campus. Mickiewicz said one of her superiors later complimented the speed of Santa Cruz’s response.
“He said ‘Only in Santa Cruz would you be able to mobilize that much of a resource in that short of time,’ ” Mickiewicz said. “Because this is a community, this is a community hospital, and these are all of our kids and teachers. So, we were ready.”
“We had many staff members who were very distressed because not only were their children at school but they also had high schoolers, middle schoolers, etc.,” added Mickiewicz, a mother herself to four children not attending the high school. “It caused a lot of unnecessary emotional distress. And, in spite of that, they stepped up, because they were ready to take care of whatever needed to be done.”
The hospital brought in an employee assistance psychiatrist to speak with workers, “because it still felt real to them, even though it turned out to be nothing,” Angelo said.
Some patients, already in the emergency room and others who were on their way, opted to leave or delay coming to the hospital for treatment, once they heard of the emergency call, a situation that is “never a good thing,” Mickiewicz said.
An extensive effort also went into preparing blood supplies that proved to be a wasted effort, Angelo said.
Lessons learned
While not considered a positive event, Angelo and Mickiewicz said there were some lessons learned that may prove valuable for future large-scale emergency responses. To maintain effective communication despite the very loud hustle and bustle in the emergency department, Angelo said more electronic communications may be useful. Mickiewicz said that while all the communication channels were working effectively, managing the flow of information from various sources could be “fine-tuned” in the future. The emergency department also would benefit from having a few extra pieces of equipment standard in operating rooms, Mickiewicz said.
Hospital authorities, prior to releasing workers gathered, also turned the event into a further training opportunity.
“We used a megaphone to tell everybody what had transpired, and then we used that opportunity to speak to everybody about what could have been done better and make improvements,” Angelo said. “We actually spent the good portion of another half an hour, 45 minutes interviewing people on what we could do better, if this was a real event.”
Originally published at Jessica York