If a shooting tragedy on the scale of the one Sunday night in Las Vegas occurred in Georgia, many victims better hope they’re in a metro area.
Minutes count.
There are only five state-designated Level I trauma centers in Georgia, and only two of those are nationally certified. One is Grady Memorial Hospital in Atlanta, and the other is Medical Center Navicent Health in Macon.
State-designated Level II trauma centers speckle parts of the state but leave broad swaths of Middle and South Georgia empty, especially where people are lower-income.
“If you get shot an hour and a half away from here, it’s a long time,” said Dr. Peter Rhee, who directs Grady’s trauma center.
If a shooting victim arrives needing surgery, especially to stop bleeding, Rhee said, he or she needs it now. “The amount of time we will keep them in the emergency bays is three minutes.”
Dr. William Roden, who now works in North Georgia and was an orthopedic combat surgeon with the U.S. in Grenada, said that to a certain point, many Georgia hospitals would be prepared to handle mass casualties. “It’s really a matter of triaging” — at some central point, identifying who needs to be seen most urgently — “and then getting them to facilities.”
Rhee and Roden said hospitals will typically do mass-casualty run-throughs at least once a year to spot weaknesses. Grady is the coordinating trauma hospital in the Atlanta region, which includes 23 acute care hospitals for 3.3 million people. There are 14 regions in the state overall.
Rhee and Roden pointed out that a large hospital will have dozens of rooms and bays available for patients, and when a mass casualty happens doctors and nurses will come in to work whether or not they are scheduled that day. That means a hospital could easily see 30 to 50 emergency patients at once.
Grady, Rhee points out, is usually near full already, though, so patients would be overflowing.
Rhee is explicit about the need for civilian authorities such as police officers on patrol to adopt some combatlike medical preparations because of the prevalence of guns now in the civilian United States.
“Well, as many assault rifles as are out there now, we’re in a combat zone,” he said. Rhee served as a Navy combat surgeon and was with the Marines in Iraq and Afghanistan.
“When I was in Ramadi I did … my one big mass casualty, 200 people injured in a bombing. I took care of 75 people in two hours at one time,” he said. “You’ve got to realize at the height of the Iraq war you’d only get about 400 casualties per year; 200 from bullets, 200 from bombs. Per year. When we’re on call here in Grady we can have 10 in a day that are shot.” In the U.S. there are 33,000 gunshot deaths a year, he said.
When he worked in Arizona, Rhee helped care for Congresswoman Gabrielle Giffords after a schizophrenic, Jared Lee Loughner, shot her and others with a handgun. They got a lot of media coverage for that care, Rhee said, "but in actuality it wasn't that much more than some of our real busy days."
Rhee is talking to Atlanta-area law enforcement agencies, advocating that officers carry special tourniquet and bandage kits that are useful in the military. The bandages have medications that can help stop bleeding. He thinks other places where people congregate, such as shopping centers, ballparks and grocery stores, also need to be prepared.
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