The Call of a Trauma Alert

On June 12, 2016, shortly after two o’clock in the morning, 36 patients were rushed into to the Level One Trauma Center at Orlando Regional Medical Center (ORMC) in only 36 minutes. Due to the close proximity of ORMC to the scene of the Pulse attack, there were no warnings, no overhead trauma alerts for the team; the injured just started coming. While, understandably, any emergency department would feel overwhelmed by the sheer volume of patients and critical injuries, our trauma team staff quickly and calmly took control. Relying on their training, after a few deep breaths, everyone began to work together as a team.

“We drilled for this,” Dr. Michael Cheatham, Chief Surgical Quality Officer for ORMC, says about the Pulse incident. “There is no way to prepare for the reality of such an event, but everybody stepped up to the plate. It was a huge team effort.” Because the specially-trained staff at ORMC had prepared for a mass casualty incident multiple times, team members knew what to do, where to be and what their role was.

What’s a Mass Intake Drill?
On April 6, 2017, four counties in central Florida, 80 agencies, 26 hospitals, and over 1,000 volunteer victims participated in a Full-Scale Community Exercise to train for a possible mass intake incident ranging anywhere from a terrorist attack to an epidemic. Since 2010, Orlando Health has participated in 11 of these drills and ORMC received 201 victims in the latest drill.

“I want everyone to be ready. I want to make sure all of the hospitals in our system are best prepared for what may impact us and that we are able to care for the sick and injured in our community,” explained Eric Alberts, Corporate Manager, Emergency Preparedness at Orlando Health.

During a normal 24-hour shift in the Trauma Center, staff can see anywhere from 15 to 25 patients. Patients present with several injuries – a fall from a roof, electrocution received during a home improvement project, a motor vehicle accident and more. When any one patient arrives, 12 to 15 team members are ready and waiting for them. In a mass intake drill, trauma team members practice the art of scaling back what seems like an unlimited amount of resources for one patient, to finite resources for multiple patients.

What lessons from Pulse were incorporated into this year’s drill?
All trauma alerts, but particularly a mass intake alert, cause the trauma team to go from 0 to 350 mph in the blink of an eye. Drills allow for the team to practice every step of their job in this same heightened and intense environment. Each drill offers new lessons and experience for the team, which is shared with hospital systems throughout the country. “We are the community’s safety net,” said Dr. Chadwick Smith, Trauma Surgeon at ORMC. “To have the best outcomes, you need to be busy. Experience and exposure to trauma injuries is what helps to create our level of expertise and quality.” What effect does the drill have on the trauma center? So, what outcomes do these types of drills have on those working in the trauma center? The drill is meant to provide training, funding and a sense of readiness for everyone who may be affected by such an incident coming through the doors. The result, is a team of people who all know how to take initiative and perform their jobs to the best of their ability.

“I love my job,” said Sarah Duran, RN. “I get to see patients on their worst day and help make them feel better. Trauma team staff are lucky enough to care for patients on both an emotional level and physical level, offering both spiritual and medical support.”