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Blend of luck, professionalism make the difference
Hospitals that received most of the wounded in the Columbine High School shootings in Littleton, CO, initially thought they would run out of intensive care beds in trying to accommodate the expected number of wounded victims. Initial reports from the scene indicated dozens of victims in need of immediate transfer to area hospitals.
In fact, the number ultimately admitted to each of the intensive care units (ICUs) was far less.
"Fortunately, we received only four in our ICU. Three went straight to surgery. A fourth was admitted to the pediatric ICU," recalls Vicki Owens, RN, nursing operations manager of the emergency department and surgical ICU at Denver Health Medical Center. The hospital was one of three Denver-area facilities that received the most seriously wounded.
Minutes after the first news reports filtered in, hospital staff performed a quick bed availability assessment and began coordinating with all floors on patient triage and transfers to make ICU beds available, Owens says.
At Centura St. Anthony Central Hospital, 15 miles away from the school, officials anticipated going into disaster alert based on early casualty reports. "That’s how bad we thought things would be," recalls Cindy Elger, RN, clinical nurse manager of the surgical ICU.
The 12-bed unit ultimately admitted two patients. A third was sent directly to a step-down floor. All three needed surgery to repair internal injuries.
And at Swedish Medical Center, the hospital closest to Columbine High, three of the four worst cases were admitted to the ICU following surgery. But at least a dozen more were treated in the emergency department and either released or admitted to general medical floors, says Ann Randall, RN, director of patient care for the critical care unit.
Officials at the three hospitals credited a combination of luck, professionalism, and strong community spirit for results that day. Fortunately, staffing wasn’t a problem. Nurses and other ICU personnel arrived for work early once they heard the news reports; and at Swedish and Denver Health, there were extra nurses on hand due to inservice programs originally scheduled that day.
Emergency department physician Chris Colwell, MD, was among the first clinicians on the scene with paramedics and triaged most of the patients to area hospitals. "He did a great job to make sure no one hospital got overloaded," Elger says.