'Patients on gurneys, on the floor, covered in blood': Sunrise Hospital ED Director Dr. Scott Scherr recounts Las Vegas shooting, effects 1 month later

Scott Scherr, MD, emergency department director at Las Vegas-based Sunrise Hospital & Medical Center and regional medical director of Knoxville, Tenn.-based TeamHealth, told Becker's Hospital Review he was nearly asleep when his phone started "blowing up" with calls to come to the hospital Oct. 1. He said in those first few moments, he wasn't aware he would be responsible for more than 200 of the nearly 500 individuals injured during the deadliest mass shooting in U.S. history to date.

In an interview with Becker's Hospital Review, Dr. Scherr described his experience in the hours and days after Stephen Paddock opened fire on crowds of concertgoers during a country music festival in Las Vegas Oct. 1.

Sunrise Hospital, the closest medical facility to the Mandalay Bay Resort and Casino, treated 200-plus of the nearly 500 people injured during the incident, Dr. Scherr told Becker's.

Editor's note: Responses have been lightly edited for length and clarity.

Question: Can you describe the initial scene of the hospital on the evening of Oct. 1? What was the atmosphere like?

Dr. Scott Scherr: I was actually at home and was about to go to sleep when my phone started blowing up. I didn't really know what was going on; I was just told there had been a mass casualty incident and to report to Sunrise Hospital. I got to the hospital a little bit before 11 p.m. On the way there, I was listening to the radio and the information was still coming in; reports just said two confirmed dead, shooting at the Mandalay Bay, multiple injured — I wasn't really expecting all that much.

When I got to the hospital, there were multiple security guards in the parking garage. One of the guards, whom I knew, just had a thousand-yard stare. I looked behind him and there were four victims who were dead on arrival in gurneys behind him. Seeing that, my expectations of that night changed. They changed again when I went into the ambulance bay and saw more private vehicles than ambulances. As soon as I walked into the ambulance entrance there were patients on gurneys, in wheelchairs, on the floor, covered in blood. That's when the true magnitude of the moment sunk in.

Q: What was your plan to provide adequate care for all those who came in seeking help?

SS: We had such an incredible response. At least 35 TeamHealth physicians, nurse practitioners and medical scribes showed up to the hospital within 30 to 90 minutes after the incident occurred. We expanded the footprint of the emergency room almost fourfold because 100-plus other members of the medical staff, including physicians, physician assistants, ambulatory staff and nurses showed up. Once the ER was filled to capacity, we started taking patients to the pediatric ER next door, as well as the postanesthesia care unit and two other observation units. We worked really well with the trauma surgeons and pediatric surgeons that responded that night; we did more than 27 surgeries during the first eight hours after the shooting.

For triage, we tagged all of our patients with a certain color to connote varying chances of survivability: patients who were dead on arrival were black-tagged; patients with red tags had seconds or minutes to start doing resuscitation; yellow was for patients who had about an hour or so. Our procedure for a mass casualty incident is to do our initial triage, but then reassess because there's always the chance patients with whichever tag could become unstable.

Q: What were the days following the incident like?

SS: For the rest of the night on Oct. 1, our goal was to just go through all of our patients and treat the sickest individuals first, making sure they were taken care of and were stable, and then continue down the line to make sure the next wave of patients were stable. I ended up spending about 21 straight hours at the hospital because it was my responsibility to make sure the ER was ready and able to handle the volume of patients we were experiencing and that we had enough medical supplies on hand to care for everyone.

We had 12 patients that didn't make it that night. During the evacuation period at the concert, people didn't have their purses or wallets, so it was difficult to identify the patients. We had to work with families and have them identify the individuals. So I stayed at the facility the morning of Oct. 2 because I felt it was important for the families to be able to speak to a physician that worked that night and to notify them of their loved ones' deaths.

The day after the incident was eerily calm. Typically we see about 300 patients a day, but that Monday (Oct. 2) we saw about 215 patients. I think everyone in the city was probably at home with their loved ones, so we didn't see the patient volume we typically see for a few days.

Q: How prepared do you feel Sunrise Hospital physicians were for such an incident?

SS: The hospital conducts mass casualty drills, but nothing can really mimic what we went through that night. I think watching the events unfold and seeing the various area hospitals' response to the shooting will help prepare other facilities for other mass casualty incidents of this nature. The medical staff's response and the communication between the command center and physicians in various departments — everyone brought their A-game and did a great job and saved a lot of lives.

One thing that really helped us within each physician group was having a way to communicate —  to get that additional help is key. Our ED has the ability to send mass texts to everyone, and that really saved us.

After the incident, we aimed to make sure all healthcare clinicians had access to counselors and such to make sure we had a formal debrief of the situation and identify members of the staff who may need additional help or were severely affected by the events of that night. That's what has been weighing on my shoulders the most since the incident: making sure that my team is OK. Every TeamHealth physician at Sunrise had the opportunity to speak with a grief counselor during the entire week after the shooting. The counselors responded to the facility that Tuesday, Oct. 3. We've also since sent follow-up phone calls and such to check in with our staff. I think most of our staff is managing well after the incident, but there are a few who are still struggling and may need some more time.

Q: How do you feel nearly a month after the shooting? What are some things that have stood out to you the most?

SS: I have a lot of pride — pride for my team of healthcare workers and first responders and others who helped during the incident. I also have pride for the city of Las Vegas and this community, which has done a really good job coming together not only to show support for the victims, but also for the medical staff and first responders and healthcare workers. I think that's really helped this community heal. I've lived in this city for about 20 years and I've always thought that the city really is filled with a community of people. After this, I've realized that Las Vegas is much more than that. Everyone really came together, whether through monetary or emotional support, to just get through this tough time, and that's something that's pretty awesome to see.

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