Others were on the way from the bloody scene at the Fairplex Exposition Complex about a mile away. Dozens of them.
“Active shooter at the Fairplex!” someone called out to hospital staff, who immediately sprang into action. “There’s going to be 40 or 50 more coming.”
That’s how the first large-scale, mass-shooting training drill to test the hospital’s 1-year-old trauma center began Tuesday, April 24. The exercise unfolded in the mid-morning quiet of a typical weekday, as law enforcement and fire authorities managed the simulated concert shooting at the fairgrounds.
The national readiness goal for hospitals to prepare for multiple victims is 15 minutes from first notice of an incident — all too necessary in today’s world of bloodbaths in places like Orlando, Fla., and Las Vegas, Nevada.
“This is as real as it gets,” said Dr. Michael Jimenez, director of the Pomona trauma center and its lead surgeon.
The center, opened in March 2017, serves cities in eastern Los Angeles County and western San Bernardino County and has eight surgeons on staff.
Even for a make-believe event, there was no escaping the sense of urgency. Emergency department staff had to prepare for and treat victims of gunshot wounds transported to the Garey Avenue hospital in ways mimicking the October 2017 shooting in Las Vegas that left 58 people dead and 851 injured.
The wounded, portrayed by hospital volunteers, arrived haphazardly — alone, in pairs, and by the dozen in personal vehicles, a public bus, police cars and ambulances. One — a dummy used in the exercise — was flown by helicopter to the rooftop pad atop the patient parking structure across from the emergency department.
In the midst of the pretend chaos that engaged more than 200 hospital staff and volunteers, a human touch still mattered.
“Do you know your name?” Aimee Castillejo, a registered nurse at the trauma center, gently asked the first of 50 victims.
“Lauren,” the young woman answered, watching Castillejo tie on a tourniquet.
The nurses attached “Triage Tags” that include color-coded tabs to indicate a victim’s treatment needs. A black tab grimly represents “morgue” but there’s a red tab for immediate, yellow for delayed, green for minor — mirroring similarly colored plastic arms on the gurneys.
In a space at ground level in the parking structure, collapsible lightweight gurneys made from PVC pipe — called Rapid Response Emergency beds — were stacked and stored where they could be quickly wheeled over and placed on a pair of tarps in the triage area. Each tarp was marked with outlines of where to position up to 10 gurneys.
Wheeled into position nearby in the covered entryway: a trio of multi-tiered disaster carts packed with gauze bandages, elastic tourniquets, wound dressings, oxygen masks, sutures and splinting material.
Over the din of the wounded screaming “Help!” or moaning in pain and the chatter of the dozens of doctors and nurses, the voice of Dr. Jimenez could be heard issuing orders as calmly as he soothed the wounded.
“All right, we need a tourniquet over here,” he called out while examining the fifth victim to arrive. “We need a tourniquet, guys.”
It’s the job of Jimenez, 41, to guide the staff through the paces of the “15 ’til 50” manual, a template created by emergency planners at two other California hospitals to handle an influx of 50 victims within 15 minutes of being notified of a mass casualty incident.
“This is something that every trauma center needs to do,” said Jimenez, who spent a year training at the R. Adams Cowley Shock Trauma Center in Baltimore, the nation’s largest trauma center, where treating 15 to 20 gunshot victims at a time is not unusual.
“It’s like a war zone,” Jimenez said of the place that prepared him well for the Pomona exercise.
One moment, he was comforting an older woman separated from her friend. “I don’t know where she is,” the woman, wounded in her neck, told him. “Her name is Gloria.”
Jimenez showed her how to put pressure on her wound and offered assurance: “We don’t know exactly where she is now. We’ll let you know if we find out anything.”
Next, he rushed to an operating room a few floors up to “perform surgery” on a police officer bleeding from his carotid artery. He walked fast but explained that if this were real, “I would be in an all-out sprint.”
He planned to gather with staff later to go over the notes that Nurse Stephanie Smith-Raby, trauma services director, jotted on a note pad of what was working well and what wasn’t — things like making sure wheelchairs are available and operating rooms are ready.
The next such drill will be in fall 2018.
Said Jimenez when Tuesday’s exercise ended less than two hours after it began: “This is good for planning.”
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©2018 The Orange County Register (Santa Ana, Calif.)
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