Emergency rooms adapted on the fly to the Las Vegas shooting. Photo: John Locher / AP

Kevin Menes was the doctor in charge of the emergency room at Sunrise Hospital in Las Vegas on the night of the deadliest mass shooting in American history. He's written a piece in Emergency Physicians Monthly describing how he and his colleagues handled that night — how they prepared, how they adapted and how they managed to process 215 victims with gunshot wounds (known as "GSWs" in medical jargon) in just a few hours.

The bottom line: "We had dispositioned almost all 215 patients by about 5 o'clock in the morning, just a little more than seven hours after the ordeal began. That's about 30 GSWs per hour. I couldn't believe that we saved that many people in that short amount of time ... We did everything we could."

You should read the whole thing, but here are some of the most incredible excerpts:

  • "I was out in the ambulance bay when the first police cars arrived with patients. There were three to four people inside each cruiser. Two people on the floorboards and two in the back seat, and they were in bad shape … I pulled at least 10 people from cars that I knew were dead."
  • "We all do it as emergency physicians. You look at a GSW and guess the trajectory and the potential internal injuries. Then you decide if they're dying now, in a few minutes, or in an hour … I would look at these patients as they came in, and I would grade them red to green."
  • "It was important to get the red tags into the operating room because the orange tags would start to crump and become the next red tags. The yellow tags would start becoming orange tags. After 30 or 40 minutes, I'd triaged the sickest group of patients I had ever seen."
  • "One … nurse would shout, 'Menes! I need you here!' and then another would pull me to another patient. I said, 'Bring all your patients together.' They brought them all towards me, and I was at the head of multiple beds, spiraling out like flower petals."
  • "As fresh ER doctors would arrive, I would brief them on the layout, the list of workarounds we were doing, and tell them, 'You're a shark. Get out there and find blood!' I wanted them to find those dying patients in the sea of patients still there."

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