On June 12, 2016, the staff of the emergency trauma center at Orlando Regional Medical Center treated Pulse nightclub shooting victims during the second deadliest mass shooting in U.S. history, with 49 lives lost. The surge of patients overfilled the hospital’s aging trauma bay, pushing staff to the limit. However, all 35 victims who made it to the hospital alive were saved.
“We made it work when we needed to,” says Dr. Joseph Ibrahim, an Orlando Regional trauma surgeon who treated Pulse shooting victims. But he adds that with rapid population growth, it would become more common for everyday injuries, whether gunshot or car crash victims, to fill up the trauma bay. “It doesn’t take a mass shooting; it can be a Saturday night.”
Eight years after the shooting, Orlando Health has completed a redesign and expansion of the trauma bay, the first since it opened 30 years ago. It remains the only Level I trauma center in Central Florida capable of treating the most severely injured and sickest patients. The updates were based on and inspired by feedback from physicians and nurses who treated Pulse shooting victims. They also used virtual reality headsets to help point out where new equipment and supplies should be located throughout the bay.
The improvements are at the heart of the hospital’s $25-million makeover of its emergency department, expected to be complete in early 2025. The new bay is more than double the size of the previous space, allowing the team to quickly add 10 treatment areas during a mass casualty situation. Further updates include new computers, movable shelving, two new CAT scanners (now three in all), and monitors that allow the staff to “have cognizance of all the patients, all the time,” says Dr. Tracy Zito, a trauma surgeon and medical director of the trauma center. “It has really added to our efficiency in taking care of these patients.”
‘Organized Chaos’
Dr. Joseph Ibrahim was called in to work on the night of the Pulse shooting: “Walking in from the parking lot, it didn’t seem much different. But then as you got to the trauma room it was definitely a different feel. It was way more crowded than even a busy night. We had to kind of get creative with how we put stretchers in that room in order to fit everybody in who needed to be seen in that trauma room. Obviously, you can imagine it was a little hectic, but we like to call it organized chaos.
“In the moment it’s very surreal. You just kind of put your head down and do the work. As the situation gets under control it really kind of hits you, this is something that again you don’t ever anticipate being part of, and kind of the emotional side hits you. Why do these kinds of things happen? What did we do that works well? What can we do going forward?”