Healthcare workers: The 'great helpers' in times of disaster, violence and trauma

The great Fred Rogers once said that in times of disasters, he remembered the words of his mother: "Look for the helpers. You will always find people who are helping."

And time and time again--355 times this year alone, according to one group's definition and count--healthcare workers were among the helpers every time a "mass shooting" took place in the United States. That's more than one shooting in which four or more people were killed or injured by gunfire per day on average.

And the horrific shooting in San Bernardino, California, was the second mass shooting on Wednesday. The other took place in Savannah, Georgia, but didn't get as much media attention due to the events and number of people injured and killed in California.

So much violence and trauma and every time we thankfully have emergency responders on scene as well as clinicians and staff at local hospitals preparing for victims to arrive and treat those with the most serious injuries. And the grim reality of the rate of mass shootings taking place in this country is that healthcare workers must be ready at any time to treat multiple victims with traumatic injuries that are typically seen in times of war.

And it can be overwhelming for even the most experienced clinicians. Thirty-five surgical teams from 10 hospitals across Paris treated the most seriously injured in the massacres that took place in that city last month. We learned about their experience treating so many injuries in a recent piece for The Lancet.

"Although emergency physicians have been receiving training in disaster medicine for more than 30 years, never before had such a number of victims been reached and so many wounded been operated on urgently. A new threshold has been crossed," the authors wrote.

Paris implemented what it calls its "white plan," a coordinated national response to an emergency that called healthcare personnel to work all over the city, mobilized ambulances and got beds ready in all hospitals. Meanwhile, first responders set up mobile triage units at the scenes of the attacks to treat minor injuries so clinicians at hospitals could handle the more serious injuries.

The national plan is impressive, mobilizing 40 hospitals, 100,000 health professionals, 22,000 beds and 200 operating rooms, according to MedPage Today.

In the days after that terrorist attack, the U.S. called on hospitals to review its disaster plans. Unlike Paris, most hospitals rely on their own plans and coordinated responses with local or state officials. And it raises the question, as another MedPage Today piece noted, whether our hospitals are prepared to treat hundreds of victims with war-like injuries.

Not surprisingly, the answers to that question are conflicted. Some experts, including A. Alex Jahangir, M.D., medical director of Vanderbilt University's Center for Trauma, Burn, and Emergency Surgery, say trauma teams are prepared to handle a similar crisis as Paris. But Alexander Isakov, M.D., of the Emory University School of Medicine, told the publication he wasn't so sure that overcrowded urban emergency medical services systems could handle the number of casualties and severity of injuries.

It's a legitimate concern, but we've learned a lot as a nation about how to respond to disasters since 9/11 and the more recent Boston Marathon bombing. In Boston, the city handled 144 patients after the terrorist attack and passed the disaster planning test.

But the world we now live in requires well thought out--and executed--disaster plans, training on how to treat combat-type wounds and clinicians who rely on their medical instincts and natural desire to help people.

So in this moment of national grief and disbelief, a sincere thank you to all the healthcare workers--our great helpers--who make this world a better place and give us all hope for the future. Ilene (@FierceHealth)

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