Hospital well-prepared for surge that never happened after mass shooting

For Loma Linda (Calif.) University Medical Center (LLUMC) and its emergency department (ED) staff, waiting for a large surge of patients who were victims of the Dec. 2 mass shooting in San Bernardino, Calif., was a matter of putting their training to use.

As soon as LLUMC received a message that a mass shooting had occurred, Kathleen Clem, M.D., emergency medicine department chair, raced to find the hospital’s on-call ED physicians who, as luck would have it, were already on-site for a meeting.

Clem gathered 12 physicians, triple the number that usually staff the ED, and stationed trauma teams at the front entrance of the department.

Even though they were not certain of the scope of the shooting, which killed 14 and injured 21, the hospital was ready for a large number of patients. LLUMC is only 3 miles from Inland Regional Center, the site of the attack, and the only Level I Trauma Center in a five-county region.

“We were well-prepared for what happened. We were up and ready with emergency response teams within 15 minutes of getting news of the shooting,” Clem says.
That’s a reflection of the hospital’s commitment to emergency preparedness and the use of what Clem calls a variation of the Hospital Incident Command System, the standard health care facility protocol for emergency response.

The 900-bed LLUMC holds emergency response drills at least once every three months and additional “surprise drills” throughout the year to prepare for a range of possible events ranging from mass shootings to bioterrorism, says Susan D. Onuma, media relations specialist, LLUMC.

As if the uncertainty about the extent of the shooting were not enough, the same afternoon of the shooting, the hospital received a bomb threat. Police quickly responded, searched the hospital for explosives and issued an all-clear in less than an hour, Onuma says. No hospital evacuation or lockdown was required.

Emergency staff continued to wait into the evening for more than the five patients it treated that day. “We were prepared to take up to 50 patients,” Clem says. Because there were so many fatalities in the attack, the surge for which LLUMC anticipated and prepared never happened, she says.

The attack occurred as San Bernardino County's Department of Public Health hosted an event in a conference room at one of the buildings that make up the Inland Regional Center complex in San Bernardino. The husband and wife responsible for the attack were later killed in a shootout with police.