A trauma team responds to a mass casualty and works to prevent others

It was around noon on Tuesday, May 24, 2022, when University Hospital’s Level I trauma team got a page. A gunman had entered Robb Elementary in Uvalde. Adults and children were wounded. At least two of the injured would be coming to University Hospital, and there could be more.

Without hesitation, the trauma team prepared multiple resuscitation and operating rooms, ensuring they had equipment and specialized staff ready to go to treat a large number of severely injured patients. About an hour after the page, the first patient arrived by air. An air ambulance with the second patient landed an hour after that, and two more shooting victims arrived by ground transportation later in the day. Disappointment and sadness set in as members of the trauma team realized they would not have the chance to save additional lives – many of the injured had died at the school.

For some of them, the Uvalde shooting triggered an immediate flashback. This was not the first time they had responded to a mass shooting. Five years earlier those same pagers notified them that nine adults and children were headed to University Hospital from a mass shooting at the Sutherland Springs First Baptist Church. They had learned a great deal from that experience and had since worked to prevent other deaths from traumatic bleeding.

They had already launched the American College of Surgeons’ Stop the Bleed training across South Texas, teaching community members from all walks of life how to prevent those injured from bleeding to death while they waited for emergency help to arrive.

University Hospital trauma doctors had also worked with the South Texas Blood and Tissue Center to develop the most advanced program in the country to place cold-stored whole blood on ambulances and emergency aircraft so that patients with severe blood loss could get whole blood in the field, before getting to the trauma center. One of the Uvalde patients received whole blood at the scene, which may have kept her alive.

Some University Hospital trauma surgeons had also participated in the American College of Surgeons’ Firearm Strategy Team called FAST. The ACS group brainstormed and found consensus around a set of recommendations to address the firearm public health crisis from a nonpartisan perspective. Their aim was to better understand and address the root causes of violence, and make firearm ownership as safe as reasonably possible for people who own guns, and for those who don’t. The tragedy in Uvalde has provided an important platform to advance these common sense recommendations.

Nine days following the shooting, Dr. Ronald Stewart, University Health’s chair of surgery, spoke at a national ACS press conference to encourage elected officials to take action to reduce firearm injuries and deaths through the following:

  • Background checks for all those purchasing and transferring firearms
  • Firearm registration and an electronic database for all registered firearms
  • Reassess the classification and regulation for high-capacity magazine, semi-automatic rifles such as the AR-15. Reclassifying them as Class 3 weapons would require a more lengthy approval process for ownership
  • Formal firearm training for all new gun owners
  • Require safe storage of firearms and hold owners accountable for adverse events
  • Use due process to remove firearms from individuals who are a danger to themselves or others
  • Develop firearm technology to prevent unintentional firearm discharges
  • Federally fund research for firearm injury and prevention
  • Promote education for recognizing mental health warning signs and seeking professional help

“We can save lives. We know we can do it and we must act,” Dr. Stewart said. “The public wants and expects us to do that.”

A detailed article outlining the ACS committee recommendations appears in the Journal of the American College of Surgeons.

Contact media relations logo.
Contact Media Relations
Call 210-358-2335 or email us for more information about University Health news.
View other related news by: