The Department of Emergency Medicine at Texas Tech University Health Sciences Center El Paso plays a major role in preparing physicians and first responders for mass casualty incidents like the Aug. 3 shooting at the Walmart in East-Central El Paso. The attack killed 22 people and injured more than two dozen others.
Approximately every 18 months, the department conducts large-scale disaster drills as part of its three-year training program for emergency medicine residents. The department’s disaster drill in 2017 was based on an active-shooter scenario. In April 2019, the department ran a two-day drill featuring a scenario involving trauma and toxicology: a train crash that unleashed a spill of hydrofluoric acid.
The drills typically bring together a wide range of participants, including residents training in other specialties, TTUHSC El Paso medical and nursing students, personnel from the El Paso Fire Department, and first-responder trainees from the community. Middle and high school students from area schools have also participated in the drills, sometimes role-playing as simulated patients or training as part of their high schools’ first-responder programs.
“Physician residents and TTUHSC El Paso students have some opportunity during their training to see multiple patients, one after the other, in the emergency department, but it’s very rare that it is at the pace of a mass casualty incident,” said TTUHSC El Paso Professor of Emergency Medicine Stephen W. Borron, M.D., M.S., who helps organize the disaster drills.
“Being able to juggle multiple balls—keeping patients alive when you’re taking care of several patients at a time, and their conditions are changing very quickly—is a skill set that almost has to be learned outside the emergency department, because we just fortunately don’t see these kinds of incidents frequently,” Dr. Borron said.
TTUHSC El Paso Associate Professor of Emergency Medicine Scott Crawford, M.D., who works with Dr. Borron to organize the drills, said the exercises help emergency responders maintain focus and efficiency in an often-chaotic environment.
“One of the biggest benefits of (the drills) is that in a relatively controlled setting, they allow individuals to experience the challenge with communication and coordination of care between groups,” said Dr. Crawford, who also serves as director for the Training and Educational Center for Healthcare Simulation (TECHS) at TTUHSC El Paso.
Alejandro J. Rios Tovar, M.D., assistant professor and the associate trauma medical director for TTUHSC El Paso’s Department of Surgery, participated in disaster drills while completing his general surgery residency at TTUHSC El Paso from 2011 to 2016.
“I would always take the drills seriously as if they were real. The mass casualty drills help and it showed on the day of the shooting,” said Dr. Rios Tovar, who treated gunshot victims at University Medical Center of El Paso on Aug. 3. “Everybody knew what they were supposed to do.”
Now that the community has tragically experienced a mass-casualty incident that it hoped would never happen, the Department of Emergency Medicine will examine whether it can organize more frequent disaster drills, Dr. Borron said.
Dr. Crawford said the next drill likely won’t be based on an active shooter scenario because it could be emotionally traumatic for those that worked in emergency rooms on the day of the shooting.
Given the drills’ proven benefits, future events will surely include more participants from an array of academic departments, the physicians said.
“There needs to be even more interaction between physician residencies,” Dr. Borron said. “For example, it would be good for us to drill with the surgical department, the trauma residents, the radiology residents and the orthopaedic residents at a minimum; and maybe some of the internal medicine and pediatric residents. Almost every specialty comes into play in some way or other in a disaster situation.”