Learning from Tragedy

May 31, 2022

As we pause and reflect on the school shooting that occurred last week in Uvalde, Texas, our thoughts most certainly have turned toward trying to comprehend how something so horrific could occur.

It’s a difficult analysis, as what happened defies rational thought. We all need to take time to mourn along with the Uvalde community and process the tragedy in our own way.

As emergency managers, we need to find a way to learn from tragedy. Our duty calls us to process and analyze. It’s hard, especially in this case. In our work, we toil extensively and diligently in the preparedness and mitigation phases trying to prevent tragedies, although we know deep down that, despite our efforts, they still occur.

We have to come to understand the shooting, not just from the standpoint of pain and anger, but also from the standpoint of systems and processes, alerts and notifications, logistics and response, and care and comfort. Undoubtedly, these factors were tested to their maximum as the emergency response and health care infrastructure in rural Uvalde faced perhaps the greatest and most enduring challenge it ever had. Emergency managers and health care professionals must evaluate what worked and what can be improved so that we can learn, teach, and improve future responses.

The health care disaster challenges of rural communities, particularly when it comes to mass casualty incidents, are not a new concept for us. Consider the following when looking inward at your planning:

• What is the ability of your EMS system to “flex up” and increase transportation capability due to a no-notice event? Do you have additional transportation resources that you can stand up? What about non-traditional and/or alternative transportation resources?
• Does your facility and/or emergency department have a robust plan for mass casualty incidents? Does it acknowledge the need to provide sustained care for critical trauma victims while transportation is facilitated? Does it have a pediatric-specific component? Have you tested it lately?
• Where does your facility fit into the regional trauma system? Do you have transfer agreements with regional resource trauma centers? Have you explored eligibility for a lower level trauma designation (such as Level IV) for your rural facility?
• Do you maintain situational awareness to take advantage of early warning notification of events? Are you connected with your regional health care coalition to coordinate with health care and emergency management?
• Have you worked with your schools to pre-plan cooperation for mass casualty events involving schools and students? If so, have you considered tracking and reunification?

These are just a few of the questions that we should process it the wake of a tragedy such as the one we experienced last week. No doubt these are difficult discussions, but know that you are having them for the right reason.

The HAP Emergency Management team is available to support and assist member facilities with these and any other questions you may have. Please contact me, or any member of the team.