Surge of Gun Violence Forces Chicago Hospital to Divert Patients

Marcia Frellick

August 05, 2019

While the US was reeling over the weekend from two mass shootings in Texas and Ohio, Chicago was dealing with its own all-too familiar crisis related to gun violence.

Multiple gunshot victims sent to Mt. Sinai Hospital in Chicago early Sunday morning forced the hospital to temporarily divert ambulance traffic to other area trauma centers.

Chicago's gun violence came amid mass shootings in El Paso, Texas and Dayton, Ohio, that left at least 31 people dead and dozens injured.

Overall in Chicago, at least seven people were killed and 48 wounded by guns in what was the city's most violent weekend this year, according to the Chicago Tribune.

Dan Regan, director of communications and public relations for Sinai Health System, told Medscape Medical News on Monday that there was a shooting in Douglas Park near Mt. Sinai about 1:30 AM Sunday.

Seven people were shot there, he said, five of whom were sent to Mount Sinai.

"In addition to those five patients, we also received a couple of trauma patients from two motor vehicle accidents that occurred at the same time. That volume briefly led us to go on bypass, which simply means that ambulances bypass our hospital and go to a different trauma center," Regan said.

He said Mt. Sinai — one of five level 1 trauma centers in Chicago — was on bypass from 4:30 AM to 6:30 AM.

"We were still accepting walk-in patients. We were just on bypass for ambulance traffic," he said.

The rush of seven patients in addition to the other emergency department patients already getting treatment and walking in pushed the hospital to enact what is a "relatively unusual" step, Regan said. He said bypass is ordered at the hospital only a few times a year.

"There's a coordinated effort with (emergency medical services) and the other trauma centers to direct other ambulances and ensure there is proper care for patients," he said.

Regan said the health system doesn't track the numbers of patients who would have come to Mt. Sinai had the bypass not been in effect.

Nancy Foster, the American Hospital Association's vice president of quality and patient safety policy, told Medscape Medical News that in many communities nationwide, EDs are having surges in demand from the opioid crisis and virus outbreaks, along with the usual accidents and illnesses.

"When a hospital receives a large number of critical patients all at once who fully engage the available doctors, nurses, and other staff and resources, the emergency department may go on diversion as a way to ensure its staff can continue to focus on the patients who have already arrived, and other hospitals can be called on to attend to additional patients rapidly," she said.

"Diversion is not a perfect solution to overcrowding in an emergency room, but it is one strategy many hospitals use," Foster explained. "Some hospitals and emergency response teams are experimenting with other strategies for ensuring that patients' needs are met in a timely fashion, and the AHA shares successful strategies with others around the country as they emerge."

"Public Health Epidemic"

The Texas and Ohio shootings challenged several other emergency departments nationwide.

In El Paso, a mass shooting at a crowded department store on Saturday killed at least 22 people. The updated toll included a death late Sunday night and early Monday morning, according to the Associated Press. Police have a suspect in custody.

Hours after the El Paso shooting, on Sunday in Dayton, Ohio, a gunman opened fire on a crowd in a popular entertainment district, killing at least nine and injuring 27, according to the AP. The suspect was killed by police within a minute of the start of the rampage, the AP said.

The shooting in Dayton is the 22nd mass killing this year in the United States, according to the AP/USA Today/Northeastern University mass murder database. The 20 before this weekend have resulted in 96 deaths.

Vidor Friedman, MD, president of the American College of Emergency Physicians, said in a statement:

"News reports are numbing, and even the most well-intentioned thoughts and prayers fall short. As emergency physicians, we are on the frontlines of treating the victims of these senseless, violent acts. The frequency of firearm injuries and fatalities in this country is staggering, and there is no doubt about the threat posed to America's public health and safety."

Friedman added, "Firearm injuries — accidental or otherwise — should be addressed as a public health epidemic, with investments in research and a sweeping commitment to change that matches or exceeds the level of a number of diseases, outbreaks, or disorders that capture the public conscience but have exacted far less of a human toll in recent years."

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