Amid More Gun Violence, Responders Must Prepare To Treat Children

Jan 17, 2019

Disaster planning often focuses on treating adults and overlooks the special needs of children. KUNR’s Anh Gray reports as more communities nationwide experience gun violence, emergency workers are learning how to care for young victims of mass shootings.

About 50 responders from various agencies are gathered at the region’s command center. They’re running through scenarios that focus on pediatric triage, mass sheltering and how to allocate scarce resources when catastrophe strikes. This is the first time a training in Washoe focused solely on children.

Brittany Dayton coordinates emergency management for the Washoe County Health District.

“Since October 1 happened down in Vegas, we want to prepare for all hazards,” Dayton said. Nevada became home to the deadliest mass shooting in modern history in 2017 when a gunman opened fire at the Route 91 Harvest Music Festival in Las Vegas. 58 people were killed and several hundred were injured. During large-scale emergencies, first responders are trained to treat adults.

The Regional Dispatch and Emergency Operations Center in Washoe County.
Credit Anh Gray

Federal research shows gaps in the care of children.

“They have different considerations as far as their general make-up, and so they breathe faster and breathe deeper,” Dayton explained. “They’re going to be impacted on a greater scale than adults because of being smaller.”

Minors make up about a quarter of Washoe’s population, so roughly around 100,000. Aside from providing medical treatment, emergency workers also grapple with other issues.

Gregg Lord is the instructor for this training session, and he's using a FEMA-based curriculum funded by the Department of Homeland Security.

“How do we manage missing children? Those who have become separated from their guardians, or from their family, is one of the really big issues that, we see this at every disaster,” Lord said. “There’s always children who get separated and lost in the proverbial chaos. ” 

The Centers for Disease Control and Prevention is reporting nearly 40,000 gun deaths nationwide in 2017. That’s the highest rate in 40 years. And in Nevada, the rate is even higher. That’s why Lord travels the country to prep communities for dire scenarios, including mass shootings, which can happen anywhere.

“Everything from your churches, and your religious community to your malls, and now, unfortunately, over the last couple of years,” Lord explained, “we’ve seen a fairly rapid increase in mass shootings at hospitals, health care centers, for various reasons.”

To save more lives, Lord says it’s become essential to empower everyday people to help gunshot victims from bleeding out.

“It’s the number one reason people in this country die from trauma is because they bleed to death,” Lord said, “and that’s a preventable death most times if we just stop the bleeding.”

Emergency responders in Northern Nevada receiving training on how to care for children during disasters.
Credit Anh Gray

A national campaign called Stop the Bleed trains bystanders to help injured victims. They learn skills like how to tie a tourniquet while waiting for help. The Regional Emergency Medical Services Authority—or REMSA—is an ambulance service provider in Northern Nevada that hosts community-wide trainings several times a year.

But it’s not just mass shootings that participant Dr. Kristina Deeter is concerned about. She’s the medical director of Renown Children’s Hospital Pediatric Intensive Care Unit, and she’s seeing more unintentional gun injuries.

“The child that gets into their parents' guns at home has been the patient I’ve been taking care of for the last twenty years,” Deeter said. “It continues to happen despite parents' best efforts to keep guns safe.”

Researchers from John Hopkins found that more than 8,000 children end up in the ER each year because of gun injuries. That’s why Deeter brings up gun safety. “It’s still a huge risk factor for us,” Deeter explained, “and something we ask about in our pediatric offices is when we see a family and we see a child is: 'Do you have a gun at home and how is that gun secured?' ”

Since gun violence often affects communities on a larger scale as well, Washoe County Emergency Manager Aaron Kenneston must prepare for mass-casualties.

“We’re currently planning a big statewide exercise that would have a lot of moving pieces,” Kenneston said, “but one of them that we’re discussing would be a shooter-in-a-school scenario.”

Regardless of how many trainings and drills there are, Kenneston says a community can never be 100 percent ready.

“We’re never done because, by definition of a disaster, it’s unanticipated and of greater scope than you would have thought possible.”

The school-based active shooter exercise Kenneston mentioned is slated to take place later this year.