Nation

At Las Vegas hospital, staff treat physical and mental wounds

LAS VEGAS — The vast majority of people brought to a major hospital here after being injured at a concert Sunday night suffered from gunshot wounds, and because of the high-caliber, high-velocity weaponry that was used, the wounds were worse than what doctors normally see, a trauma specialist here said Tuesday.

“We did notice that this was not normal as far as the pattern of injuries,” said Dr. Douglas Fraser, trauma surgeon and vice chief of trauma at University Medical Center of Southern Nevada, the state’s only Level 1 trauma center.

“The wounds we normally see with handgun injuries are smaller entrance wounds,” he told reporters gathered outside the hospital Tuesday. “These were quite large wounds that we saw. The fracture and shrapnel from the high-velocity rounds created kind of a different pattern and really injured the bone and soft tissue very readily. . . . It’s a high-caliber round, and it does more tissue destruction as it makes impact.”

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And, of course, some of the concertgoers who were killed — at least 58 as of Tuesday — never made it to a hospital.

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“Many victims succumbed to their injuries at the scene, given the high-caliber weapon that had been used,” Fraser said. “Unfortunately, the coroner has a big job cut out trying to identify everybody who unfortunately did not make it.”

Some of the more than 500 people who were injured at the concert were not shot but instead suffered injuries — such as dislocated shoulders, rolled ankles, and bumps and bruises — while trying to escape. Some were hurt from being trampled, and at least one person was hit by a car while trying to run away from the chaos, Fraser said.

But he said more than 80 percent of the 104 victims brought to UMCSN for treatment suffered from at least one gunshot wound, including some whose injuries were less serious because they were grazed or hit by a ricochet. Some suffered from multiple gunshot wounds, and some victims’ injuries required surgery, though he was not aware of any whose injuries required amputation.

“A lot of the injuries we did see were gunshots to the chest,” Fraser said. “Fortunately, many of those did not require surgery but they did require a chest tube to drain the blood out of their chest so they could breathe better.” Others had bones shattered by the impact of the ammunition.

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Fraser said there are still patients at the hospital with “significant injuries” that will require close monitoring and, in some cases, operations. Some patients still required a ventilator with a breathing tube.

“There’s still a few that remain very critical,” he said. Even some of those who are in a more stable condition have suffered life-altering injuries.

“You can take a healthy 50-year-old male and he can break his leg and then he can’t work if he does labor and things like that. So those are life-changing injuries for people,” he said. “Sometimes just simple injuries . . . can be very debilitating and impact a family for many, many months ahead.”

There will also be a mental toll on many survivors and witnesses of the attack — physically injured or not — as well as the family members of victims and first responders.

“Patients also suffer from the mental impact of this, and we have services available to them afterwards for grief counseling and other things like that, and PTSD, and we definitely have services and social services available for that,” Fraser said.

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“We’re not only treating the patients, but we have a lot of family members there. So when I make rounds and see them, I’m also treating the families and trying to explain to them what to expect,” he added.

“We have a lot of visitors here in Vegas, so this is not home for everybody, so we have to deal with them trying to get back to their home states of Texas and New York and California, Florida, all over the country really.”

Fraser commended hospital staff for their dedication and tireless work Sunday night, with many nurses and doctors working overtime to help.

“I can’t say enough about the staff,” he said. “It really was kind of a big symphony of all hands on deck helping out.”

The hospital has trained for such mass casualty scenarios, and a trauma doctor from an Orlando hospital recently visited UMCSN to speak about what medical staff dealt with after the Pulse nightclub shooting.

All the hospital’s training and preparation “kind of proved its point that we were ready for this, unfortunately. We never want to be, but it was nice to see everything come together when it was needed.”

Matt Rocheleau can be reached at matthew.rocheleau@globe.com. Follow him on Twitter @mrochele.