On October 1, 2017, at 10:05 p.m., a gunman opened fire on attendees of a country music festival in Las Vegas, using modified semi-automatic weapons to spray bullets across the crowd of 22,000 people. In the worst mass shooting event in U.S. history, 546 people were injured and 58 died. More than 200 of those casualties presented to the emergency department of Sunrise Hospital, a Level 2 trauma center just east of the Las Vegas Strip, in a “no notice” event. Anesthesiologists and CRNAs at Sunrise participated in triage and stabilization of patients in the ED and ICUs and facilitated more than 60 emergency surgeries over the following 24 hours. As in similar tragic events, post-incident debriefing revealed important lessons. These are summarized in the table on page 10, with the following key points:

The former chief of anesthesia...

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