Little known group critical in Mass Casualty Response

- On a typical day about 70 people enter the Baylor Scott & White Emergency Room in Round Rock seeking medical care. Dr. Ross Tobleman heads up the ER.

"Every day is different and every day you have to be ready. That’s what we train for, emergency physicians and emergency nurses, when we come to work we never know what’s going to come through the door,” said Dr. Tobleman.

The emergency room is rated as Trauma IV. The staff specializes in injuries like broken bones and abrasions. The focus, especially during a crisis, is to stabilize.

" So the walking wounded so to speak, are the type of patients we'd get,” said Dr. Tobleman.

The attack in Las Vegas - with more than 500 wounded is an example of how hospitals can get overwhelmed.

"well, I think it was Mike Tyson that said, everybody has a plan until they get hit in the mouth,” said Dr. Tobleman.

Between San Antonio and Temple there are 5 Level 1 Trauma Hospitals, which are affiliated with academic research or provide a residency program. There are also 5 hospitals rated as Level II. In March, the Austin area will officially get another Level II trauma care hospital. It will be at St. David's - South Austin Medical Center. For the past several months the staff there has been allowed to provide that higher level of care as they work toward final certification. There are 6 more hospitals in the area rated at Level III and 20 at Level IV. Central Texas hospitals are part of a regional network. The idea is to have a single point of contact to manage a mass casualty event.

"We help coordinate where those patients go, based on the situation,” Ron Weaver with the Capital Area Trauma Regional Advisory Council, known as CAT-RAC. The organization covers an 11 county region working with hospitals that have the potential of providing 3,000 hospital beds."

"So we have a way of quickly getting a bed report, form those hospitals on what they can currently staff, and if need be what they can surge to,” said Weaver.

With CAT-RAC critical care patients can be sent to different top trauma teams - like those who were shot on Fort Hood in 2009. The plan also includes managing viral outbreaks- like the flu crisis 8 years ago. Back then-  mobile clinics were set up to ease the pressure on emergency rooms. The goal is to be flexible; getting the right injury to the right hospital without overloading the system.

"I am satisfied that we work well together that our community partners, fire, police and ems, work together on a routine basis, we know each other and we can call each other and we can respond,” said Weaver.

To keep that edge, hospitals go through training exercises every year - like this one in 2014.

First responders and medical staff, at St. David’s in Georgetown, simulated rescuing patients after a direct hit by a tornado.
In November- CAT-RAC will conduct a terrorism drill. The focus then will be on dealing with people who are trying to locate injured family members.

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