WHITE COAT

'Every patient that could have been saved, we saved': ER doc who treated Las Vegas shooting victims

Dr. Kevin Menes' entire career seemed to lead to that trauma bay on Oct. 1, 2017 after Stephen Paddock opened fire from a window of a Las Vegas hotel room into a crowd at a country music festival. Sunrise Hospital, where Menes works, saw about 200 patients that night. They saved all but 16.
Dr. Kevin Menes was the ER doctor in charge that night at Sunrise Hospital. Being only eight kilometres from the festival grounds, about 200 patients came through the ER that night, most with gunshot wounds. (Hector Torres Photography, courtesy Sunrise Hospital)
Listen26:29

When Stephen Paddock opened fire into a crowd at a country music festival last October in Las Vegas, he became responsible the deadliest mass shooting in recent US history.  Paddock injured more than 500 people and took 58 lives. 

But eight kilometres away, at Las Vegas' Sunrise Hospital, the only thing on Dr. Kevin Menes mind was saving lives.

"I think every… not I think, I know that every patient that could have been saved that night, we saved them," Menes told White Coat, Black Art  host Dr. Brian Goldman. 
Las Vegas police and emergency vehicles on scene following the deadly shooting. When police officers brought in the first of the casualties from the festival Menes calculated that he had about 10 seconds to triage every patient. (Chase Stevens/Las Vegas Review-Journal via AP)

Menes was the ER doctor in charge that night. He and his team treated about 200 patients, most with gunshot wounds. They managed to save all but 16.

He says the first bunch of casualties arrived in the back of police cruisers, 15 minutes after the shots were fired,

"These were some of the sickest gunshot wounds I've ever seen," he remembered.

Doing the math afterwards, Menes calculated that he had about 10 seconds to triage every patient.

“Every single person who walked in [to the ER] had the exact same look on their face - shock, disbelief, horror and confusion all mixed and rolled up into one,” Menes said.
  Despite the time constraints, he and his colleagues refused to follow normal protocols that would mean "tagging" patients according to the severity of injury; green tags for minor wounds, red for severe but savable, grey means the patient is alive but beyond hope — black means they are dead. 

They wanted to give everyone a fighting chance, 

"That night we did save a huge majority of grey tags," he said, adding that he and the ER team "were all going to try until we dropped dead ourselves." 

Anyone who could push a wheelchair or gurney was sent down to the ER to help and hundreds of emergency staff were called in.

"Every single person who walked in had the exact same look on their face — shock, disbelief, horror and confusion all mixed and rolled up into one," Menes said, recalling staff members' initial reactions.

Worst-case scenario

"To ask if I was scared or nervous… none of those things were happening. I was just ready to work," he said, probably because Menes was, in many ways, preparing for that night for much of his career.  

As a trainee in Detroit, he saw many gunshot wounds, which started his interest in learning about how bullets impact a human body.  

That led him to volunteer with with a S.W.A.T. team where he grilled team members about ballistics, adding to his knowledge about how to treat bullet wounds. 

While he was in Detroit, the city hosted The Superbowl, so the hospital had a just-in-case plan for a possible mass casualty, something that started Menes thinking about how he'd handle such an incident. 

Menes began mapping out worst-case scenarios in his head, prompted by the 2008 Mumbai attacks. He also started what he called "pre-planning," believing Las Vegas might be a target for a terrorist attack given its draw as a tourist destination.  
“I think every… not I think, I know that every patient that could have been saved that night, we saved them,” said Menes of the staff pictured above.

Still, Menes is reluctant to take credit for what happened at Sunrise Hospital that night, pointing out that it was a huge team effort. 

"We had about a 100 doctors, nurse practitioners, physician assistants... and 200 nurses come in. This is a Sunday night at 10 o'clock... for these staff members to first take the phone call, then decide they are gong to come in and help, to this day, still amazes me," he said.

Menes says he's kept a close watch on the team that worked that night, for signs of possible post traumatic stress. 

"I'm proud of what we did. I'm not having flashbacks, I'm not having any issues with PTSD but a lot of my staff members were telling me things that were very concerning to me," he admits.

But he says many have found comfort in the visits they've received from the patients they saved that night, who have come back to thank them. 

"And to see those same staff turn around and look at me and tell me the story about this victim that came in [to say hi] it tells me that they've gotten past that dark spot."