In his presence before a committee of the United States House of Representatives, Dr. Roy Guerrero, a pediatrician from Uvalade, Texas, told lawmakers he saw two of the 19 children killed in the Robert Elementary School massacre. He said they were so distorted that they could be identified by the clothes they wore.
Over the years, the medical profession has devised strategies such as rapid patient evacuation to save a large number of victims. But trauma surgeons interviewed by KHN say that even these improvements can save only a fraction of patients when they are wounded by a military-style rifle.
With large wounds, many victims died on the spot before reaching the hospital, they say. According to surgeons, those who go to trauma centers seem to have more wounds than in the past.
However, doctors added, the weapons used are not new. Instead, what is happening is that there are more and more of these particularly deadly weapons being used more and more in mass shootings and in the daily violence that communities endure across the country.
Doctors frustrated by the massacre have called for widespread action to curb the rise in gun violence.
Even weeks after the Uvalade school shooting, it is unclear what steps the country will take to prevent another such attack. The House of Representatives approved measures a few days ago to reduce gun violence, but their approval in the Senate remains uncertain.
Many doctors agree that something significant needs to be done. “A single solution will not solve this crisis,” said Dr. Ashley Hink, a North Carolina resident who was a resident trauma surgeon at South Carolina Medical University when a white supremacist killed nine black church members. African Methodist Episcopalian mother Emanuel in 2015. “If anyone wants to bet on just one solution, they are not informed enough about this problem.”
Weapons of mass shootings – often defined as incidents in which at least four people were shot – are not merely military-style rifles, like the AR-15 used in the Uwalde. Surgeons say they have increased the use of semi-automatic handguns used in the shooting at Charleston Church. They can hold more ammunition than revolvers and fire faster.
Gun violence in general has increased in recent years. By 2020, gunfire has become the leading cause of death for children and adolescents. Gun-related homicides rose 35% in 2020, the Center for Disease Control and Prevention (CDC) reported in May. Most of these deaths were caused by gunfire.
Still, trauma surgeons, such as Dr. Rob Todd at Atlanta Grady Memorial Hospital, have blamed the high level of violence for the deaths on military-style rifles and the lifting of the national ban on assault weapons in 2004.
A recent study published in the Jama Open Network found that six more people were injured in each of the mass shootings. Surgeons interviewed by KHN say the number of injuries appears to have increased.
“I think we’ve seen an increase in violence over the last decade,” said Dr. Joseph Saqran, a trauma surgeon at Johns Hopkins Hospital in Baltimore. He referred to the number of times a person was shot and said that each time they were shot at a range close to them.
Tacoma, president-elect of the American College of Emergency Physicians, Dr. Christopher Kang of Wash, said the survival rate in a mass shooting depends on a number of factors, including the type of firearm used.
Several have survived recent shootings.
The Charleston genocide perpetrator shot each of the nine people who died more than once. One of them was taken to hospital and had no pulse when he arrived.
Only one survivor of the shooting at three Asian spas in the Atlanta area last year.
Dr John Armstrong, a professor of surgery at the University of South Florida, said the chaos at the scene of the mass shooting – and the presence of an “active” shooter – could seriously delay the arrival of the victim at the hospital. “With high-powered weapons, you see more tissue destruction, more bleeding.”
Dr. Sanjay Gupta, a neurosurgeon who is the chief medical correspondent for CNN, writes about the force and force involved in a gunshot wound caused by an AR-15-style rifle used in a recent mass shooting in Buffalo, New York. The power is like throwing a watermelon on a cement floor, Gupta said, quoting Dr Ernest Moore, director of surgical research at Denver Health Medical Center.
Over the years, advances in medicine, including lessons learned on the battlefields of Afghanistan and Iraq, have helped save lives, said Armstrong, who trained the U.S. Army Surgery Team.
These strategies, he said, include the proper use of tourniquets, quick removal of the injured and the use of “whole blood” to treat patients who need large amounts of all blood components, such as severe bleeding. It is used in place of blood which is divided into plasma, platelets and red blood cells.
Another effective strategy is to train viewers on how to help victims. A protocol called “Stop the Bleed” teaches how to apply pressure to a wound, apply a bandage to control bleeding, and apply a tourniquet. Stop the Bleed grew out of a 2012 shooting at Sandy Hook Elementary School in Newtown, Connecticut, which killed 20 children and six adults.
The CDC, which has been able to investigate guns since the congressional ban in the last two years, has funded more than a dozen projects aimed at studying gun violence from a public health perspective. These projects include the study of gunshot wounds and the collection of gunshot wound data in emergency rooms across the country.
For some doctors, gun violence has given rise to political action. Dr. Annie Andrews, a pediatrician at the Medical University of South Carolina, is running as a Democrat for a House seat on a platform to prevent gun violence. After the school shooting, Andrews said many women around him approached him and asked, “What can be done about this? I’m worried about my children.”
Dr. Ronald Stuart, a professor of surgery at San Antonio Health University, told KHN that those who were shot in the abdomen had “high-strength, high-velocity” bullet wounds. Four of them, including three children, have been shifted to University Hospital, where they are being treated for high-level trauma.
Hospital and Stuart already know about such genocides. San Antonio Hospital treated victims of a shooting at Sutherland Springs Church in 2017 that killed more than a dozen people.
Two of the four victims of the Yuvalde shooting have been released, Elizabeth Allen, a spokeswoman for the University of Health, said, and the other two were hospitalized until Thursday, June 9.
It will be a bilateral effort to bring about meaningful change in what gun owner Stuart calls a “significant epidemic” that does not threaten the Second Amendment right. Stuart noted that public safety measures have reduced the number of unintentional injuries in car accidents. As for intentional violence, he said, no progress has been made.
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