CINCINNATI -- Tom Lakamp's mind immediately swung into emergency mode when he heard about Sunday's mass shooting in Las Vegas. He's the Cincinnati Fire Department's district chief in charge of emergency planning.
Some of his first thoughts: "What would I be doing? How would I be responding? Where would I be going?"
Those questions, and more, were on the minds of first responders around Greater Cincinnati on Monday. Hamilton County's mass casualty incident plan is being updated now to cover the county, Cincinnati and adjacent counties in Ohio, Kentucky and Indiana. Glendale Fire Chief Kevin Hardwick is writing the updated plan for the Hamilton County Fire Chiefs Association.
"You try to prepare the best you can. It's with the training. It's with practices and drills," Hardwick said. For example, there was a drill at the Cincinnati/Northern Kentucky International Airport last month, simulating 108 people injured.
In Las Vegas, a shooter killed 58 people and injured 515 more. Coordination is mandatory in a mass casualty situation. Lakamp said the plan has five levels, which could assemble up to 80 medical units from all over the Tri-State.
"How do you transport people? How do you triage the people?... getting the resources on the scene where you need them as quick as you need them to get those people out," Hardwick said.
The doctors staffing trauma centers and emergency rooms also took note of Sunday night's events and checked their own plans, too. The University of Cincinnati Medical Center and Cincinnati Children's Hospital Medical Center are the region's level-one trauma centers, designed to handle any sort of case day or night. But the Las Vegas shooting took things to a new level, doctors said.
"It's scary because it can happen anywhere," said Dr. Kennth Davis Jr., UC professor of surgery.
UC West Chester and Bethesda North are level-three trauma centers. Doctors and surgeons quickly mobilize when they get word of a mass casualty case.
"Radiology is available. If we know in advance that we need certain specialists, we can call them. They're in house — they can be there on a moment's notice or be there when the patient arrives," Davis said.
All hospitals work together in a mass casualty incident, Dr. D. Millar said: Trauma is "a team sport."
"We require emergency medicine surgeons, trauma surgeons, the full might and power of any hospital facility with emergency rooms, recovery, nursing staff," Millar said.
And, like the first responders bringing patients to the hospitals, doctors run drills, too.
"We'll train and we create protocols that will allow us to surge beyond our normal capacity to be able to handle something like this," Millar said.
UC Medical Center was in the center of a mass casualty incident six months ago, after the Cameo Night Club shooting. Davis said doctors were ready then and ready still.
"We do trauma every day. We're a level-one trauma center. There's nothing beyond us," he said.