A Message from Parkland, Florida

Dear Fellow HFH ER Alumni,

I am a proud graduate of the Class of 2005. I am married to Paula Coghlan (Class of 2006). We have two daughters, Emma (10) and Gabriella (7). 8 years ago we relocated to Parkland, Florida to raise our children and further pursue our careers.

Boyar Family PhotoParkland is a beautiful, quiet city nestled in the northwest corner of Broward County. As of the 2010 census, the population of Parkland was 23,962, and the 2016 census estimates a population of 31,507. Parkland is known for its zoning laws, which are designed to protect the “park-like” character of the city. Initially, there were no stores or traffic lights in Parkland, though this began to change in the mid 1990’s and early 2000’s with the additions of large neighborhood developments and a highly recognized public school system. In 2017, Parkland was named the safest city Florida.

I am currently the Chairman for the Department of Emergency Medicine at Broward Health North. Our facility is a 409 licensed bed hospital, 51 bed ED, level 2 trauma center. Our annual ED volume is 65,000 with an admission rate of 27%. We are part of Broward Health which is one of the ten largest public health systems in the United States.

I have provided the above background in efforts to give some insight into my frame of mind as the events that I am about to described unfolded.

February 14th 2018: The Stoneman Douglas High School Shooting, the deadliest high school shooting in American history, killed 15 students and 2 faculty members in Parkland, Florida.
At approximately 2:40 pm that day I was at home waiting for my daughters to come home from school. I received a phone call from the Chief of our local EMS division stating “Active Shooter alert.” Multiple GSW victims would be coming to our ED and we needed to be prepared NOW. As further intelligence became available, it was clear that these victims were students and faculty members from the high school literally around the corner from my house.

As I was driving at light speed to the hospital a million thoughts entered my mind both personal and professional in nature, however, I needed to maintain clarity to facilitate implementing a hospital wide response (Code Green) to this mass casualty incident (MCI).

The response seemed instantaneous; we set up a command center at the Charge Nurse Desk, we maintained direct communication with on-scene EMS personal, multiple trauma bays were prepared, OR rooms cleared and available, lab and blood bank alerted, all ED holds were immediately taken upstairs to magically created space, available stretchers lined the hallways, countless RN’s from the in-patient units presented to the ED and were assigned tasks, radiology suites were cleared, transporters were on hand, environmental services expedited room cleans, registration prepared disaster charts in our computerized tracking system, multiple physicians from the medical staff presented to the ED to assist, additional ED physicians came in from home, administrative leadership was present, security, guest relations and many more were on hand. Despite the surge in necessary personnel, everyone adhered to their assigned task. This was one of the most important components in eliminating chaos.

Additionally, we had to maintain normal ED operations despite this MCI. We placed providers in triage and dedicated providers to the current ED patients to ensure their safety and quality of care.
We received nine patients including the active shooter suspect. Two patients had lethal injuries. The suspect was treated and released to police custody. Of the remaining victims, several presented with multiple GSW’s requiring emergent life-saving procedures in the trauma bay and multiple operative interventions. These were children scared and critically ill, without parents to consent or console them.

Perhaps the most difficult aspect of the MCI began after the initial stabilization of the victims. During the acute phase, we were all in auto-pilot mode, doing what we do best, practicing Emergency Medicine. We all have had those nights of 20+ “Room 1 and Room 2” resuscitations at Ford or even in our current practice environment. What I never experienced was the emotions attached to the countless parents flocking to our facility with the hope that their child was there. You would think under normal circumstances a trauma center is the last place you would want your child to be. However, during this tragedy, if your child wasn’t home or at the local trauma center, that meant they never made it out of the building. It took until 8:30 pm to identify all the victims from our facility and our sister facility. Initially the majority were registered under “trauma” or “disaster” names. The conversations with parents and families after 8:30 pm meant their loved one or child was one of the 15 victims that were deceased in a hallway or classroom of their school, which was now barricaded off as a crime scene.

That evening, we held a debriefing session in our ED conference room. It was obvious how tangible this tragedy was to everyone involved. We implemented a plan of action to have counseling resources available to all staff.

The next few days now weeks, have been very difficult for our community of Parkland. Students (teenagers) attended funerals, vigils, and participated in walks to mourn the loss of their friends. Efforts to create change for the better continues. Our community has adopted the motto “MSD STRONG.”

Our hospital received an outpouring of letters and gifts from literally all over the world. It certainly lifts our spirits and allows us to believe there is far more good than evil in this world.

As for as any pearls that I may leave you with, I believe preparation is key. I strongly encourage “Active Shooter” drills at your institution. As faith would have it, we had an “Active shooter” drill just a few months ago which proved instrumental in our response to this tragedy. Cohesive engagement with your administration and medical staff translates to a seamless team approach to any challenge that your hospital may encounter. As for the sadness and vacancy we continue to struggle with, I recommend loving and cherishing your family and friends each and every day.

Yours in Fords,
Evan Boyar