The harm in second-guessing first-responders

In the days and weeks that follow a response to a disaster it’s expected and necessary that those involved retrace the steps they took and the decisions they made to ensure that needed resources are at the ready, that everyone is trained and prepared and that lines of communication are clear.

Such reviews following last year’s deadly Oso landslide led to changes — including a clarification when the state’s “all-hazards” incident management resources can be called upon — that better prepare first-responders and officials for the next large-scale disaster.

It’s not second-guessing; it’s a thoughtful debriefing.

And a review of the response to the Oct. 24 shooting at Marysville Pilchuck High School, which ultimately claimed the lives of four students and the young gunman, is also necessary and proper.

But not hours into the response when shock still gripped emergency crews, some of them with children at the school. And not by relying on incorrect information and assumptions.

A report published Friday by Herald Writers Scott North and Chuck Taylor has revealed:

It was only hours following that shooting when officials at Seattle’s Haborview Medical Center, overseen by UW Medicine, began questioning the decisions made by Marysville first-responders and doctors at Providence Everett Medical Center. A review of internal emails between Harborview officials shows that eight hours after the shooting, Harborview’s chief health system officer, Johnese Spisso, wrote the hospitals’ chief of trauma, Dr. Eileen Bulger, that she was “appalled” by on-scene decisions to transport four critically injured victims by ambulance to Providence rather than having them airlifted from the scene to Harborview, the state’s premiere trauma center. Two days later Dr. Mary King, Harborview’s chief of pediatric critical care, called the decisions an “epic system failure” in an email to Bulger. Spisso in an email to Bulger would later accuse Providence of using the tragedy “for personal PR.”

Had it remained an email conversation, it could have ended there, but Bulger, just days after the shooting, shared her doubts about the triage decisions made in Marysville with the Seattle Times, second-guessing then repeated by Seattle TV stations, all calling into question the decisions made by Marysville first-responders and doctors at Providence.

But the contention in emails and the Seattle media that Airlift’s helicopters were “hovering” over the scene only to be waved off is false. Review of flight logs and their tracking data, which were obtained only after a public records request and a five-month delay, show that Airlift helicopters were in-flight either in Skagit or King counties and still dozens of minutes away from the scene as ambulances were loaded and on their way to Providence. Victims arrived at Providence within 12 minutes. Waiting for helicopter transport to Harborview would have meant added delay to the victims’ care.

It’s important to remember that the gunman’s victims and the gunman, himself, were each shot at close range in the head. The gunman and one of his victims died at the scene. The only survivor sustained a gunshot wound to his jaw.

Again, reviews of tragedies such as this are important. But if improved emergency response and delivery of medical care is to be the outcome, they can only be performed once the necessary information has been gathered and verified.

In such debriefings, turf wars, egos and prejudgments have no place.

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