Why Counting Injuries Is Difficult

It's hard to get an exact number of the people shot during the massacre in Las Vegas, especially because of the enormous number of victims.

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In the aftermath of a mass shooting here in Las Vegas, officials are trying to answer the most basic of questions - it's how many people were shot on Sunday night. We know more than 500 people were injured. What's hard to answer is how many had gunshot wounds. Here's NPR's Rebecca Hersher.

REBECCA HERSHER, BYLINE: You'd think it would be simple. After all, a gunshot wound is hard to hide. But now imagine you're the head trauma surgeon at one of the many hospitals that took in dozens or even hundreds of injured patients overnight on Sunday. You're trying to save lives and count injuries.

CHRIS FISHER: It did look - it did, like a war zone. I mean I can't say that it didn't - frantic families, blood in the hallways.

HERSHER: Dr. Chris Fisher is the medical director of trauma services at Sunrise Hospital. It's right around the corner from where the shooting happened. When we spoke, he was still at the hospital. He'd slept four hours in two days. He says one of the difficult things about Sunday night was the lack of information about who was coming through the door.

FISHER: There's no paper charts prepared for all those patients, no documentation. So they just write on the patient - write down where the wounds are.

HERSHER: Like, with a marker?

FISHER: Yeah, like with the marker.

HERSHER: Quick, simple, impersonal by necessity.

FISHER: What stuck out to me was probably my first patient of the night. I literally didn't even meet the guy, see the guy's face. He was literally on the operating room table, ready to go when I walked in the room.

HERSHER: The man had been shot in the abdomen. Fisher's job was to find the damage that the bullet or bullets had done.

FISHER: It rips the tissue as it goes through.

HERSHER: That first patient made it through surgery. Fisher did seven surgeries in 12 hours. In all, the hospital treated 214 people from the shooting. The gunman fired from above, and the wounds were everywhere.

FISHER: We had patients shot in the head, shot in the spine, chest, abdomen, extremities. A lot of the gunshot wounds went side to side, so you anticipate that people were either running away or ducking.

HERSHER: And that's where, on top of the controlled chaos of the night, counting gunshot wounds gets complicated. Some people taken to other hospitals had scalp lacerations from bullets that grazed their heads, or they were struck by shrapnel kicked off by bullets striking other objects. Those may or may not have been documented as gunshot wounds as patients came into the ER.

And so, the county sheriff says, it's still unclear how many people were shot. The numbers at Sunrise Hospital - about 120 gunshot wound victims - suggest it could be more than half of the about 500 people injured. But even that number could change. A spokesperson for a network of suburban hospitals in the area said Tuesday that some injured people who had initially gone home after surviving the shooting were checking into the hospital for the first time. Rebecca Hersher, NPR News, Las Vegas.

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