As we mourn with the families of those who were killed in the Las Vegas shooting incident this week, we should take the opportunity to learn from it (Gunman kills at least 58 at Vegas concert; Oct 3).

There are several lessons we can reflect upon from a medical angle.

•This shooting resulted in many severely wounded victims. Should there be a similar situation here, first responders may be overwhelmed by the large number of victims. Their task is made even more difficult if the shooting is still going on and there is pandemonium caused by the panicked crowd.

•An ambulance fleet will have to be ready and coordinated for a mass evacuation.

•Police outriders will have to be mobilised to clear entrances to the affected area and exits. Some outriders may have to escort the ambulances to the nearest medical facility.

•We may have to clear the facility's emergency department to receive the injured and mobilise medical personnel from the wards. Police may have to be deployed at emergency departments to perform crowd control as well.

•Many wounded victims will require emergency surgery and intensive care. Medical personnel on duty will have to empty the operating theatres, high-dependency wards and the intensive-care unit to receive them.

•Security in the hospital will need to beefed up too to handle the sudden increase in visitors there to see their loved ones who are recuperating.

•Counsellors trained in post-traumatic stress management have to be ready to reach out to the families and victims.

•Private hospitals should be drafted into such emergency plans. In the event that all our facilities are overwhelmed, we may even have to seek help from neighbouring countries.

•Medical personnel from the uniformed groups and civil resources should also be on stand-by when the usual resources are stretched.

Last, but not least, all this coordination and planning can be executed smoothly only if there are frequent rehearsals prior to the event.

Leong Choon Kit (Dr)