When Lisa Smith, M.D., received a call that 32 children injured in a Tennessee bus crash last month were being rushed to the emergency department at Children’s Hospital at Erlanger, Chattanooga, Tenn., the clinicians took action.

The first thing she did was draw on the strength of different departments, says Smith, the pediatric surgeon on call at Children's, part of Erlanger Health System. As the surgeon in charge, she built 32 separate teams to receive each patient, and directed the injured based on their conditions. To fill those teams, Smith called in 33 of her surgical colleagues — pretty much every surgical resident in town — and more than 100 other clinicians including nurses, child life specialists, anesthesiologists, pediatricians and ED doctors all jumped in to help, she says.

“It was really comforting [for] me to look out and see a sea of people waiting to say, ‘Now, what do we do?’” she says. “I can’t imagine [the team responding] better than they did.”

The Level I trauma center at Erlanger is no stranger to disaster, but the November bus crash that killed six students and injured dozens more was the largest Smith has seen since she started at the hospital, she says. “Unfortunately, lives were lost; some injuries were too severe,” she says. Among the survivors, “I would say, looking at where the children are, the best outcomes from their injuries are being attained.”

The outcomes are a product of the teamwork demonstrated by everyone involved, from first responders to hospital administrators, she says. The  coordination and relationship among police, the fire department, emergency medical services and the ED helped with their readiness. 

One of the immediate tasks at hand was matching the many familiy members in the hallways with their children, something that pediatricians and child-life specialists did, says Smith. Hospital administrators were on the floor bringing blankets to children and families, Smith noted. “Their physical presence during the event was a big difference, too,” she added. 

And while the emotions of that tragic night continue, Smith says she is proud of the way she and the hospital staff handled the situation, and it likely will remain one of the major events of her life. She says that she expects to look back years from now to say, “I was part of this.”