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More Hospitals Prepare for School Shootings, Including Explosives; Shooting Described as War with IEDS; Hospital Gives Press Conference on School Shooting Injuries; Shots Fired Heard on Police Audio. Aired 1:30-2p ET

Aired May 18, 2018 - 13:30   ET


[13:30:00] DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: They're still describing the patient as in critical condition, and that means they haven't as of yet been able to fully control that blood loss, which is certainly what they're trying to do right now.

But the protocol at every step of the way, the first responders in the field to the type of training, the type of injuries that hospitals are now trained to be able to deal with has changed over the last several years -- Wolf?

WOLF BLITZER, CNN HOST: In this particular case, they're worried about injuries not just from gunshots but also from explosive devices with the pressure cookers and bombs along those lines. Sanjay, this creates even further difficulties for these local hospitals.

GUPTA: It creates further difficulties. First of all, going back to the training. That's the sort of training many of these first responders and the people who are then caring for these patients in the hospital have to be aware of. They have to understand how to take care of these types of injuries. Most of this was done basically in the battlefield, the military sort of training in medicine before. So this is happening much more now, obviously, in civilian settings.

But also, they have the resources. UTMB is a level-1 trauma center. That means they've got the surgeons, the nurses, everybody who is in house to be able to care for these patients, when necessary. When they come in the door, they have operating rooms that are standing by. They have blood of all different types that they can transfuse.

That's what you need to have. But when you start to have multiple patients coming in and the concern about more patients coming in, you have to be able to prepare for that as well. You have to have a lot of redundancy in the medical system to be able to handle that. Typically, I work at a level-1 trauma center. We all start to get calls. We may be getting more patients, we need to have you either here at the hospital standing by very close, whatever. I'm sure those calls have probably been going out, especially in Galveston around that level-1 trauma center.

BLITZER: Sanjay, listen to some more of the eyewitness accounts of what happened. Listen to this.

(BEGIN VIDEO CLIP) UNIDENTIFIED WITNESS: We heard the alarms. Everybody just started leaving, following the same procedure as we did because nobody thought it would be this. Nobody thought it was a shooting. Everybody just thought it was a normal procedure or practice fire drill. And next thing you know, we just hear so many -- three gunshots, a lot of explosions, and teachers were telling us to run, run, go, run. Me and my friend, Ryan Calvert, ran to the floor so we could get shelter. That's when I called my mom.

UNIDENTIFIED WITNESS: I couldn't understand her. There was just noise coming out of her body. I could tell she was in distress. And she said she's in a field behind the school, hiding. And I don't know what's going on, so I'm in panic, sheer panic. I called my supervisor. I was like, I'm out of here, I got to go. I got here, and it was kind of a struggle to get in here because of the cops trying to block everything off. It wouldn't have mattered. I would have got to her somehow. I would have ran. Her friend got shot. It's disturbing. And she's fearful because she says she has to go to school tomorrow. And I'm like, you're not going to school tomorrow. You're not going back.


BLITZER: Sanjay, it's not just those that were injured with a shooting or an explosive device, but the emotional toll, the psychological toll. These kids and their families, they're going to go through enormous distress, maybe for a long, long time, and you have to deal with this, right?

GUPTA: There's no question, Wolf. Every -- it's hard to even imagine. I got kids starting high school next year. You can't imagine you send your kid to a place that's supposed to be a safe place, a place of learning, and this is the call that you get. It's what happens. But the psychological impact on the students certainly, but the entire community, and these hospitals, Wolf, the doctors and nurses, the health care teams there, they all live in these communities as well.

Oftentimes, when I've covered these, and I know you have as well, you're talking to these people providing care who also have students that go to this high school who may have even known somebody who was injured or killed. So there's no one immune when it strikes a community like this. Everybody from, obviously, the students and the people at the school, but to the people who are providing the care, sometimes really tough care to provide.

BLITZER: It certainly is. It's an awful, awful situation.

Shimon Prokupecz is still with us.

You're working your sources. You're getting additional, very disturbing information.

SHIMON PROKUPECZ, CNN CRIME & JUSTICE CORRESPONDENT: Yes, and a key piece of evidence here, perhaps, for information for law enforcement. We're told they have found and are searching a trailer in that area where they believe the gunman may have been building these bombs, these pipe bombs, the pressure cooker. So clearly, they are now in the middle of going through that safely. They have found also a pressure cooker, so a key piece of evidence here for investigators.

You know, we've done this before. We've covered these kinds of cases. And law enforcement always wants to find a place where someone has built these kinds of devices, and it looks like police here, the ATF and FBI there, have now found that place and are in the middle of searching it. And obviously, those are going to be key pieces of information.

It's also going to give us even more indication just the level of planning that perhaps went into this. They have now a site where the gunman, the alleged shooter here, was building these devices, how long he was there for, when did he start building all that. They could realize all that and find that all out in that location.

[13:35:44] BLITZER: It's almost like they're describing what we call in a wartime situation, whether in Iraq or Afghanistan, IEDs, improvised explosive devices.

PROKUPECZ: Right, and that would be the pipe bomb, the pressure cooker. That's how law enforcement describes it. We were told from the beginning that there were some IEDs they found that they were concerned about.

BLITZER: They're using those letters, IED?

PROKUPECZ: Yes, they are using those letters. And that's how bomb techs speak a lot and that's how law enforcement describes these devices because they are improvised devices. They appear to have been built, at least now, they believe, by this person in this trailer, and they're in the middle of going through that. Obviously, it's a key development here, key pieces of evidence here for law enforcement. But it still doesn't mitigate this concern that law enforcement has out there.

BLITZER: Let's go to one of the regional hospitals. They're briefing us on some of the patients who are there.

DR. SAFI MADAIN, EMERGENCY ROOM DIRECTOR, CLEAR LAKE MEDICAL CENTER: Out of those eight patients, six of those patients have been discharged with non-life-threatening injuries. Two of the patients did go to the operating room.

UNIDENTIFIED REPORTER: The condition of those patients?

MADAIN: Right now, I could say that one of the patients is in critical condition. I would say the other patient is in fair condition.

UNIDENTIFIED REPORTER: Are you able to talk about injuries at all?

MADAIN: I cannot do that right now.

UNIDENTIFIED REPORTER: For those that are already discharged, what were the extent of the injuries?

MADAIN: I can't comment on that, either.

UNIDENTIFIED REPORTER: Can you tell us what type of gun was used?

MADAIN: No, ma'am.

UNIDENTIFIED REPORTER: Ages of the patients?

MADAIN: All I can say is they were high school students, right, so high school ages, 14 to 18, but I cannot tell you exactly what the ages of these students were.

UNIDENTIFIED REPORTER: Have all their families been notified?

MADAIN: Yes, ma'am. They have been.

UNIDENTIFIED REPORTER: Can you give information about the expected length that the other two patients will remain in surgery?

MADAIN: I can't comment on that, either. I'm not sure.

UNIDENTIFIED REPORTER: Were the majority of people here for gunshot wounds or other reasons?

MADAIN: They were all here for gunshot wounds.


MADAIN: I believe so.

UNIDENTIFIED REPORTER: This is a level-2 trauma center. How often do you prepare for moments like this and when was the last time you had a dress rehearsal for something like we saw this morning?

MADAIN: We prepare for moments like this on a regular basis. The last time we were prepared for a mass casualty was last week. Yes, we are a level-2 trauma center.

UNIDENTIFIED REPORTER: What does that mean to prepare for a mass casualty? Walk us through the process.

MADAIN: We do essentially a mock mass casualty where we get all the services prepared, we get all the staff prepared, labs, doctors, nurses, techs, to prepare for situations like this. We will actually call patients overhead as if they are real patients. We go into a room and act as if there's a real patient there, like we're treating real live patients.

UNIDENTIFIED REPORTER: Do you feel that played a role in this morning?

MADAIN: Absolutely.

UNIDENTIFIED REPORTER: Talk a little about how you think the morning went. MADAIN: The morning went really well. Since it's practice makes

perfect with these types of mock trials, right, so we're preparing for the real thing. So during practice, we make sure that everybody is there, and we run through the motions, essentially, just like we would, like this morning.

UNIDENTIFIED REPORTER: The patient that has been here, can you describe how they are doing emotionally?

MADAIN: Specifically, I can't tell. I sure they're all pretty rattled going through something like this.

UNIDENTIFIED REPORTER: You said they're all students?

MADAIN: I believe so, yes, ma'am.

UNIDENTIFIED REPORTER: How do you train for this. What was it like going through the real thing today?

MADAIN: You can never really emotionally prepare for the real thing. I have to say that as emergency physicians, gunshot victims are not foreign to us, right, so we see this throughout all of our training. We're in there, we know what to do, we've done it before.

UNIDENTIFIED REPORTER: How emotionally rewarding was it to see parents connect with children for the first time, not knowing exactly what the status of their child was?

MADAIN: As a parent myself, I think it's always great to see parents come in and connect with their children. I think right now it's just a really emotional time. It's not a happy moment for anybody because everybody is grieving at the same time.

[13:40:12] UNIDENTIFIED REPORTER: Seeing the six patients be able to go home, it's nice?

MADAIN: Of course. Yes, absolutely. We always wish the best for our patients, right? So seeing them go home alive and well with their parents is very rewarding to see that. Regardless of the situation.

UNIDENTIFIED REPORTER: The patient you said is fair, when will he or she be discharged?

MADAIN: I don't know.

UNIDENTIFIED REPORTER: Is he or she expected to stay days or --

MADAIN: I would assume several days. But I don't know exactly.

UNIDENTIFIED REPORTER: How did it go today? I know you just went through this.


UNIDENTIFIED REPORTER: Is there anything that you guys learned? You're still going through it -- MADAIN: Sure.

UNIDENTIFIED REPORTER: -- but moving forward, did it go as planned?

MADAIN: We haven't had a moment yet to actually sit down and debrief and talk over it. It's all still pretty fresh. But that is definitely the plan. Any time something like this happens, we always sit down afterwards with E.R. staff, hospital leaders, and go over it to definitely due process improvement.

UNIDENTIFIED REPORTER: What time did patients arrive here?

MADAIN: I believe roughly around 8:30.

UNIDENTIFIED REPORTER: Can you spell your last name.

MADAIN: Sure, it's Madain, M-A-D-A-I-N.

UNIDENTIFIED REPORTER: Would you say you got the less critical patients from the shooting?

MADAIN: I don't believe so. I don't know exactly what kind of patients went to other hospitals. But I don't believe so.

UNIDENTIFIED REPORTER: Two other questions on this end. Is there an official title or official name for the procedure when you guys go into this active shooting scenario that you have here?

MADAIN: It's a mass casualty.

UNIDENTIFIED REPORTER: There's no code red or anything?

MADAIN: I have to defer. I don't know if we've -- we call it overhead. It's a mass casualty overhead, right? Yes.

UNIDENTIFIED REPORTER: You say mass casualty?


UNIDENTIFIED REPORTER: What process did you go through to ensure that the six people could be discharged? What are the things you checked and when were those folks discharged? What time roughly did they begin leaving?

MADAIN: Every trauma patient gets a head-to-toe exam. Depending on what their injuries are, we try to focus in on that with x-rays, CT scans, and so forth. I can't exactly tell you what time they began being discharged though.

UNIDENTIFIED REPORTER: You've had a lot of students and parents and everyone from all over the --



UNIDENTIFIED REPORTER: So talk a little bit about, it sounds a little bit like a reunification point for a bunch of these people.

MADAIN: So we did provide them an area for all these students and parents to come together. We provide counselors. And we do have clergy here to help with the grieving process. So we definitely make space for them and tried to accommodate them as much as we could and provide them with everything we could provide.

UNIDENTIFIED MALE: Thank you very much.

Could anyone else address that with another institution --

BLITZER: That was Dr. Safi Madain, the emergency room medical director at the Clear Lake Medical Center, in Webster, Texas, right near the Santa Fe High School, Santa Fe, Texas, area. Ten people were murdered. Ten people were shot. Nine of them students. One teacher.

The gunman is in custody and another person has been detained as well for questioning. There were explosive devices planted at the school, outside the school. And police are warning to be on the lookout for these kinds of explosive devices.

We also have some stunning new audio from local police as they went into the school. You can hear some of the shots. Listen to this.


UNIDENTIFIED LAW ENFORCEMENT OFFICER: Thirty-one, we're making entry.

DISPATCHER: Where are you making the entry at?

UNIDENTIFIED LAW ENFORCEMENT OFFICER: Through the front by -- front of the school.



DISPATCHER: More shots fired. Additional shots fired.

UNIDENTIFIED LAW ENFORCEMENT OFFICER: They'll have several more shots.


UNIDENTIFIED LAW ENFORCEMENT OFFICER: He's active shooting. He's in the art room. We've got shots right now, guys. We need you all up here.

UNIDENTIFIED LAW ENFORCEMENT OFFICER: The subject is in custody. At least one subject is in custody.


BLITZER: Those are just some of the shots that clearly were fired.

Josh Campbell is joining us. He's our CNN law enforcement analyst, former FBI supervisory agent.

When you hear that kind of audio, the scanning audio from local police, as they go into the school, they hear shots fired, Josh, what goes through your mind?

JOSH CAMPBELL, CNN LAW ENFORCEMENT ANALYST: Obviously, the adrenaline is pumping, the stress hormones are coursing through one's veins as they get ready to make entry. Their main goal is protection of life. As we talk about way, too often, unfortunately, this notion that the law enforcement's standard procedures have shifted away from holding a scene and preparing to make entry once you have all assets in place to go into some of that gunfire. We heard that dramatic audio where officers are going into a chaotic situation. And oftentimes, as we've seen here, when they hear gunfire, they're going to report that back. For all the officers that hear that, it raises the anxiety, the stress, and it's an "all hands on deck" situation when you know you have live fire and people's lives are in danger.

[13:45:35] BLITZER: In this case, you heard him say the shooter is in the art room, so, somehow, the shooter got into that school, the art room, and presumably had explosive devices at the same time. What does that say to you?

CAMPBELL: Yes. So many unanswered questions. Obviously, one of the first questions they'll have is, how did this person gain entry? Was he supposed to be there? Did he have a lawful presence in the location? Or was he someone who came in off the street? Maybe he had some kind of grievance. Obviously, a lot of unanswered questions that are there. It shows this level of depravity when you add in reports of these improvised explosive devices. It's interesting that we don't see these detonating, so it's really tough to put yourself in the mindset of one of these types of mass killers, someone who goes in there with the intent on causing harm. But so many questions as you see the level of planning and sophistication with having devices, yet not employing those. Again, there are a lot of unanswered questions investigators will have to look at here.

BLITZER: Local police on the scene, they're describing these explosive devices that were found at the school off campus and may still be at large as pipe bombs and pressure cookers. They could be very deadly, right?

CAMPBELL: Absolutely. And you know, it makes it that much more difficult for investigators whenever they're going through a scene. Obviously whenever they arrive at a large location like a school, they're going to have to go through in order to determine, are all threats mitigated, are all victims cared for? But it makes it more difficult for first responders around the scene for another layer of danger when there could potentially be devices that are there.

What's interesting, when something like this happens, we were listening to the hospital give their update, when word goes out to dispatch that there's an active shooter situation, word goes out to hospitals and other first responders. I was texting with a helicopter paramedic in the Houston area who told me, once this happened, they will actually fly in and stage a situation that's serious enough where they have to move to a trauma center. Even with all these assets staged around the location, if word comes there are potential IEDs, and that would inhibit making entry and being able to move closer to the scene, it adds another layer of danger that these brave responders have to go through.

BLITZER: The whole notion of this tragedy, this massacre going on right now, when you say, "all hands on deck," not just local, county, state police, but federal law enforcement involved. They'll be involved weather the FBI, ATF, isn't that right?

CAMPBELL: That's right. It's all hands on deck. Law enforcement officers will surge to the scene. This is a location that's an hour there outside of Houston. I actually grew up just a little less than an hour from Santa Fe, and it's one of these typical Texas towns that -- I can't count the number of times I traveled there on Highway 6 between Sugarland and Galveston. It's one of these typical towns that never expect anything like this to happen.

Unlike a large metropolitan area like Houston or Orlando or areas where you have these tactical teams that are already kind of located and strategically placed. When you're out in a more remote area, whoever is closest to the sound of gunfire, they're going to surge that location. It doesn't matter if you're FBI, ATF, state, local, federal, they'll move on the scene. And contrary to what we see in the movies, where people are trying to debate who is in charge, they don't care who is in charge. They're going to show up, work together, fuse together in that unified command in order to save lives.

BLITZER: Josh, I want you and all our listeners and viewers to listen to what this one student said when they were told what to do by their teacher as the shooting unfolded. Listen to this.


PRESLEY LUMMIS, STUDENT: It's like instinct. You're scared, you're running as fast as you can.

UNIDENTIFIED REPORTER: When did it become clear that a shooting had happened?

LUMMIS: It became clear when all the cops were pulling up because you're thinking, this is not a fire drill. This was obviously something very serious. There was a lot of cops. That's when it all clicked. It was like, oh, my gosh, something traumatic has just happened. I never thought this would happen in our school. School is in a place that you feel safe in and you think, that's never going to happen to me. It's kind of scary now that it has happened and to think about it.

[13:50:07] UNIDENTIFIED MALE: He said he heard shots next door, and they all got up and then the door opened up, and there was more shots and they ran. That's it. There's broken glass.

UNIDENTIFIED REPORTER: So a group of students came to your house?

UNIDENTIFIED MALE: Yes, ma'am. There's five of them. Yes, ma'am. Reporter1: How are they doing right now?

UNIDENTIFIED MALE: They're doing all right. Their parents were there. Their parents came and got them. They were stirred up. Happy to be away. They were out the breath by the time they got to my house.

Reporter1: As a parent, you see them coming to your house like that, what was going through your mind?

UNIDENTIFIED MALE: I just woke up. And I couldn't believe it. I'm just glad that they're here and they're OK.


BLITZER: Terrible situation.

Shimon, you reported just a little while ago investigators now are looking at a trailer not far from the school where they describe what they're calling IEDs, improvised explosive devices, are believed to have been assembled.

PROKUPECZ: Yes, and that's a key piece of information. It's going to help investigators as they try to figure when this planning went into place. This would have obviously required some planning. You have the assembly of pressure cookers, pipe bombs. They would have had to buy the supplies to make all of that. All of that is now part of the investigation. That will be key hopefully in figuring out when this all started and will, hopefully, help law enforcement figure out what the motive is there.

This trailer we're told that ATF and the FBI are all now searching is the place where law enforcement believes these devices were put together. It's where they were built. And that is a huge lead here for law enforcement.

BLITZER: Josh, Josh Campbell, if FBI agents, ATF, local law enforcement, they want to go into this trailer and inspect it and see if there are IEDs inside. This is potentially a dangerous situation and they could inadvertently trigger some of these devices.

CAMPBELL: That's absolutely right. It's not something that you rush into. Law enforcement, they're trained in that, large, local, metropolitan police officers, that all they do is focus on how to interdict, disrupt explosive devices. When you're entering where there could be danger inside, they're going to go at it very methodically. We've seen in the past where they can actually conduct x-rays to see what are they dealing with here.

When they go in, the question is, how do you preserve evidence in order to determine what was this person thinking, what was this person using? We have a lot of unanswered questions now, but if somebody is going to be places devices in one location, could he or she have placed devices in other locations. What are the ingredients, what is the person using, what other evidence might be there? In some instances, you'll have letters left behind, for example, where

someone is going to dictate what they did and what was going through their mind. If the person had a laptop computer, some kind of social media, some kind of medium that will allow investigators to get into the mindset of this person and determine what it is they were doing.

And just as important as that is, it's going to be very important for investigators to try to determine were there any pre-incident warning indicators that maybe others would have picked up on and didn't report that to law enforcement, really get a full picture of who this person is. It's not just on other people, witnesses to provide information, law enforcement officers will go through their own holdings and determine is this someone known to us, someone made aware perhaps on a tip. This will be a very lengthy, in-depth investigation to answer all of those questions.

BLITZER: It one thing, Josh, for a shooter, unfortunately, to go into a school here in the United States, and we've seen it way too many times. It's another thing for the shooter also to have these explosive devices, right?

CAMPBELL: That's right. This takes it to a whole different level. You think about having access to firearms, we've been debating that for a long time in this country, getting hands on firearms and weapons, this is the next step. This is someone who is taking his own initiative to actually put together a device, gather the ingredients necessary to build device that's going to kill people. Again, that's a whole new level of criminality, a whole new level of depravity. Again, at least in the minds of law enforcement officers, try to determine what was going through his mind as he set out today to take lives.

[13:54:38] BLITZER: Stand by, Josh.

Shimon, stand by as well.

We'll hear shortly from the Texas governor, Greg Abbott. He will give us an update of what's happened at the Santa Fe High School, outside of Houston.

Much more of our breaking news coverage right after this.


ANNOUNCER: This is CNN breaking news.

[13:59:02] ERICA HILL, CNN ANCHOR: I'm Erica Hill, in today for Brooke Baldwin.

We are staying on this breaking news out of Texas. A deadly school shooting at a Texas high school. We can confirm 10 people are dead, nine of them students, one a teacher. Police say a 17-year-old student is in custody, another student is detained.

All of this unfolding this morning at Santa Fe High School, which is southeast of Houston. Investigators say explosives were found at the school and also off campus. Leaving that county on high alert. The school district is on lockdown. At this hour, investigators are searching a trailer where they believe those devices were assembled.

Here's more from student and parents. Listen to them as they described the terrifying moment of chaos that broke out this morning just after classes began.


UNIDENTIFIED WITNESS: We heard the alarms. Everybody just started leaving, following the same procedure as we did because nobody thought it would be this. Nobody thought it was a shooting. Everybody just thought it was a normal procedure or practice fire drill. And next thing you know, we just hear so many -- three gunshots, a lot of explosions, and teachers were telling us to run, run, go, run. Me and my friend, Ryan Calvert, ran to the floor so we could get shelter. That's when I called my mom.

UNIDENTIFIED WITNESS: And everybody was panicking, everybody was crying.