Surgeons, chaplains and social workers swing into action to help crash victims

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Jennifer Ruiz, 26, attends a vigil in Los Angeles for her mother, Rosa “Rosalba” Ruiz, who was one of 13 people killed in the tour bus crash in Desert Hot Springs.

(Gary Coronado / Los Angeles Times)

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Felipa Martinez leaves her condolences while attending a Los Angeles vigil for the victims of the tour bus crash in Desert Hot Springs.

(Gary Coronado / Los Angeles Times)

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Friends and neighbors attend a vigil for the victims of the tour bus crash at the corner of Olympic Boulevard and Vermont Avenue in Koreatown, where the bus was supposed to return.

(Gary Coronado / Los Angeles Times)

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Rita Roden, left and fiance Darryal Molett, wait to board a QH Express bus headed for Pala Casinoas a vigil for the crash victims is held nearby.

(Gary Coronado / Los Angeles Times)

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Jennifer Ruiz, 26, attends a vigil for her mother, Rosa “Rosalba” Ruiz, a victim of the crash.

(Gary Coronado / Los Angeles Times)

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Jennifer Ruiz, 26, hugs a supporter at a vigil for her mother, Rosa “Rosalba” Ruiz, and the other victims of the bus crash.

(Gary Coronado / Los Angeles Times)

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California Highway Patrol and National Transportation Safety Board officials at a news conference Monday about the crash investigation.

(Gina Ferazzi / Los Angeles Times)

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California Highway Patrol Border Division Chief Jim Abele, right, and Earl Weener of the National Transportation Safety Board speak at a news conference Monday.

(Gina Ferazzi / Los Angeles Times)

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Jose Ramirez, who said he had planned to go to the casino on the USA Holiday tour bus but changed his mind, visits a memorial for the crash victims.

(Al Seib / Los Angeles Times)

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Rosa Cabello crosses her heart as she says a blessing at a memorial for the crash victims.

(Al Seib / Los Angeles Times)

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Gabriel Urano, who drives an 18-passenger van to the casinos, places a St. Christopher medal on a memorial for the victims of the tour bus crash.

(Al Seib / Los Angeles Times)

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Authorities said 13 people were killed and 31 injured Sunday morning when a tour bus crashed into the back of a big rig near Palm Springs. (Gina Ferazzi / Los Angeles Times)

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The bus struck the rear of a tractor trailer in Desert Hot Springs.

(Gina Ferazzi / Los Angeles Times)

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The front of the bus was crumpled and the first few rows of seats were completely crushed, a witness said.

(Gina Ferazzi / Los Angeles Times)

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Broken bus seats and other debris is removed from the scene. (Gina Ferazzi / Los Angeles Times)

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A tow truck driver drags a broken bus seat away.

(Gina Ferazzi / Los Angeles Times)

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Shortly after the wreck, which occurred just after 5 a.m., firefighters used ladders to climb into the bus to search for bodies and survivors.

(Gina Ferazzi / Los Angeles Times)

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A CHP officer packs purses and backpacks into brown paper bags.

(Gina Ferazzi / Los Angeles Times)

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Bodies of victims are removed from the scene.

(Gina Ferazzi / Los Angeles Times)

By Anh Do

Oct. 23, 2016 8:55 PM PT

Reporting from PALM SPRINGS —

The victims from Sunday’s deadly bus crash streamed into the Desert Regional Medical Center trauma’s unit around the early-morning shift change.

Because of the scope of the tragedy, the hospital summoned chaplains and additional social service workers, extended overtime and made sure there was enough blood to treat the wounded.

Bilingual nurses and lab techs helped doctors communicate with many of the injured Spanish-speaking passengers. Other hospital workers provided transportation and meals for the patients’ family members.

“Everyone was involved today — from X-ray to lab to housekeeping,” said Dr. Ricard Townsend, a trauma surgeon.

Those who were easily removed from the twisted wreckage were the first to arrive. Judging from the injuries, Townsend said, it appeared the passengers were not wearing seat belts. He said the language barrier and lack of identification for some passengers complicated matters, especially when patients were transferred to other units within the hospital.

“In almost 35 years, I’ve never been to a crash where there’s been 13 confirmed fatals,” said California Highway Patrol Border Division Chief Jim Abele. “It’s tough … you never get used to this.” (Gina Ferazzi / Los Angeles Times)

Shortly after the accident 14 patients — ranging in ages from 20 to 70 — arrived at the hospital. Many had facial injuries, involving soft tissue and bone, and some had to undergo plastic surgery.

By Sunday evening, four patients remained in critical condition while one patient listed in serious condition arrived as a transfer from another hospital, according to Richard Ramhoff, spokesman for Desert Regional Medical Center.

Another person had been transferred to a Los Angeles hospital for ongoing treatment; overall, nine patients were treated and released from Desert Regional, Ramhoff said.

Townsend said he had never seen an accident quite like this one. But he was proud of the way the hospital responded.

“We respond to crisis with teamwork,” he said.

Anh.Do@latimes.com

Twitter: @newsterrier

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UPDATES:

8:55 p.m.: This article was updated with the status of the injured patients.

This article was originally published at 7:25 p.m.