Dr. Chris Kaufmann, on duty Wednesday morning when injured students in the Pennsylvania high school stabbing were rushed into his trauma unit, said he struck by the size of the knife wounds.
"The stab wounds were large in my experience," Kaufmann, director of the trauma center at Forbes Regional Hospital, said at a news conference. "These were all impressively large holes in each of the patients I saw."
At least 20 people were injured Wednesday after a 16-year-old boy wielding two knives went on a rampage at Franklin Regional Senior High School in Murrysville, Pa.
Here is the latest update from the two hospitals that are treating the wounded.
Forbes Regional Hospital, Monroeville
Eight of the most seriously injured were taken to Forbes, a hospital just a few miles away in Monroeville. Some of the injured had such serious wounds that the patients could have bled to death if taken to a hospital any farther away, Kaufmann said.
Two patients arrived with dangerously low blood pressure and were taken directly into the operating room. A third underwent surgery later. Some of the wounds were more than an inch wide.
Of those who underwent surgery, two were in critical condition but stabilized Wednesday afternoon, said Dr. Mark Rubino, the chief medical officer at Forbes said.
Most of the knife wounds were to the lower abdomen, Rubino said.
"They seemed to almost have a pattern," Rubino said. "Most of them were to the right lower abdomen and right flank," which he said contributed to the critical nature of the wounds and caused injuries to internal organs.
Rubino, an obstetrics and gynecology doctor, said it was difficult to set emotions aside when seeing the young patients and their parents arrive.
"A number of these patients, their moms are our patients … and these are kids that we very likely delivered," he said. "One thing about being a doctor that lives in the community that you serve … these are your friends and neighbors, in addition to your patients."
Asked about the severity of the wounds, Rubino said young people tend to be resilient.
"Someone who's younger and strong can often tolerate these injuries better than someone else," he said.
University of Pittsburgh Medical Center
Twelve people were treated at four University of Pittsburgh Medical Center hospitals, said Wendy Zellner, a UPMC spokeswoman. Nine patients, including one adult, have been discharged, she said.
Two students remain in fair condition at Children's Hospital of UPMC, Zellner said.
The most seriously injured at UPMC Presbyterian Hospital is a 17-year-old boy with a single 1.5-inch stab wound that reached through to his spine, Zellner said. He was speaking when he arrived at the hospital and has undergone surgery to stop the bleeding, she said. He will undergo more surgeries in the days ahead.
The knife missed the boy's heart and aorta "by millimeters," said Dr. Louis Alarcon, director of trauma surgery at UPMC Presbyterian. He was on breathing machines and sedated, Alarcon said at a news conference. Doctors are concerned about additional blood clotting and bleeding, but "we are very optimistic that he is going to make it," Alarcon said.