Complete coverage  THE VICTIMS Portraits of the R.I. fire victims  RELATED GRAPHICS Fire and smoke’s effects on the body Inside The Station Pyrotechnics safety Deadliest nightclub fires Identifying victims Site of the fire Possible defendants in lawsuits Foam and fire PTSD: Reliving the experience Town documents  MESSAGE BOARD What measures should be taken in Boston to ensure the safety of its nightspots? Read messages  PHOTO GALLERY Images from the nightclub fire  FROM THE GLOBE ARCHIVES The 1942 Cocoanut Grove fire Coverage from the 50-year anniversary The Cocoanut Grove inferno Night of hell recalled Hands of destiny Doctors discuss horror, heroics Editorial: The Cocoanut Grove Photos: The Cocoanut Grove fire Also: Chicago nightclub stampede kills 21 (2/18/2003)  RELATED LINKS Great White Web sites www.mistabone.com Guitarist Ty Longley's Web site Photos of the band at The Station in West Warwick, April 2000 State and town agencies: Town of West Warwick West Warwick Fire Department R.I. state fire marshal Rhode Island Hospital

By Richard C. Lewis, Associated Press, 02/21/03

PROVIDENCE, R.I. -- At 12:01 a.m., Rhode Island Hospital issued its equivalent of an emergency distress call.

It was a "blast" page, and it went to hundreds of doctors and nurses. Some were only a half-hour removed from working a typically grueling shift in the hospital's trauma unit.

The news was sketchy: Some dead, hundreds injured from a fire at a nightclub in West Warwick. Many were on the way to Rhode Island Hospital, the state's largest hospital and only full-service trauma center.

Despite the patchwork information, some 200 doctors and nurses, and hundreds of support staff, rushed to the hospital. Others simply came to work once they'd heard the news, just to see how they could help.

"It's human nature of people wanting to help other people," said Joseph Amaral, a surgeon who is president and chief executive officer of Rhode Island Hospital.

The scene was similar at Kent County Hospital, the nearest hospital to the fire, and other health care facilities in Rhode Island.

Doctors, nurses, triage specialists, pharmacists, social service workers, cleaning personnel -- all heeded the call, without hesitation or fuss, to respond to one of the most catastrophic events in this state and one of the deadliest club fires ever in the United States.

At Rhode Island Hospital, the trauma unit went into immediate formation: emergency personnel handled arriving patients; doctors performed triage on patients, stabilizing the most injured; administrators supervised where patients should be moved; staff kept in contact with the outside world.

"It was like watching a race car with a pit crew where everyone knows what they're doing," Amaral said.

Kent County treated 60 people, said Michael Dacey Jr., director of the intensive care unit. At least 17 doctors were called in, along with scores of nurses, pharmacists and respiratory specialists.

When administrators were told the first patients would be coming in 15 minutes, the emergency room was already full. Physicians performed a second round of triage at the hospital while they waited for beds to open in the emergency room.

The injured came in unrelenting waves. They were burned mostly on their faces and hands, Dacey said, from shielding themselves against the "wall of fire."

Hospital staff separated the most injured patients. Teams of doctors and nurses went from bed to bed caring for the wounded, offering ointment and painkillers. Dacey said he gave out more morphine in three to four hours than in the past six months.

Triage specialists dumped saline solution down the throats of some victims to clear their lungs. The room reeked of smoke. Dacey, to his horror, realized he might run out of ventilators, and ordered nine more from an outside vendor.

"This was the worst thing I've ever seen," the former military mass casualty specialist said.

The cafeteria was turned into a waiting room for nervous families. Nurses shuttled between the cafeteria and the emergency room, trying to match victims with families. By early afternoon, the hospitals had shared lists of victims and compiled a master list.

Robert Baute, hospital president, delivered the news: "At one point, I read off the list of names," he said. "It was apparent there were more families" than victims.

Administrators credited firefighters and emergency rescuers for the orderly treatment. They said rescuers successfully identified the most injured at the scene and rushed them to the hospitals.

At Rhode Island Hospital, Amaral admitted that neither he nor anyone else had experienced such a great number of casualties.

The hospital was prepared, he said, because it had dealt with severe trauma -- from automobile accidents to 18 workers and rescuers treated at the hospital from a chemical plant explosion in Cranston two weeks ago.

"The best disaster plan is the one you use every day," Amaral said.

Doctors said the next two to three days would be the most critical, as patients battled infections from the burns, pneumonia from the smoke, and kidney failure.

Despite their best efforts, the odds of survival are against some victims.

"A lot of the severely burned patients will die in the days and weeks to come," Dacey said.