INDIANAPOLIS — The fight for the life of a child wounded by gunfire in Indianapolis often begins with a radio call to the charge nurse at the front desk of the Riley Hospital for Children Emergency Department.

“Gunshot wound to the abdomen,” crackles the voice of an EMT out on the streets of the city.

With that warning, a team of up to 30 doctors, nurses, specialists and support personnel rush to the ED and assume their posts in anticipation of a grievously injured child with a physiology that presents its own complications for treatment.

”The injuries we tend to see tend to be very similar as to where they are located as adults, so as a result, the epidemiology of where these injuries occur within the physical body of a patient is similar,” said Dr. Matthew Landman, Riley trauma medical director. “The damage can be very significant, as you know, there’s a very small patient, and if you have a high-velocity bullet, that can cause a lot of damage.”

”It is an unbelievably complex system that is needed to take care of a 12-year-old that is shot,” said Dr. Cory Showalter, interim division chief of Riley Pediatric Emergency Medicine. ”Children are not just miniature versions of adults. Everything’s different proportionately. It’s not just half the dose or a third of the dose.”

From the temperature of the shock room to the size of tubes for intubation, every piece of equipment and each procedure must be scaled to address the unique challenges of treating children who have been shot.

”We’re trained to take care of these kids,” said Dr. Showalter. “We wish there weren’t so many to take care of certainly.”

More than a dozen pediatric firearms injury patients have been wheeled into the Riley E-D thus far this year.

In the last month alone, two children from Indianapolis have died of accidental self-inflicted gunshot wounds and a teenager from Edinburgh succumbed from his firearms injury.

A 15-year-old was shot on the east side of Indianapolis Tuesday.

Since the start of 2018, Riley has treated 220 juvenile gunshot victims.

As the state’s only Trauma One Emergency Department, Riley accepts pediatric gunshot patients from across Indiana.

”The whole goal is to get that patient to the operating room as fast as possible,” said Dr. Landman. ”The dance of the trauma resuscitation, it really is a dance, everyone kind of knows their steps, everyone has their role, we have everyone do that role, they don’t do anyone else’s job, and that allows us to get to the operating room quite expeditiously.

”Trauma really is a team activity. There may be one or two people leading that resuscitation, but it takes an incredible amount of people to get a patient from this point to that point and also support their family and support the people around them as the patient comes in.”

Riley invited FOX59 News into its Emergency Department to provide an unprecedented look at the simulated response of its team to the treatment of a child gunshot patient.

“We’re not making anything up,” said Dr. Showalter. “This is trained, worked on, drilled through simulations like this.”

To the untrained eye, the response may seem chaotic with doctors directing the staff and nurses and support personnel coordinating their responses in a flurry of activity and noise.

”Everybody knows their roles because already precious minutes have been lost before arrival,” said Dr. Showalter. ”We like to get these patients to the OR, to the CT scan in under 30 minutes.”

Often parents of the patient are present in the shock room with a chaplain or social worker nearby to explain the treatment their child is receiving.

”Our goal is to involve parents as much as possible in seeing a resuscitation, being present for their child, even right here in the room as things are happening,” said Dr. Landman. ”Not only obviously is that patient’s life changed forever but that family will carry with them something that is indescribable in its sadness and its permanence. That just doesn’t go away.”

After the patient is wheeled into the operating room, the Riley team does a self-assessment to determine not only how each member performed but also to share their emotional responses.

Dr. Showalter still recalls one of his first teenage gunshot patients from more than a decade ago.

”This was just a pristinely healthy 15-, 16-year-old kid, had his whole future in front of him and despite fifty people doing all they could with all their training….no one could help this child, it was too late, and it was just a waste, just a terrible waste, this completely healthy person was shot and dead despite all these people trying to help. That will never leave me.”

After the treatment, the Riley doctors then engaged in conversations with the family either regarding their child’s recovery or a decision to volunteer their youngster as an organ donor or to consider gun safety in the home.

”Certainly when I’m having that conversation with a patient’s family, it’s too late, something’s already occurred,” said Dr. Landman. “I think a lot of families, and I’ve seen it over the years, didn’t even think about safe storage until that moment happened.”

May is Trauma Awareness month and the Riley team advises that if anyone in Indianapolis wants to help reduce the damage done by gunfire to children, they should donate blood.

And be patient when visiting the Emergency Department.

”What you might see is a long wait for the room if you go to the ER with an ear infection,” said Dr. Showalter. “You never know what’s going on behind the scenes and sometimes it’s because we’re all in this room trying to save somebody’s life.”