It's not every day that 25 ambulances stream into San Francisco General Hospital back-to-back. But that's what happened July 6 after the crash-landing of Asiana Airlines Flight 214 at San Francisco International Airport.
Of the more than 300 passengers and flight crew onboard, 181 were injured -- 12 critically -- and three killed.
As the one-year anniversary of the crash approaches, the hospital that treated 67 of the victims within six hours of the incident is reflecting on what became an emotional and life-altering day for doctors, nurses and other staff.
Terry Dentoni, chief nursing officer at General Hospital, was at the gym that Saturday morning when the South Korean airliner clipped a seawall while landing just before 11:30 a.m.
Dentoni's pager buzzed and she hopped into her car to head to the hospital, assuming the incident would be minimal.
"As I was driving to the hospital, I could see all the fire engines going toward the airport and I thought this was going to be big," Dentoni said. "And it was."
General Hospital is no stranger to trauma cases. The only full-service, or Level 1, trauma center in San Francisco, the hospital sees about 65,000 emergency room visits per year and receives 30 percent of The City's ambulances.
The morning of the plane crash, doctors and nurses had already treated a self-inflicted gunshot wound to the mouth, cardiac arrest and a stab wound to the abdomen, said Dr. Malini Singh, medical director of the emergency room.
But the plane crash united hospital workers in a whole new way.
The cafeteria, for instance, became a hub for family members of victims and hospital staff. The U.S. Department of Homeland Security even stationed workers there, since the plane crash victims had not been through customs, said Dr. Peggy Knudson, interim chief of surgery at General Hospital.
"This was an international disaster -- very different than what we were used to," Knudson said. "There were different cultures and customs that we had to be respectful of."
While hospital officials say they responded flawlessly after the crash, staffers anticipate that General Hospital's new hospital and trauma center -- set to open in December 2015 -- will be able to see even more patients when disaster strikes again.
"We use every sort of traumatic event that happens, whether it be a gunshot wound or Asiana or anything, to see what could we have done better and what could we improve upon," Dentoni said.
New hospital features will include double the number of beds in the ER, from 27 to 58; six trauma rooms, up from four; an additional isolation exam room; and two more pediatric exam rooms.
Construction of the new hospital -- expected to cost $887.4 million -- also has not affected hospital operations since workers broke ground in 2009.