JOINT BASE SAN ANTONIO, Texas -- Brooke Army Medical Center held a no-notice mass casualty exercise May 31 to test the staff's ability to respond and care for multiple casualties.

"During exercises, we practice what we would really do," said Steve Burton, BAMC emergency management specialist. "With this one, we wanted to take it a step further. We gave the staff a one-week window, the actual date and time was very close-hold, only a few people knew when it would take place."

The exercise was a collaborative effort between BAMC and Schertz emergency medical services, fire and police departments, which took about five months to plan.

The scenario mirrored real-life events that have taken place in cities across the world. A large crowd gathered for a festival at Pickrell Park in Schertz when a vehicle plowed into the crowd sending 25-30 casualties to BAMC. Inclement weather and a traffic accident on IH-35 added real-world elements to the planned scenario.

"The rain and a traffic accident gave us the ability to really see how long it would take our staff to get here once they were notified," Burton said. "All these things are valuable to see how effective we are to responding to a mass casualty event.

"A disaster doesn't knock on your door and say, 'is this a convenient time,'" he added.

Mike Shown, clinical manager for Schertz EMS, said this was an opportunity for the city of Schertz emergency personnel to train for a mass casualty emergency as well.

"We learned a lot," Shown said.

The emergency department set up two areas in preparation for the patients' arrival. Two nurses were ready to evaluate patients who were able to walk in on their own to the waiting room area.

"We are here to access them quickly to see if they have minor injuries," said Amanda Scallon, registered nurse. "If anyone needs to go back urgently we are going to send them to the emergent area."

As ambulances began to roll into the emergency department, teams were ready to move patients into the trauma bays as quickly as possible.

"This is the first time, that I know of, that we have had a no-notice recall like this," said Air Force Col. Mark Antonacci, Emergency Department chief. "I think it's gone well."

Several Schertz emergency medical personnel were on hand to observe how the patients were triaged and treated in the ED.

"BAMC is our primary trauma center, we work with them day-in and day-out," Shown said. "We need to work together or we can't get the job done."

To add to the excitement, the decontamination team was activated in response to another scenario involving a train carrying chemicals striking a 15-passenger van. "This type of accident really happened here in 2004," Burton said.

The DECON team was up and running within minutes. The 10 additional simulated casualties were sent through the decontamination process before being brought to the emergency department for additional treatment.

"This was definitely different from our usual training," said Air Force Staff Sgt. Matthew Coley, noncommissioned officer in charge of the DECON team. "We hit the ground running and it put more pep in our step."

"My team did absolutely phenomenal," Coley said. "I'm proud of every single one of them."

Burton said he hopes to continue doing the MASCAL exercises this way.

"Our goal is to make sure that we can respond as an organization as effectively and efficiently as we possibly can," he said. "So the more we practice, drill, and understand the operations plan, it helps us get the right people to the right place at the right time. All of those variables only mean one thing -- better patient care."