JOINT BASE SAN ANTONIO, Texas -- "Alright, we've got patients coming out. Everybody be ready." The word went out as medics from Brooke Army Medical Center joined with medics from the 59th Medical Wing and the 959th Medical Group on the tarmac at Kelly Field on March 20. They, along with personnel from the Southwest Texas Regional Advisory Council, were participating in the National Disaster Medical System's response exercise.

"With any joint civil-military operation, there's going to be differing forms of command and control, communications, technology platforms, even airframes," said Army Col. Peter Mack, administration chief for BAMC. "We hope to bring everyone together as part of a community, and to learn from each other, and to keep practicing these exercises over and over again so that, in the event of a natural disaster, we all come together and function effectively as a unified team."

The exercise is designed to increase interoperability and cooperation among military and civilian medical assets and response teams when dealing with a mass casualty. Tornadoes, hurricanes, and fires are just a few examples of events that could trigger a mass casualty event necessitating the activation of the NDMS. One of the major areas of concentration for the training was in ensuring patients were properly accounted for throughout the emergency.

"(Exercises like this help) us establish the process on the front end to build those systems, and manage those in a no-notice event here locally," said Scott Hitchman, Director of Emergency Preparedness and Resources for STRAC, which covers 22 counties across Southwest Texas. "Or, if an event like this (speaking of the scenario events) actually happened where we're taking in federal patients from somewhere else in the country, to be able to relay back to Health and Human Services, as well as NDMS, where those patients actually wound up in San Antonio.

The military personnel in the Patient Administration Division, in cooperation with the STRAC personnel, took patients in to determine which location around San Antonio they would need to be transported to for further treatment. More than 30 hospitals and more than 70 EMS providers are part of the STRAC. The members of the PAD team take into account the patients' injuries or ailments that they listed when they got onto the transport and their condition when they arrive to the staging area.

After a slower-paced initial run through, the whole team, including personnel moving patients on and off of the military aircraft, the PAD team and other members of the military and civilian response, took the exercise at full speed. In addition to the local teams on hand for the exercise, a team from Keesler Air Force Base in Mississippi, observed the training.

"We've seen how well the STRAC and the military work together here, so we're going to try to incorporate that with all the local assets when we go back," said Air Force Master Sgt. Lisa Johnson, Federal Coordinating Center chief at Keesler. "That way, we can incorporate it all into a system instead of having a wide range of systems that don't communicate with each other."

At the end of the day, teams conducted individual after-action briefs, or "hot washes," in addition to a more extended after-action meeting at a later date. The leadership team members said they were pleased with how the military and civilian units came together and worked toward their common goals.

"I think it went well," said Mack. "We're going to identify gaps and shortfalls and we'll do this again next year. We're going to make it better and continue to improve."