LANDSTUHL, Germany -- In partnership with several German emergency response organizations, Landstuhl Regional Medical Center conducted Exercise Maroon Response 19, Jun. 15, to test patient decontamination operations, recall and accountability procedures, information reporting and distribution, and the readiness of the medical force."We're always training," said Maj. Garrett Stotz, chief of LRMC's operations and readiness division. "This exercise was a great way for us to test not only what we would do in a mass casualty event for patient care, but also ensuring that behind the scenes we are coordinated and synchronized with logistics, supply, medical and support capabilities."To create a stressful environment, Stotz and his team developed a scenario that generated over a dozen exercise casualties who required evacuation and medical attention as a result of a mock train derailment in Kindsbach, Germany, roughly eight kilometers away from the hospital. Stotz also added notional liquid chlorine exposure which would test hazardous material rapid response teams and the LRMC decontamination protocols, emergency room operations and patient movement during a mass casualty event.When the exercised commenced, Stotz initiated a telephonic alert of all military and civilian personnel assigned to LRMC through the Army AtHoc system that sends alerts to all users. A 100 percent accountability was issued requiring all supervisors to obtain confirmation that their subordinates and their families were safe."We had a really great response rate from our personnel," said Lt. Col. Stephanie Sido, commander of LRMC's Troop Command that provides administrative and readiness oversight of all Army Soldiers at LRMC. "The members of the decontamination team who were alerted reacted within 30 minutes."As the recall was underway, so too were the Landstuhl fire department, Kaiserslautern HAZMAT Rapid Response Team and German Red Cross who received notification of the incident and proceeded to activate their emergency response systems. Over 100 German emergency responders made their way to the notional crash site and immediately began patient triage and decontamination."Our partnership with the German medical and first responders is critical," said Stotz. "Not only do we rely on the German Red Cross to provide ambulance services for patient transport to LRMC, but we also depend heavily on their expertise in emergency situations like the one we created for Maroon Response 19."In total, 14 volunteers with notional injuries were treated both at the contamination site as well as after transport to LRMC. While at the hospital, patients went through further decontamination procedures before moving to the emergency room or intensive care unit."This exercise was great for my team," said 2nd Lt. Samuel Wingerter, the officer in charge of the decontamination unit for the event. "We're all still relatively new to the decontamination process so being able to test our knowledge of the procedures and training for situations like this is great."Wingerter, a registered nurse in the LRMC medical surgical unit, said his decontamination team is comprised of other nurses, medics and techs who each complete training outside of their normal positions to join the response unit. In addition to learning about a variety of chemicals and their effect on the human body, Wingerter and his team are also responsible for maintaining their own personal protective equipment to ensure they do not contaminate themselves or others."At a contamination site, our role is not to administer medical care," said Wingerter. "We check to see if the patient requires immediate medical treatment like managing blood or if someone is having difficulty breathing, but overall, we are there to clean and irrigate contaminated areas of the skin before releasing for transport back to the hospital."As the medical portion of the exercise carried out, the LRMC emergency operations center was activated, requiring the recall of key and essential personnel to the hospital. The hospital commander, Col. Michael A. Weber, hospital deputy commanders, and leaders from the logistics, patient administration, security, intense care unit, and facilities departments among others were gathered in the EOC to conduct all of the necessary actions required to ensure successful provisions of safe, quality healthcare to those injured patients."When the EOC is activated and we're working with a mass casualty event like that in the exercise, every part of the hospital has to be synchronized, not just with each other but with our external partners like the garrison emergency team and host nation agencies," said Gustavo Beltra, LRMC's emergency operations officer. "When the key leaders are in the EOC, there's a battle captain who runs the show and provides updates to the whole group when needed. It's a very detailed process and we have policies and regulations that outline how, why and when we operate."According to Stotz, Maroon Response 19 went very well, allowing for full simulation training of the joint German and American emergency medical response."We were able to identify some gaps in our processes and we also learned what worked very well," said Stotz. "Overall, this exercise will definitely help us to improve upon our ability as a hospital to maintain a ready medical force."