FORT CAVAZOS, Texas — Fort Cavazos officials conducted a full-scale exercise May 6 on the installation, practicing a response to a train derailment at the railhead behind Carl R. Darnall Army Medical Center.
“This is part of our multiyear training exercise plan as a contingency to make sure that we’re ready and prepared in case of any kind of incident or unexpected event,” said Juan Nava, chief of plans and operations, Directorate of Plans, Training, Mobilization and Security. “Many unexpected events have happened on this installation before, so we’re just maintaining our readiness to be able to respond and react.”
The exercise posed multiple casualties, some of them at CRDAMC, where the hospital simulated a triage response with role players portraying victims being triaged and moved for treatment.
“Our initial concern is making sure that we are receiving and treating casualties,” said Col. Joseph Yancey, chief medical officer, CRDAMC, and hospital incident commander for the exercise. “Our emergency room has a whole drill about how we set up and triage those casualties when we have more than we can handle, line in a normal fashion. So that starts without us doing any coordination first because they’ve already drilled that, and they drill that all the time.”
Sharon Moton, a registered nurse, Women’s Health Center, CRDAMC, took the initial assessment of the victim role players, presenting them to the physician and watching their conditions in case of decompensation.
She stressed the importance of maintaining readiness.
“We have to be ready at all times because emergencies do come in,” Moton said. “We have had previous emergencies here on the base with two previous shootings, and we also have had incidents where we have stood up the EOC (emergency operation center). However, the casualties (that did come in) … we were able to care for them.”
“What we do is then we make sure that we are set up to make sure those casualties are received here,” Yancey explained. “Where do they go from there? Are we able to keep them here? Do we need support from civilian partners in the community? What other resources do we need? And for that matter, an incident like what happened notionally today, we have to be concerned about the safety of the building itself. So there’s a lot of things that we talk about and drill through about how we would handle our own internal movement or internal evacuation, potentially, of patients.”
Much communication and coordination goes on within the hospital itself, between administration, hospital command, pharmacy, nurses, physicians and others to assist victims and ensure treatment, Moton said.
Yancey noted outside coordination is just as vital, saying linking emergency managers with III Armored Corps, other units and community partners assists in numerous ways, such as informing the public of altered hospital operations and patient transportation.
“If this (train derailment) had really happened and we were in a real-world (situation), we would have shut down a variety of our elective operations,” Yancey said. “But we need help to be able to get that word out. And so we rely on our partners to help us with that, as well, among several other things.”
Coordination also took place between on- and off-post agencies, including CRDAMC, DPTMS, Directorate of Emergency Services, area hospitals, Killeen Independent School District and BNSF Railway.
“The (coordinating organizations) all need to be able to bring in their information together so they can create one common operating picture for the commander so (he or she) can make a decision,” Nava explained. “We want to make sure (the commander is) provided relevant and timely information so that we can minimize damage, mitigate the hazard and recover and go back to normal operations.”
“It can’t be done any other way,” said Patrick Brady, general director of hazardous materiel safety, BNSF Railway, about the open communication in the EOC. “When you find incidents that don’t go very well, it’s all about communication and coordination. If you don’t have somebody within the EOC that’s helping communicate and coordinate, that’s when mistakes are made and things go south.”
In a scenario like a train derailment, not only would local partners be necessary for notification, but regional and national partners, as well, including the Department of Transportation, National Transportation Safety Board and Environmental Protection Agency, Brady said.
This is not Brady’s first full-scale exercise with Fort Cavazos, having participated in one involving a chlorine-related incident scenario approximately 15 years ago.
“Since that period of time, there has been a lot of training, both in the public and with agencies on incident command and how you do proper incident management,” he said. “It has changed a lot from six people sitting in a conference room with a whiteboard trying to figure it out. Now we have tools in place. More people are involved, so it has improved substantially and is a better process now.”
Communication and coordination with all partners is critical, said Greta Buccellato,
deputy to the U.S. Army Garrison-Fort Cavazos commander.
“Major League Baseball teams and National Football League teams, they don’t play their big games without practicing, right?” she said. “So while we hope to never play these games, it’s important that we’re ready. In order to be ready, we have to practice and to practice without your key partners, you miss something in the big games. It’s very hard to form impactful relationships on the day of the big game. You need to do it before then.
“The value of these types of exercises,” she continued, “is not only establishing the relationships and furthering the relationships over time, but gaining a comfort level that your teammates are going to be there when you need them and that they’re going to come through for you.”
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