HONOLULU -- As part of the U.S. Navy's Rim of the Pacific exercise, or RIMPAC, Tripler Army Medical Center participated in a joint-service mass casualty exercise, Operation Chianti, here, July 20.

The disaster scenario involved a 9.5 magnitude earthquake that hit Chile generating a 25-foot tsunami, which devastated the island of Chianti leaving significant damage and numerous fatalities and casualties.

TAMC staff immediately activated the mass casualty emergency operations plan while awaiting the first surge of patients to arrive by air and ground. Tripler and U.S. Army Health Clinic-Schofield Barracks treated 62 casualties during this Humanitarian Assistance/Disaster Relief MASCAL exercise.

The challenges this year were unique in that for the first time, as 23 civilian hospitals participated in MASCAL alongside Tripler.

Thomas Bookman, Emergency Manager and Medical Planning officer, Pacific Regional Medical Command, worked very closely over the last two years with Toby Clairmont, director, Emergency Services for the Healthcare Association of Hawaii (HAH), and Lt. Cmdr. Patricia Serrano, deputy fleet surgeon, U.S. Third Fleet, to coordinate the exercise.

As mock patients were evaluated at Tripler, many other elements of the exercise were in motion.

The Hawaii Disaster Medical Assistance Team established a 50-bed Acute Care Module, or ACM, for 48 hours. Co-located on Ford Island with U.S. Navy elements and Tripler Deployable Rapid Assembly Shelter, the DRASH was used for casualty moulage, which is a process of applying mock injuries by means of rubber or latex molds. Approximately 130 casualties were moulaged and transported to the various medical facilities in the state.

"With the help of 18th (Medical Command), we had the DRASH operational in an hour and 10 minutes," Bookman said. "It went seamlessly."

For the first time, Tripler deployed their Special MEDCOM Response Team, or SMRC, Stress Management Team (SMRC-SM) & Pastoral Care Team (SMRC-PC). Tripler also utilized three ambulance buses and U.S. Army Garrison-Hawaii deployed two Handi-vans for transportation from Ford Island to HAH coalition hospitals.

In addition, two new systems were tested during the exercise: Hawaii Patient Assessment & Tracking System, or HPATS. In the event of a mass casualty event, the ability for both operations and the receiving hospitals to view the number of patients, and their corresponding acuity levels inbound prior to their arrival is an invaluable coordination and planning tool. HPATS can assist with the allocation and re-allocation of resources and support. With supervision from Christopher Crabtree, Program Development Coordinator, HAH Emergency Services, 22 healthcare facilities were trained in the basic use of HPATS and provided access to the system prior to the start of the RIMPAC exercise.

Hermes & Glimpse equipment, which was used in search and rescue operations.

"We staged casualties at two sites … Ms. Shay Walden, Urban Search and Rescue Element Leader, then released her live find dog as well as the recovery dogs. The dogs located and personnel completed victim markings on five victims in approximately seven minutes. Location of all live and deceased victims were mapped and marked with coordinates, passing information along to Army National Guard Urban Search & Rescue so that stabilizing & rescue could begin." Bookman explained. "(The equipment) provided a live feed back to Navy (participants) could see it. The Army National Guard Urban Search & Rescue Team under the direction of Captain Aaron Blanchard rescued casualties from ruble piles."

"It was a big success," he added.

Brig. Gen. Keith Gallagher, commander, PRMC and TAMC, was the Incident Commander for the exercise and oversaw the activities from the PRMC/TAMC Hospital Command Center, or HCC, which provides command and control for internal and external disasters.

"These exercises enable us to work on procedures and scenarios that we don't (deal with) every day," Gallagher said. "When this kind of event really happens, the fact that we are up on the hilltop means that we have a responsibility to the community and we will take that responsibility seriously and do, I think, extremely well."

This year celebrates the 23rd RIMPAC exercise since 1971. Twenty-two nations, 40 surface ships, 6 submarines, more than 200 aircraft and 25,000 personnel are participating.