Disasters can overwhelm medical facilities, but few doctors and nurses have experienced them.
That's why Hawaii Marines and the doctors and staff at Adventist Health – Castle Medical Center worked together Tuesday to prepare for the worst: A terror attack.
The exercise centered around a mock terror attack at Marine Corp Base Hawaii.
It was dubbed "Lethal Breeze" and the action began early Tuesday on base.
Local, state and federal agencies all took part in the drill, which imagined the consequences of a drone attack with explosions and numerous casualties.
After the fake attack, more than 31 patients were taken by ambulance and other vehicles, flooding the ER at Castle.
"This is a blast injury. We saw plenty of broken bones, impaled individuals, respiratory issues, head injuries," said Dr. William Scruggs,chairman of Castle's Emergency Room Department.
Outside the ER, a decontamination tent stood at the ready while upstairs in a large conference room the command center oversaw the entire operation.
"We work really hard all year long to be ready for these types of events, but this large scale exercise really allows us to pull it all together," said Richard Kirchner, facilities director at the hospital.
FEMA trained several members of the hospital staff in how to set up the command center. And one of their goals Tuesday was to standardize communication methods — something that was a major problem encountered by first responders during the attacks of 9/11.
"We responded very well. We trained for this. We're ready for this and they did very well today," said Scruggs.
Added Kirchner, "I think it really builds confidence. When they execute the procedures. You know we receive the training, they practice the procedures, and now we put it all together."
The mass casualty drill was just one of several the medical center conducts each year.
In May, it simulated the treatment of victims of a hurricane and last summer the emergency simulation featured so-called casualties from the RimPac military exercises.