Last Monday, a who’s who of emergency agencies combined forces to stage and rehearse a Mass Casualty Incident within Joshua Tree National Park. Volunteer victims were needed to make the day a success.
Excited about the day’s events, I was the first “victim” to arrive at Joshua Tree National Park Headquarters, to participate in the staging of a Mass Casualty Incident (MCI) – a large-scale rehearsal involving nine emergency agencies and 30 volunteer “victims.” Hosted by the National Park Service (NPS), the agencies included the San Bernardino County Sheriff’s Department, CHP, fire departments from the state, Marine Corps, and San Bernardino and Riverside County, the Desert Care Network, Morongo Basin Ambulance and Mercy Air.
“You don’t need these pants, right?” asked Sara Morning, a EMS nurse/educator for SB County Fire, as she easily shredded the bottom half of my ancient khakis. Using powders, gels, latex and a gooey jar of fake blood, Sara created the worst day my right shin has ever imagined, looking like an alien exploded out of my flesh. The crafted leg wound was so believable that when I got up to walk away, I limped.
Soon, other “victims” arrive, including Matt Shragge, general manager of the Twentynine Palms Water District. Minutes later, Shragge is just a guy with an oozing head wound. Twentynine Palms City Manager Stone James is told he will be ‘losing’ two fingers that day. With the two fingers taped back, his hand ultimately looked like he’d lost a fight with a garbage disposal.
Third District Supervisor Dawn Rowe also faced a very un-typical Monday morning by accepting some nasty bruising and an ugly wound on her right ankle. Then came the students from Twentynine Palms High School, all enrolled in an emergency medical responder course and all looking forward to their own grisly makeovers.
Each victim was then given a wrist band that included key vitals – respirations per minute, pulse rate, perfusion status, location of wound, and ability (or lack of) to walk and communicate. Also, each victim was given a color-coded status to determine urgency level; green (minor injuries, can walk/communicate), yellow (unable to move due to injuries), red (needs immediate care) and black, meaning deceased.
Hanging in the hallway with other mangled victims, I chatted with Troy Pennington, Medical Director for the San Bernardino County Fire Department, who was excited about deploying a new patient-tracking phone app during the drill.
“With a digital tool, if you have an internet connection, you can take a photograph of the victim, you know, for reunification later at the hospital. So we put a wrist band on them, we scan that wrist band, that creates the patient chart. and then we can take photographs of injuries, we can put in vital signs, we can even do more sophisticated things if we had more time, like EKGs, and stuff like that.
Warning: Simulated Graphic Injuries
And then when that patient moves from the triage area collection point to an ambulance, when the ambulance comes up, they scan that wristband, it immediately takes all the information and puts it onto their phone so we know that the patient has moved to the ambulance and then when they get to the hospital, they get scanned. So, it’s almost like moving a package with UPS. So you can track them each step of the way. Basically, a chain of movement. It completely changes everything for those of us at the hospital and those at Incident Command.”
The detailed planning of something on this scale is mind-boggling. And while agencies often hold MCI trainings annually or quarterly, in recent years they have been more focused on “escalated threat” – perhaps a shooter incident. This MCI marked a return to a mass transportation accident, the planning of which began six months prior.
Nearly 24 years ago, one of the largest real-life MCIs occurred on September 11 when nearly 3,000 people died in terrorist attacks in New York, DC and Pennsylvania. Emergency responders are still learning lessons from that horrible day, namely, the frustrating and deadly challenge of different departments and agencies unable to communicate with one another because they use separate radio systems on different parts of the spectrum.
Eric Sherwin, Engineer/Public Information Officer, San Bernardino County Fire District, addressed this challenge.
“There are some challenges that these agencies will get a chance to successfully negotiate today, communications being one of the biggest ones, where we have some agencies on an 800MHz system, some are using VHF, some are using different VHF with different repeaters. Does your repeater provide service in this area where we are conducting the drill? Lack of cell service. Is there technology out there today that we might be aware of that are available to them and they may not know they are available, specifically Starlink,” said Sherwin.
We’re gonna be working an area of the park today that was specifically chosen due to the lack of cell coverage. We have become quite dependent on technology but as soon as we remove that cell service that supports that technology, can they successfully negotiate or work without that tech? Or can they find, perhaps, there might be Starlink available that can bring their technology back online,” said Sherwin.
All the bloody types were asked to board two school buses and we rode to a remote area of the park not open to the public. Upon arrival, we saw a staggering number of emergency vehicles and uniformed personnel – clearly, a massive operation.
Thankfully, three adorable emotional support pups were also on hand to provide a necessary dose of fuzzy cuteness. Ember, Bailey and Cooper were joyfully unfazed by all the smiling zombies angling for pets.
Morning and her make-up assistants came around and juiced up our wounds with extra blood. A woman with a clipboard welcomed all the victims, expressed gratitude, and prompted us on our roles as bus accident victims. (The actual staged scenario was a bus colliding with two vehicles.) Various personnel advised victims to act out the pain and “really play it up.” Wailing, whining, whimpering, and even screaming, were all encouraged.
Most importantly, if our tag said we could not walk, we had to stick to that story. One firefighter prompted Rowe in this exact scenario, advising her to be as helpless as possible, as this would help with the training.
We then re-boarded the buses and were told to take crash positions. I was tagged on my wrist band as “Unresponsive/Unable to Communicate” – an unnatural state for this chatty reporter. The triage team came around and tied a color tag on the other wrist to pre-designate my status. I got a red stretch tie so I could be identified as an Immediate. They put a black velcro tourniquet just above my horrific wound. Meanwhile, Rowe laid on the floor of the bus and gamely played along, “I can’t walk,” she told responders.
I was moved to a stretcher and, as a rescue helicopter hovered overhead, I was laid out on a red tarp. Triage tags with bar codes were placed around the necks of all patients – just like a mail package, as Pennington described.
I was soon joined by a believably-bloody duo of James and Shragge, whose fake wound was now warmed by the sun and dripping down both sides of his face. We all laid there, taking dramatic turns at suffering, and playing our roles for the first responders who are playing theirs. They had questions (“How old are you, ma’am?”) and it was hard not to speak. James truly looked like he was having a Very Bad Day; Shragge is down, bleeding and moaning, while Rowe is being carried to a yellow tarp so her wounds can be assessed. I hear students screaming for their lives, committing to the story.
Finally, my hero arrived in the form of Flight Officer/Paramedic Darrin Darling. He came with a stretcher and I was whisked away to a CHP rescue helicopter piloted by the very welcoming Todd Perreira, the department’s newest pilot. (The CHP uses Eurocopter AS350 Écureuil helicopters.)
The stretcher was put in place and Darling ‘worked’ on my wound. He placed headphones/microphone on my head to keep us connected. “If you are not feeling well or get motion sickness, you let me know,” he said. (Of course, it was the opposite – I was so thrilled to be on the copter!)
Taking in a bird’s eye view of our beautiful national park felt like the biggest treat. But there was a moment I felt a rush of cold panic in my gut. ‘What if this was real? What if I was injured so badly that I needed to be airlifted to the hospital?’ My stomach clenched with a sense of fear, gratitude and relief all at once. Where would we be without these emergency responders caring so much? Bleeding out in the sand, apparently.
Normally, rescue helicopters take patients to the Hi Desert Medical Center in Joshua Tree or Desert Regional Medical Center in Palm Springs but neither wanted to play pretend on this particular day so I was taken back to my car at the JTNP offices off Utah Trail where we were greeted by more first responders to play out the scenario.
Lured by the promise of a free lunch, I jumped into my car and headed back to the staged accident where first responders turned into cooks and fed all us bleeding souls with hamburgers and hot dogs. All uniformed personnel then gathered for a debriefing, with each unit commander offering their take on how the day unfolded. As expected, there were some challenges with radio communications. An important realization from the day – that SB County does things one way and Riverside does them another – good intel to have should there be an incident in JTNP as it borders both counties.
Briefly, I chatted with JTNP Superintendent Jane Rogers, who said the event was a detailed marvel that took many phone calls, emails and meetings to plan but she was grateful for the attention to preparation, especially heading into the busy spring season.
It’s not hard to imagine such an event. In 2016, a tour bus crash on I-10 in Palm Springs killed 13 people. Just three years prior, on Super Bowl Sunday, another bus crash killed seven people on State Route 38 near Yucaipa. The nations’ national parks see multiple bus crashes annually, and in California alone, there are about 2,700 school bus-related accidents each year.
Though my day of pretend pain and helicopter rides was exhilarating – not to mention the devilish fun of exposing my ‘wound’ to a horrified and unprepared Z107.7 staff – it was hard not to grasp the enormity of what I’d experienced. True accidents are unplanned, traumatic and terrifying and the collective power of all those agencies coming to our rescue was remarkable to witness. Some jobs require a certain kind of person and I’m so grateful these people are out there.
In the words of my smiling rescue pilot, “Can you believe we get to do this for a living?”
