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News | Nov. 8, 2022

Code Green: Mass Casualty Exercise Tests WRNMMC’s Response Readiness

By Bernard Little, WRNMMC Command Communications

WRNMMC, Bethesda, MD  –   How would Walter Reed National Military Medical Center (WRNMMC), the flagship of military medicine, respond if a multi-vehicle accident resulting in numerous mass casualties occurred on the Capital Beltway near the facility?
WRNMMC’s Emergency Management and hospital staff tested the medical center’s readiness posture for such an event, or anything similar, during a mass casualty (MASCAL) exercise, also known as a Code Green exercise, Nov. 3.
The Code Green exercise is to test and evaluate its response procedures in accordance with Joint Commission Emergency Management standards. The recent WRNMMC’s MASCAL exercise simulated an accident involving an overturned tractor trailer catching fire causing multiple crashes and injuries on the I-495 Inner Loop. More than 150 people are hurt, and many of them brought to WRNMMC for care.
“The purpose of this exercise was to test and evaluate the hospital’s mass casualty plan activation procedures,” said Chris Gillette, command emergency manager at WRNMMC. “This included evaluating emergency notification, staff response, set up of mass casualty receiving stations and ensuring those areas were equipped with appropriate personnel, supplies and personal protective equipment (PPE).
“We also wanted to ensure leaders were clearly identified in each of our mass casualty stations, there was evidence of team huddles, ongoing communication, and teamwork throughout the exercise,” Gillette continued. Several joint incident planning objectives with the installation for receiving casualties and family members from off base were also evaluated during the Code Green, he furthered.
Gillette explained the Code Green exercise is the culmination of smaller drills WRNMMC conducts throughout the year as part of the medical center’s all-hazards continuous readiness program. “The annual large-scale Code Green exercise involves the receipt and movement of casualties throughout our hospital,” he said.
WRNMMC’s Simulation Center staff also participated in this exercise, conducting a training scenario using its high-fidelity manikin. “The training tested systems and processes for initial treatment and stabilization of a mass casualty/trauma patient,” Gillette explained. The life-like manikin reacts physiologically as if it is alive with human responses, and it can recreate realistic emergency medical situations to provide learners with an opportunity to practice and refine their clinical skills.
John Skelly, program manager for national disaster medical systems at WRNMMC, agreed that the Code Green exercise helps the medical center evaluates the coordination of its emergency department staff with the rest of the hospital, including patient triage, work of the trauma teams, and patient movement from one area to another in the facility.
Pris Joyner, a nurse specialist at WRNMMC who has worked in actual MASCALs, said that during mass casualty events when hazardous materials may be involved, it’s important for hospital staff to remember to “protect themselves, protect the hospital and protect patients.” She explained if hospital staff members don’t first protect themselves, they won’t be able to provide care to patients or protect the facility.
“We want to make sure our systems, as we have them planned out, will function the way we hope,” said Matt Sias, decontamination program manager at WRNMMC. He added that this is why WRNMMC conducts continuous emergency response training to its staff.
Gillette said approximately 400 WRNMMC team members participated in the exercise in some capacity, which included staff assigned to those areas in the hospital that transition to MASCAL receiving stations; pre-designated departments that send personnel to those MASCAL stations; volunteers who served as MASCAL victims; and exercise controllers and evaluators.
Patient care, the emergency department or other clinical areas in the hospital were not impacted by the full-scale exercise, and all other services operated as normal. "Safety is paramount during any exercise," Gillette stated.
“Exercises are always good because they give our leadership and staff the opportunity to practice our processes and identify areas we can improve upon,” Gillette said.
“In a crisis situation, all things don’t go as planned, so it’s important that we have procedures in place and conduct training throughout the year to ensure we are ready to respond while most importantly, ensuring the safety and security of our patients, visitors and staff,” he furthered.
The MASCAL exercise and other training are always important to serve as processes for improvement and evaluation to maintain the highest level of continuous readiness at WRNMMC, Gillette concluded.
News | Nov. 8, 2022

Code Green: Mass Casualty Exercise Tests WRNMMC’s Response Readiness

By Bernard Little, WRNMMC Command Communications

WRNMMC, Bethesda, MD  –   How would Walter Reed National Military Medical Center (WRNMMC), the flagship of military medicine, respond if a multi-vehicle accident resulting in numerous mass casualties occurred on the Capital Beltway near the facility?
WRNMMC’s Emergency Management and hospital staff tested the medical center’s readiness posture for such an event, or anything similar, during a mass casualty (MASCAL) exercise, also known as a Code Green exercise, Nov. 3.
The Code Green exercise is to test and evaluate its response procedures in accordance with Joint Commission Emergency Management standards. The recent WRNMMC’s MASCAL exercise simulated an accident involving an overturned tractor trailer catching fire causing multiple crashes and injuries on the I-495 Inner Loop. More than 150 people are hurt, and many of them brought to WRNMMC for care.
“The purpose of this exercise was to test and evaluate the hospital’s mass casualty plan activation procedures,” said Chris Gillette, command emergency manager at WRNMMC. “This included evaluating emergency notification, staff response, set up of mass casualty receiving stations and ensuring those areas were equipped with appropriate personnel, supplies and personal protective equipment (PPE).
“We also wanted to ensure leaders were clearly identified in each of our mass casualty stations, there was evidence of team huddles, ongoing communication, and teamwork throughout the exercise,” Gillette continued. Several joint incident planning objectives with the installation for receiving casualties and family members from off base were also evaluated during the Code Green, he furthered.
Gillette explained the Code Green exercise is the culmination of smaller drills WRNMMC conducts throughout the year as part of the medical center’s all-hazards continuous readiness program. “The annual large-scale Code Green exercise involves the receipt and movement of casualties throughout our hospital,” he said.
WRNMMC’s Simulation Center staff also participated in this exercise, conducting a training scenario using its high-fidelity manikin. “The training tested systems and processes for initial treatment and stabilization of a mass casualty/trauma patient,” Gillette explained. The life-like manikin reacts physiologically as if it is alive with human responses, and it can recreate realistic emergency medical situations to provide learners with an opportunity to practice and refine their clinical skills.
John Skelly, program manager for national disaster medical systems at WRNMMC, agreed that the Code Green exercise helps the medical center evaluates the coordination of its emergency department staff with the rest of the hospital, including patient triage, work of the trauma teams, and patient movement from one area to another in the facility.
Pris Joyner, a nurse specialist at WRNMMC who has worked in actual MASCALs, said that during mass casualty events when hazardous materials may be involved, it’s important for hospital staff to remember to “protect themselves, protect the hospital and protect patients.” She explained if hospital staff members don’t first protect themselves, they won’t be able to provide care to patients or protect the facility.
“We want to make sure our systems, as we have them planned out, will function the way we hope,” said Matt Sias, decontamination program manager at WRNMMC. He added that this is why WRNMMC conducts continuous emergency response training to its staff.
Gillette said approximately 400 WRNMMC team members participated in the exercise in some capacity, which included staff assigned to those areas in the hospital that transition to MASCAL receiving stations; pre-designated departments that send personnel to those MASCAL stations; volunteers who served as MASCAL victims; and exercise controllers and evaluators.
Patient care, the emergency department or other clinical areas in the hospital were not impacted by the full-scale exercise, and all other services operated as normal. "Safety is paramount during any exercise," Gillette stated.
“Exercises are always good because they give our leadership and staff the opportunity to practice our processes and identify areas we can improve upon,” Gillette said.
“In a crisis situation, all things don’t go as planned, so it’s important that we have procedures in place and conduct training throughout the year to ensure we are ready to respond while most importantly, ensuring the safety and security of our patients, visitors and staff,” he furthered.
The MASCAL exercise and other training are always important to serve as processes for improvement and evaluation to maintain the highest level of continuous readiness at WRNMMC, Gillette concluded.
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