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Large Mass Casualty Exercise Tests Southeast’s Preparedness

October 12, 2018

More than 100 patients flooded the halls of Philadelphia area hospitals on Thursday after an explosive device detonated at a large Philadelphia area sports stadium. While the explosion was a simulation, the test that more than 35 agencies—including 18 hospitals and providers—faced was real.

Crozer-Chester Medical Center staff take their postions in the emergency department during a mass casualty exercise in Delaware County on October 11, 2018

Thursday’s simulation was the culmination of months of planning by dozens of local, state, and regional agencies and health care providers.


“It is critical that health care and emergency response partners work side by side in planning for and responding to major events.”


“In today’s environment, it is critical that health care and emergency response partners work side by side in planning for and responding to major events of all kinds. Regardless if it is a natural or man-made disaster, these organizations are called upon to mitigate the effects of the event and care for the ill and injured, potentially to a level beyond their normal capacity,” said HAP’s regional manager, emergency preparedness, Brian Barth.

Students and other volunteers from Widener University as well as the Delaware County Medical Reserve Corp arrived at Talon Energy Stadium early Thursday morning and were provided with makeup and props prior to the planned blast. At ground-zero, nursing students triaged the patients and assisted first responders arrange transport to local hospitals. The annual exercise provides a great learning opportunity for the nursing students to hone their skills in a mass casualty scenario.

An unexpected twist occurred when a second mass casualty simulation occurred sending another 60 patients to local hospitals in another area of the region.

Crozer-Chester Medical Center not only received patients during the simulation, but also served as the regional command center for the event. Tucked away down a nondescript hallway, an ordinary conference room was turned into fully functional command post. At times, dozens of employees and volunteers manned phones and radios receiving patient updates, resource availability, and staffing levels in an effort to make sure that patients and resources were directed to the appropriate hospitals.

SEPA SMART members tend to victims of a simulated mass casualty exercise in Delaware County on October 11, 2018

Out front, a common lobby area was turned into a mobile hospital. Members from the Southeastern Pennsylvania Surge Medical Assistance Response Team (SEPA SMART) deployed beds and other medical equipment to handle the excess of patients arriving to the hospital. SEPA SMART is a response organization made up of more than 400 volunteers (medical professionals, emergency responders, IT and telecommunications specialists, tradesmen of all types, among others) that may be called upon in the aftermath of disasters to provide support to the local healthcare system. A joint effort between the Pennsylvania Department of Health, the Pennsylvania Southeast Regional Task Force, and the The Hospital and Healthsystem Association of Pennsylvania, SEPA SMART is capable of providing support from medical equipment and staff to full mobile hospital unit support up to the ICU level of care. The team activates at the request of a county emergency management office within the region and responds to support operations.


Throughout the area, hospital emergency departments activated mass casualty protocols as patients started to arrive. Patients were moved, staffing levels were adjusted, and resources were reallocated as hospital leaders hurried to account for the influx of traumatic injuries.

Personnel from dozens of participating organizations gather to discuss the simulated mass casualty exercise in Delaware County on October 11, 2018

As the simulation came to a close, an equally important gathering occurred in the lobby of Crozer-Chester Medical Center. Key participants from local, state, and regional agencies joined emergency service providers, hospital clinicians, hospital administration, and volunteers to discuss the event. Praises were shared for the many things that went right during the simulation. The group was also able to identify items that can be improved to make the response better and get the highest quality care to the patients that need it most.

Barth also noted, “The purpose of training and exercises such as this is to refine current processes and find ways to improve response. While areas for improvement were certainly identified, several participants noted that takeaways learned in previous exercises helped them to respond at a higher level in this event. Planning, training, and exercising in the region and beyond has, and will continue to, lead to improved response and better care. That’s the goal of an exercise program—to work together, learn together, and ultimately respond together in the best way possible.”

The main exercise planners for the event included Crozer-Chester Medical Center, Main Line Health, Crozer EMS, Delaware County Department of Emergency Services, Widener University, and The Hospital and Healthsystem Association of Pennsylvania.

Exercise participants included:

Pennsylvania Department of Health, Bureau of Public Health Preparedness
Pennsylvania Department of Health, Bureau of EMS
The Hospital and Healthsystem Association of Pennsylvania
Southeastern Regional Healthcare Coalition
Southeastern Regional Healthcare Coalition – Healthcare Incident Support Team (H-IST)
Southeastern Pennsylvania Surge Medical Assistance Response Team (SEPA SMART)
Eastern Regional Burn Disaster Consortium (CT, DC, ME, MD, MA, NJ, NY, PA, RI, VT)
South Jersey MCC
Delaware County Department of Emergency Services
Delaware County Medical Reserve Corps (MRC)
Chester County Department of Emergency Services
Chester County Medical Reserve Corps (MRC)
Montgomery County Department of Emergency Services
Montgomery County Medical Reserve Corps (MRC)
Philadelphia County Office of Emergency Management
Bucks County Emergency Management
Health Care Organizations
Crozer Chester Medical Center
Delaware County Memorial Hospital
Taylor Hospital
Springfield Hospital
Riddle Hospital
Paoli Hospital
Lankenau Hospital
Bryn Mawr Hospital
St. Christopher’s Hospital for Children
Penn Medicine – Home Health
Doylestown Hospital
St. Mary Medical Center
Holy Redeemer Hospital
Mercy Fitzgerald Hospital
Mercy Philadelphia Hospital
Thomas Jefferson University Hospital
Grand View Hospital
Pottstown Hospital

In a cooperative agreement with the Pennsylvania Department of Health, HAP’s Emergency Preparedness program provides support to health care organizations across the state in developing and improving their level of preparedness. From participation in regional healthcare coalition activities, cross-agency coordination, planning and training activities and exercises, to support during and after emergencies, the HAP Emergency Preparedness team works with organizations to improve readiness and response. For additional information, contact Mark Ross, HAP’s vice president, emergency preparedness.

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