A mass casualty drill dubbed Operation Gray Dawn held Nov. 14, 2023, helped to identify issues and provide a timely trial – under fire – on dealing with a significant influx of wounded personnel.

As is the case for most emergency situations, insisted Terry Lerma, NHB emergency preparedness manager, such a scenario as this usually happens completely unexpected, unannounced and unforeseen.

Which is how some staff who found themselves abruptly thrust into action.

“I knew nothing about this drill,” exclaimed one nurse assigned to the Urgent Care Clinic.

“In emergency management preparedness, actual accidents and tragic incidents rarely announce themselves beforehand,” stated Lerma, noting that with the first part of the training done and the shooter neutralized, the second part was designed to test staff capability during the ofttimes chaotic crisis of dealing with a number of casualties.

NHB staff members focused on the multiple casualties in need of immediate medical assistance.

“Super impressed by everyone taking this drill seriously and making good decisions. There’s no battle plan that survives first contact with the enemy. Same scenario in an event like this,” said Dr. Elizabeth Gray, NHB Urgent Care Clinic physician, noting that Internal Medicine staff showed up in force and provide to be tremendous assets during the drill.

“They were a great force multiplier from the manpower pool to help with triage needs,” said Gray, who encouraged all participants that if they saw techniques and processes which were beneficial to annotate and pass on for future reference.

“There is always a lot of functionality which physicians and nurses don’t see but corpsman do. We need to share what worked well in treating the casualties,” added Gray. “The same goes for what didn’t work well.”



According to Lerma, the exercise provided valuable learning experience for hospital staff in coordinating, communicating and caring for the host of casualties.

All at once.

“We didn’t engage this as a full scale exercise. It was more a functional one which we used this as a learning process,” Lerma said.

There were 15 mock casualties suffering from gunshot wounds to fractured and shattered bones, along with one simulated fatality.

“I was charged with helping to maintain airwaves and assist with intubation on injured patients in the UCC,” said Hospital Corpsman 2nd Class Travis Mitchell, assigned to NHB Internal Medicine department.

When there is a mass casualty incident - defined as an emergency situation where NHB has to handle a surge of incoming patients more than the Urgent Care Clinic can timely respond – it’s an all-hands on deck obligation to provide support.

There are pre-designated assignments for the majority of staff such as manning the triage casualty receiving unit, handle staff tracking and help support in data gathering assistance.

Past mass casualty efforts have focused on dealing with a natural disaster like an earthquake to a human factor situation like a multiple vehicle rollover accident.

“As always, when an actual emergency happens, it won’t be at our convenience. It will be when we least expect it. We have to ready. Planning and training to prepare for that actual emergency will give us the experience needed to be able to handle whatever needs to be done,” said Lerma.