Amid a cacophony of wailing sirens and the anguished cries of the wounded, John Davis, Jr. stands in a white decontamination tent in the hospital parking lot, trying to cut away the clothing from a man who was injured in a “terrorist attack” and may have been exposed to Sarin gas. It’s not an easy task. His plastic personal protective suit hood limits his vision and the rubber gloves make something as simple as using a pair of scissors difficult.

Davis, a Fairhope resident, is one of more than 100 Alabama responders who participated in training the week of Feb. 7 at the Center for Domestic Preparedness (CDP). The responders include physicians, nurses, public health officials and emergency medical services specialists who came to the CDP to learn through hands-on training about mass casualty and disaster response.

“It’s a little overwhelming, but I think that’s par for the course,” said Davis, a member of the Emergency Preparedness Team and a senior environmentalist with the Alabama Department of Public Health.

During the week, the students took one of three courses that were specific to their professions. The students spent the first four days of training in their disparate courses, Healthcare Leadership for Mass Casualty Incidents (HCL), Hospital Emergency Response Training for Mass Casualty Incidents (HERT) or Emergency Medical Operations for CBRNE Incidents (EMO).

“I hoped to get more knowledge on how to handle a disaster, if it were to happen in our community,” said Donna Muckerson, an Infection Prevention Team Leader/Registered Nurse at Southeast Alabama Medical Center in Dothan, Ala. “Being an Infectious Control Nurse, you never know what’s going to happen. A disaster doesn’t have to be a plane crash. It could be a smallpox outbreak; measles is a big concern right now, especially since cases have been reported in Atlanta.” Muckerson took the four-day HCL course in which she learned more about the dynamics involved in the decision-making process during an all-hazards disaster involving mass casualties.

The individual courses ran through Thursday. Then, on Friday, the responders put all of their training to the test during a mass casualty exercise, known as the Integrated Capstone Event (ICE).

The ICE is a hands-on mass casualty exercise. This particular exercise began with a terrorist group setting off bombs laced with Sarin gas in a subway. The EMTs first encountered the survivors on a dark, smoke-filled street scattered with debris. The students triaged, treated and transported the survivors to the hospital. In the exercise, the survivors are portrayed by role players, as well as human patient simulators (sophisticated robotic mannequins) and regular mannequins.

The students didn’t have to improvise when it came to the training venues. In fact, the CDP has the only hospital in the nation that is dedicated solely to training. More than 20,000 healthcare professionals have trained at that facility since the hospital was added to the CDP campus in 2007.

At the hospital, other students either treated survivors in the Emergency Department or managed communications, logistics and operations in the hospital’s emergency operation’s center.

“This training will definitely help me relate more to situations like hospitals being overwhelmed with patients following a disaster,” Davis said.

Martha “Marti” Smith, a registered nurse who took the HCL course, found the opportunity to train with other healthcare professionals to be a perk. “It’s been great to talk with other Alabama responders, as well as responders from other states,” said Smith, who serves as the Infection Prevention Employee Health Manager at the Cullman (Ala.) Regional Medical Center. “And, of course, we’ve been able to network and talk about what [response capabilities] we have.”

By the end of the exercise, the students were exhausted from physical exertion and the adrenaline spike that had long since faded. They had lost a few patients. Luckily, they were able to save a lot more. But, the real success will be measured at a later date in cities and towns across Alabama where – if and when disaster strikes – they will use the skills they learned this week to save real lives.

“In the past, maybe we’ve relied a lot on Federal intervention,” said Lori McGrath, a nurse practitioner at the Cullman (Ala.) Regional Medical Center. McGrath also serves as a member of a Disaster Medical Assistance Team (DMAT), a group of healthcare professionals who deploy to provide medical care during disasters. “This [training] has greatly empowered the local level to be able to respond and take care of ourselves, at least for the first day or two. It may take 24 hours for a DMAT team to respond. In those 24 hours, a lot of damage can happen… or a lot of good can happen, if the community is prepared.”