More than 140 Pennsylvanians representing emergency managers, physicians, nurses, public health officials, and emergency medical services attended training at the Center for Domestic Preparedness (CDP) recently. The attendees received extensive training specific to their professions, including healthcare leadership and decision making, emergency medical response to a mass casualty incident, and how emergency medical services respond to emergency incidents in the field.

Healthcare emergency response personnel throughout the state of Pennsylvania joined together in this training effort, many meeting for the first time. Staff from these healthcare systems spent five days training at the CDP, focusing on one of three separate courses that culminated in a single training experience called the Integrated Capstone Event (ICE).

"We really got to know each other and talk about our capabilities and needs," said Michael Whalen, regional emergency preparedness coordinator for the Hospital Association of Pennsylvania. "Because we had different agencies from EMS, hospital staffs, public health, and medical examiners, we learned each other's needs and capabilities-that's very important to real-world incidents."

The ICE is a unique training approach in which students from the various courses work together in a single end-of-course exercise. ICE events may include students from up to ten different disciplines ranging from law enforcement to healthcare. The students interact, communicate, and respond to a full-impact mass casualty incident. Students from the three healthcare courses Healthcare Leadership (HCL), Hospital Emergency Response Training (HERT) for Mass Casualty Incidents, and Emergency Medical Operations (EMO) all participated in the ICE.

Original plans for their training started in July 2012 and focused on all of the students taking one course. As discussions continued, the CDP training coordinators and planners in Pennsylvania, came up with the idea of creating a statewide event including the ICE.

"We've conducted ICE training since [March 2012]," said Chuck Medley, assistant director for training delivery. "This was the first statewide ICE and the largest group from one region to attend training. Emergency healthcare workers in Pennsylvania worked hard to make this happen, and I believe it is very worthwhile for their state or other states. Training together, face-to-face, with this volume of people, has a huge impact on state preparedness and the CDP is the national leader for this training."

During the first four days of instruction, the Pennsylvanians trained in their individual courses. Day Five brought the courses together during a disaster response. The students from the separate courses assumed assigned roles and supported the response based on the previous days? training. The ICE scenario involved a small domestic terrorist organization carrying out multiple attacks on a fictitious city, resulting in more than 300 injured people needing triage and treatment. A combination of role players and state-of-the-art human patient simulators were used to add realism for the ICE.

"This has been an unbelievable opportunity," said Russ Bieniek, emergency physician for UPMC Hamot hospital in Erie, Penn. "We're meeting people we will be working with if something happens. It is so much better to know capabilities prior to a disaster."

Most of the ICE took place near and at the Noble Training Facility (NTF), the nation's only hospital facility dedicated solely to preparing the healthcare, public health, and environmental health communities for mass casualty events. More than 17,000 healthcare professionals have trained at NTF since the hospital was added into the CDP training in early 2007.

"Every state should take advantage of this training," said Schmider. "Every emergency services provider needs to get here and spend a week. You don't want to practice this in the middle of a [real-world] event."

"We had the opportunity to simulate a disaster and have just as much adrenalin flowing," said Bieniek. "A very unique training opportunity and we didn't have to shut down a hospital, work around patients, and other people?s schedules to do it. Fabulous opportunity!"

"This is absolutely the best training experience I have experienced in my life; it's top notch," said Whalen. "Everything is real-world and everyone is engaged. There is just no better place to go for training."

ICE training integrates courses and simulates a multi-disciplined response. Each scenario focuses on the foundations of CDP training incident management, mass casualty response, and emergency response to a catastrophic natural disaster or terrorist act. CDP training for state, local, and tribal responders is fully funded by the Federal Emergency Management Agency (FEMA), a component of the U.S. Department of Homeland Security. Round-trip air and ground transportation, lodging, and meals are provided at no cost to responders or their agency or jurisdiction.