At Dobbins Air Reserve Base (DARB) in Marietta on Saturday morning, Sept. 17, Emory nursing and public health students walked onto the airfield and into the cavernous body of a C-130 Hercules aircraft, where they were cheerfully strapped onto stretchers piled five-high. Moments after the two back flaps of the airplane were folded up behind them, they heard the call: “the exercise has begun.”

Georgia State Defense Force and Cobb Medical Reserve Corps personnel walked in formation onto the airplane, secured the stretchers, and briskly carried the volunteers, who were simulating patients with radiation injuries, into a bustling triage area established in a huge aircraft hangar nearby.

Emory and Atlanta VA Medical Center physicians and nurses performed simulated medical evaluations, and EMTs from Atlanta Fire and Rescue and Gwinnett County Fire and Emergency Services placed the most severely injured “patients” onto rolling stretchers, wheeled them into two mobile ambulance buses, and placed them on stretchers stacked in bunk-bed fashion. Cobb/Douglas Public Health personnel assisted the VA with command and control functions.

This mock scenario was part of a drill named “Operation Gateway,” which included more than 250 people representing over 15 health care and government agencies simulating the local response to a mock radiation incident with mass casualties. The drill began in reverse at Emory University Hospital the day before, as medical personnel and EMTs simulated unloading the injured patients from the mobile ambulance buses.

Sam Shartar, senior administrator of Emory’s Office of Critical Event Preparedness and Response (CEPAR), directed the full-scale exercise. “This exercise is important because we are able to test the processes required to receive large numbers of casualties. Improvised nuclear detonations are low probability, high consequence events. Having said this, these same processes will be utilized for response to hurricanes, floods or earthquakes, which are a higher probability event,” says Shartar.

The drill was conducted by the Emory Radiation Injury Treatment Network (RITN), which is part of the national response plan for  a mass casualty radiation incident resulting in bone marrow-toxic injuries. Emory University Hospital (EUH) is a RITN center. If a nuclear device were detonated somewhere in the United States, the National Disaster Medical System (NDMS) would be activated. Military aircraft would transport persons injured by ionizing radiation to DARB. The patients would then be transported to Emory University Hospital and Northside Hospital for treatment. Radiation injuries would include bone marrow damage, with some patients potentially requiring bone marrow transplants.

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