It was a cold and foggy morning at RAAF Base Richmond when the ‘mayday’ call rung out across the radios to mark the commencement of the Ex Paratus 22 multi-agency field exercise.
The scenario involved a C130J Hercules aeroplane which had sustained a catastrophic engine failure before the aircraft made an emergency crash landing at the end of the tarmac. Upon doing so the plane exploded.
The exercise began with RAAF Base Richmond quickly activating their fire and medical response teams before they then requested the assistance of NSW Ambulance, Fire & Rescue NSW, NSW Police and State Emergency Service.
To this point, everything was going according to plan. But as can be the case when conducting a major exercise like this, there can sometimes be unexpected challenges along the way. The good thing is, these challenges provide great learning opportunities to better prepare for the real thing.
An example of one of these “hiccups”, as described by Western Sydney & Nepean Blue Mountains Zone (WSNBMZ) Inspector Rebecca Tulk, occurred early on in the exercise.
The responding NSW Ambulance resources – consisting of a Forward Commander, an Emergency Operations Centre Liaison Officer, two SOT officers, four ambulance vehicles and an Aeromedical Operations road retrieval team – were held up in a holding pattern with other agencies waiting to be given approval to enter the tarmac to access the incident.
“This delay meant that the planned staggered arrival approach did not happen, but it was very impressive to see the line of red and blue flashing lights travelling in convoy down the tarmac,” Rebecca said.
However, when the crews reached the incident site they did what they do best.
A handover from the RAAF medical team reported a total of 18 patients, who had various injuries. Some of the types of injuries included limb fractures, a combative head injury, a penetrating chest wound, severe facial /airway burns, arterial bleeding and a spinal injury.
The Forward Commander, Mark Buchtmann, was proactive in assigning a scribe and a triage officer to assist him, and he requested an additional medical team. Also involved in the exercise was a NSW Ambulance Rescue Helicopter crew, with the aircraft landing shortly after ground crews arrived at the scene.
The helicopter crew were able to assist in the treatment of the more critical patients.
Special effects, moulage and some interesting acting skills saw some of the “patients” appear very realistic in their presentation, which was a great addition to the exercise.
Throughout the exercise patients were re-assessed and triage categories were altered due to a change in presentation or vital observations. At one point, a patient had a sudden decline and was rapidly re-triaged to a higher acuity resulting in a change to red label on the SMART triage tag.
The patient was subsequently prepared for a rapid sequence intubation (RSI) by the medical team. As part of the simulation, patients were also treated with analgesia, fluids, burns dressings, splints and lots of reassurance.
The liaison officer in the Emergency Operations Centre (EOC) was able to determine the appropriate hospital destinations for the patients, ensuring not to overload any of the facilities.
A vital lesson was learnt during the exercise with regards to confirmation of the total number of patients in the plane.
It was established there were two remaining patients who hadn’t initially been accounted for and who needed to be declared deceased.
The two NSW Ambulance SOT Officers donned their breathing apparatus and entered the smoke-filled aircraft to extricate the two deceased patients (with the assistance of Fire & Rescue NSW).
The NSW Ambulance Chaplain in attendance also noticed that these two patients were not covered, and to maintain their dignity, she demonstrated compassion and placed a blanket over them.
Along with overseeing the treatment of the patients in the plane, the Forward Commander had to think quickly and deploy resources to assess two other patients during the exercise. This included a Fire & Rescue officer who tripped over a fire hose and rolled an ankle, along with the relative of a patient from the plane crash who suffered an asthma attack.
At the completion of the exercise all participants were given the opportunity to participate in a debrief with the exercise’s planning team and the North West Sydney Regional Emergency Management Officer.
The debrief allowed for some great discussions about what the team did well and areas for improvement. The entire exercise allowed the responding paramedics an opportunity to ensure that they have the correct knowledge and understanding of NSW Ambulance’s role in a mass casualty incident.
“We are looking forward to participating in future exercises with RAAF Richmond and local emergency services,” Rebecca said.
“Working in conjunction with RAAF Richmond and other emergency services was invaluable and will definitely lead to further opportunities to build relationships.
“Seeing the C130J Hercules up close was unbelievable and gives us a better appreciation of the complications we may encounter in a real life incident.”
WSNBMZ Acting Sector Duty Operations Manager William Edwards added:
“From our first meeting with the RAAF Richmond we realised that this exercise was a great opportunity to practice our mass casualty knowledge. Our crews were outstanding and all recognised some valuable learning opportunities.”
Acting Station Officer and crash Forward Commander Mark Buchtmann described the exercise as “a massive learning opportunity.”