Prepared to Prevail in Worst-Case Scenarios: Mass Casualty Exercise Published May 26, 2025 By Staff Sgt. Pedro Tenorio ANDERSEN AIR FORCE BASE, Guam -- “The best are always prepared for the worst.” On May 14, 2025, the 36th Medical Group (MDG) conducted a mass casualty exercise on Andersen Air Force Base, Guam. Designed to simulate the harsh realities of a hostile event, the exercise plan with limited manpower and resources—an unfortunate, but realistic, scenario intended to test the unit’s readiness in contingency conditions. The exercise involved a simulated hostile attack resulting in 20 casualties of varying severity. Field response teams were dispatched to the scene, initiating triage procedures (prioritizing treatment based on urgency and severity of injury.) These high-pressure moments tested Airmen’s reaction speed, critical thinking, and ability to perform under stress. As field response teams work, transport teams have already begun mobilizing. Their Mission: move personnel safely, but urgently through decontamination and to treatment. Timing, precision, and communication would be what they were evaluated on. Within a few minutes, the first simulated patients arrived at the 36th MDG facility. This is when decontamination and processing teams took over. Airmen carried or guided patients through the decon process. The team here showed how speed and efficiency could still be achieved while upholding the highest standards of care. Once decontaminated and processed, casualties were transferred to the MDG atrium which would be the final staging area before being sent to respective treatment areas/facilities. These exercises highlight what it means to serve in the profession of arms. Mental readiness is already there. It's the job of exercises to make sure our bodies, plans, and reflexes are prepared too. For many participating Airmen, this was their first time experiencing a mass casualty simulation, for others it was their first time experiencing one on Andersen AFB. This does make a difference. “This base has unique challenges,” said Master Sgt. Susan Young, 36th MDG medical logistics flight chief and lead planner for the exercise. “Andersen AFB faces threats that are unique to our AOR and we exercise to prepare to respond to those threats” A defining way the 36th MDG prepares for any response is Mission Ready Airman. Each Airman is trained not only in their primary roles, but are also trained in specialized teams for contingency operations. For example, dental technicians serve as part of the decontamination team and lab technicians double as field response units. Everyone is ready and capable to respond to a crisis. This exercise was both about sharpening these crisis technical skills and about building interdepartmental trust and cohesion. “I think it opened our eyes to truly understand and appreciate everyone’s different functions,” said Young. “[With an exercise] you can understand where your role plays into another and strengthen that cohesive teamwork.” These roles and teamwork were all being watched by the Wing Inspection Team (WIT) who aim to evaluate all areas, whether great, good, or bad. Fortunately, for the 36th MDG, their teamwork and skills pulled through. “I think they did great,” said Master Sgt. Nathan Galati, 36th MDG dental flight chief and Wing Inspection Team team chief for this exercise. “Sole purpose of these exercises is identifying rooms for improvement. There’s always room for improvement, but they did great. We will take these findings, get back with all the Team Chiefs and make teams better.” The praise given by Galati and Young is emphasized as they appreciate and recognize all the 36th MDG Airmen who navigated professionally through the heat, the stress, and the complexity of the scenario. The mission was executed, and it was because you all came together as a team. To the WIT members, Young expressed her appreciation for their expertise and oversight. These were crucial in helping to design and evaluating this exercise. Their counsel made it possible to see how the teams operated together and ultimately led to how they can grow stronger. Galati and Young also wanted to show gratefulness to the volunteers from across base. They expressed thanks as their participation allowed the creation of a realistic environment that sharpened the skills of all the MDG Airmen present. Readiness is not always glamorous nor is it always pleasant to think about, but it is always necessary. The 36th MDG is prepared to prevail even in the worst-case scenarios.