"There was exceptional cooperation between the fire departments and EMS services, some of whom rarely have the opportunity to work together," said Brian Mullis, the drill coordinator and Director of Emergency Medical Services at Mayo Regional Hospital.

The drill took place at the former Ripley School on Route 23, located five miles west of Dexter. The town of Ripley has no public safety services and depends on Dexter in Penobscot County for primary fire and EMS ambulance response, and the Somerset County Sheriff's Office for law enforcement response and communications dispatch service.

Because Ripley is also equidistant from Mayo Regional Hospital in Dover-Foxcroft and Sebasticook Valley Hospital in Pittsfield, both hospitals were directly involved in the drill.

The drill began at 4:25 p.m. and before the last "patient" was transported from Ripley 90 minutes later, Mullis said two fire departments and five EMS ambulance services responded.

The drill scenario involved a boiler explosion and structure fire at the Ripley School, which was occupied by 25 students and staff. Dexter Fire and EMS arrived in 10 minutes, followed by Harmony EMS and Mayo EMS units, and found students and staff injured and still inside the burning building.

Within 40 minutes, EMS units on the scene included four ambulances from Mayo/Dexter EMS, and one ambulance each from Harmony, Hartland/St. Albans, Sebasticook Valley Hospital and Corinna. Total EMS personnel on hand included 10 paramedics and 11 Emergency Medical Technicians. Additional ambulances from Mayo, Sebasticook Valley, C.A. Dean Hospital in Greenville and Redington-Fairview Hospital in Skowhegan were on stand-by.

Dexter Fire responded with two engines, a rescue truck and 10 firefighters, and was assisted by St. Albans Fire with one engine and four firefighters. Garland Fire stood by at the Dexter station.

After the fire was contained and rescue operations were completed, Mullis said there were 23 "patients" at Ripley in the treatment area and ready for transport. Playing the role of patients, many in fully simulated makeup, were students from SAD 46, Tri-County Technical Center, Nokomis Regional High School and Foxcroft Academy.

Patients were all tagged for treatment, with 10 listed in serious condition. Mayo, Dexter, Harmony and Corinna ambulances transported 14 patients to the Mayo Emergency Department, and Hartland/St. Albans and Sebasticook Valley ambulances transported another five patients to the Pittsfield hospital. Other, less seriously injured patients would have been transported to Redington-Fairview, but for drill purposes were released at the scene.

The last patient was transported from Ripley at 6:05 p.m., 90 minutes after arrival of the first fire and EMS units at the scene.

Mullis said the scene management system for a mass casualty incident worked very well, which was important given the multiple services participating. Communications were an issue because three separate dispatch centers were involved, a complication caused by Ripley's location at the juncture of a three-county region.

"It was a complex drill with many different services responding, but that's how it often is in real life, and we try to have our training mirror reality as closely as we can," said Mullis.