These victims weren't in such bad shape.

"Everything in this room is the walking wounded," pre-op registered nurse Misty Cooney said in the cafeteria-turned-receiving-room of the Mountain View Regional Hospital on Saturday afternoon.

Cooney had finished recording the wounded Gordon Moon, who was alert and ambulatory, but needed treatment for a broken finger.

She and other nurses attended to Moon and a dozen other acting victims of a mock plane crash near Midwest earlier in the day. Moon, a sophomore at Kelly Walsh High School, volunteered for the event after a suggestion from his theater teacher.

The crash and victims were part of a mass casualty exercise coordinated with agencies from Casper, Midwest, Bar Nunn, Evansville, Mills, and Natrona County; the Natrona County School District, which provided buses; the Red Cross and the Salvation Army, which provided personnel and food; the Wyoming Military with the Air Guard, Army Aviation and supporting teams; and the hospital.

The staged event revolved around a fictional passenger plane, which reported the loss of an engine to the control tower of the Casper-Natrona County International Airport but lost radio contact 40 miles out about 8 a.m., said Theresa Simpson of Natrona County Emergency Management.

The airport began notifying a number of agencies about the missing plane, which carried 125 passengers and crew, Simpson said.

The first units were dispatched from Midwest about 15 minutes later, and responders found the crash site about 15 minutes after that.

Natrona County Deputy Sheriff Tom Carubie was among the first responders.

"If you are able to walk, come to this area," he said.

The dazed and confused survivors moved toward him, with some near hysterical and shouting to no one in particular, "is that guy going to be OK? Have you seen Henry?"

Carubie didn't want them to wander and told them, "focus on me."

Other agencies began responding as the word spread.

The Wyoming military, however, had set up camp the night before to test new equipment that enabled agencies using different radio frequencies to talk to one another.

"We would provide communications to incident commanders," said Master Sgt. Jason Lyle of the 153rd Communications Flight unit from Cheyenne. "We make sure all responders are on the same wavelength."

The communications equipment worked well, Lyle said.

But like real life, a training exercise doesn't always run smoothly.

A Bar Nunn firefighter became ill, county emergency management Lt. Stewart Anderson stopped the exercise, and a Life Flight helicopter from the Wyoming Medical Center was dispatched to take the firefighter to the hospital. (The WMC did not participate otherwise in the exercise because of a previous commitment.)

Likewise, two Black Hawk helicopters from Cheyenne were scheduled to participate in the exercise, but they encountered bad weather that forced them to turn back. One of the helicopters eventually made it to Natrona County.

"These are not easy things to develop," said Dr. Maria Kidner, a nurse practitioner with Cheyenne Cardiology Associates. "This is a huge effort."

She brought several nursing students and an instructor to the scene to show what happens at an incident with multiple casualties, she said.

First responders perform triage, separating the injured by their likelihood of survival usually in a half-minute by checking a victim's breathing, circulation and awareness of their surroundings, Kidner said.

This runs counter to nurse training, which emphasizes individual care, she said.

In a mass casualty exercise, responders must provide the most help for the most people, and allow those who won't survive to die with dignity, Kidner said.

At the Mountain View Regional Hospital, those who survived were brought in by the school buses and segregated by triage manager Don Coulter, who in real life is the hospital's emergency room, ICU and inpatient director.

Coulter had real-life mass casualty experience when, as a Life Flight nurse for the Wyoming Medical Center, he assisted the Carbon County Memorial Hospital in the 2006 bus crash in Rawlins that had about 40 casualties but no fatalities, he said.

The small, private hospital converted its nine-bed recovery area to an intensive care unit where victims were examined by nurses and doctors, with the assistance of a pharmacist, respiratory therapists and other health care providers.

The ones with minor injuries like Moon were quickly treated.

Those with severe head and other trauma were wheeled into the hospital's operating rooms.

"Trauma operations are fairly quick; usually in less than an hour," said neurosurgeon Dr. Tom Kopitnik.

But the large number of casualties overwhelmed the hospital's facilities, so those managing the exercise had a C-130 military transport at the airport to test the ability to take the injured - but not critically so - to other medical centers in the region.

"The idea in mass casualties is you don't waste resources on people who won't survive," said neurosurgeon Dr. Robert Narotzky.

Krisinda Wilcox, the hospital's operating room manager, worked in the triage area to direct victims to surgery and to keep the command post - set up in a separate room at the hospital - informed of the patients.

Wilcox had never participated in a mass casualty exercise, but said the intensity was the same although the numbers were higher than her regular work.

"The OR (operating room) is crazy like this every day," she said. "As an RN you have to stay calm and focus."

Reach Tom Morton at (307) 266-0592, or at tom.morton@trib.com. Read his blog at tribtown.trib.com/TomMorton/blog.