Allegheny General Hospital ran a full-scale mass casualty simulation Thursday morning, rehearsing its response to a shooting at next month's NFL Draft in Pittsburgh. The drill mobilized roughly 50 staff members, including doctors, nurses, paramedics, security personnel, and custodial teams, all working under a single scenario: a gunman opens fire at the draft.
Staff received an alert around 9 a.m. Eighteen minutes later, the first simulated casualty arrived. Over the next hour, the hospital processed 18 fictional patients under triage tents erected outside the emergency room entrance on the North Shore. Participants wore color-coded wristbands ranging from "minimal" to "deceased."
According to EMS 1, the NFL Draft is expected to draw more than half a million people to Pittsburgh. That is the kind of number that demands preparation, not optimism.
Brent Rau, medical director for the AGH emergency department, designed the exercise to mirror the chaos of an actual mass casualty event. He didn't want a sanitized walkthrough.
"It's not just doctors and nurses — we've got paramedics, we've got security at all the entrances acting like a true mass casualty event. We've got increased custodial staff turning over beds. It's an all-hands-on-deck process."
The drill included volunteers playing wounded patients. Kelly McPoland portrayed a gunshot victim. Darrin Stack, a Shaler resident whose wife works at AGH, was told to act confused but able to speak. He arrived with a simulated gunshot wound and was surrounded by medical teams working through their protocols in real time.
Stack didn't sugarcoat the experience:
"It's actually kind of scary. You go in, you are sitting there, the doctors are around you. It's something that I hope I don't have to ever, ever experience, but it is kind of interesting. Practice makes perfect."
The hospital even built in the human friction that real emergencies produce. An actress portrayed an agitated patient in the minor treatment area, upset that care wasn't coming fast enough. Kathy Sikora, a nurse and AHN director of emergency services, handled the situation the way her team would in a genuine crisis.
"Patients get upset if it's not fast enough. But she's been through a traumatic experience too. We'll get her hooked up with social work."
That detail matters. Mass casualty response isn't just about tourniquets and operating rooms. It's about managing panic, triaging emotional distress alongside physical wounds, and keeping a hospital functioning when everything is moving too fast.
Rau drew a clear distinction between everyday emergency care and what a mass casualty event demands. Normal ER work allows for deliberation, labs, imaging, and consultations. A mass shooting compresses all of that into seconds-long decisions about who lives and who waits.
"You're trying to understand, basically, what's wrong with you? Are you sick? Can you wait a little bit? Do you need to go to the operating room right now? It's not something we do every day."
Rau himself participated as a simulated gunshot victim, arriving by ambulance en route to the operating room. AGH runs these mass casualty simulations a couple of times per year, but this one carried added weight given the scale of the event it's preparing for.
The hospital has also been coordinating with the NFL and with medical personnel in Detroit and Green Bay, cities that previously hosted the draft. Learning from other cities' preparations is the kind of unglamorous institutional work that rarely makes headlines but separates competent response from catastrophe.
One of the logistical realities of a mass casualty event is that victims may arrive without identification. AGH practiced using EMTrack, a system that assigns tags to patients so they can be scanned and followed through the hospital even when names are unknown. Sikora described the approach simply:
"We may not have names but we know the person. We have the tag so we can scan them and follow them."
By 9:45 a.m., less than an hour into the drill, the team had already processed all 18 fictional patients. That speed matters when minutes determine outcomes.
There is a version of this story that gets told through the lens of fear. The "mass shooting drill" headline is designed to unsettle. But what actually happened Thursday morning in Pittsburgh is something conservatives have long argued for: local institutions taking responsibility for their own readiness instead of waiting for federal directives or hoping the worst never comes.
Half a million people in one place is a security challenge, no matter who is in office or what policies are on the books. The question is never whether risk exists. It's whether the people closest to the problem have done the work before the moment arrives.
AGH did the work. Fifty staff members showed up on a Thursday morning to rehearse the scenario nobody wants. They triaged fake gunshot wounds, managed simulated panic, tracked patients without names, and turned over beds fast enough to keep the pipeline moving.
That's not anxiety. That's competence. Pittsburgh will be ready because its hospital decided to be.