Our emergency department participates in several hospital-specific and community-wide tabletop drills and exercises each year. The largest of these exercises typically involves around 500-600 volunteer “patients” distributed throughout the city, with our facility usually receiving around 60-80. The community-wide event is held every April during the daytime, but in November 2015, approximately 7 months prior to the Pulse, we held a nighttime event. The purpose of that nighttime exercise was to better familiarize evening and overnight staff about how a mass casualty response should look if it did indeed occur.