Mass casualties in Colorado, Wisconsin and most recently Louisiana show the threat can happen anywhere and without warning, and Horry County Fire Rescue emergency responders are getting drilled on how to react should a situation happen here.
"The biggest benefit to this is to take something that they've learned online or in a book or in a fire station and then actually put it together in an actual exercise," said Assistant Chief Justin Gibbins.
Thursday morning, training officers set up a scenario where a man drove his truck through a daycare and hit several children.
"You practice like you play," said paramedic Steve Montgomery. "We're not really sure what we're walking into."
During the drill, there were seven different patients with seven different injuries forcing responders to act quickly and figure out who could be treated at the scene and who was most critical.
"Whether you've been doing this job for 15 years or 15 months, you're going to be overwhelmed and that's the intent of this training," said Gibbins.
"That's theor intention is to create confusion," said Montgomery.
While confusion was sometimes a factor, experience set in.
Horry County Fire Rescue has used the mass casualty training in real world scenarios four times since July, usually car accidents, said Gibbins.
"The simplest call that we get everyday at work turns into organized chaos if things are not planned out," said Montgomery. "That's why we do this."
The need for that experience is all too real because the recent mass shootings sit in the backs of responders' minds.
"Can you imagine trying to handle that scenario with three hundred people running out of an auditorium and trying to manage that situation?" asked Montgomery. "It'd be a nightmare."
"We do have movie theaters here. We do have a college in our area," said Gibbins. "This could potentially happen right here, but we have small scale incidents that happen everyday."
Kids who volunteered for the exercise were given free passes to Wild, Water and Wheels.