by Blake Herzog
Art Carlton, an emergency planner for the Pinal County Office of Emergency Management, says he remembers when most mass-casualty training exercises for first responders relied on pieces of paper to describe the injuries or vital signs that volunteer “patients” were supposed to have in the context of the drill.
“They used to have just a little half-sheet of paper stuck to them, telling them what their wounds are,” he says. “I noted the medical personnel, the police, going out to them and saying ‘Oh yeah, you know, it’s just another exercise, you read the card and it’s already got everything described on them.
“It clicked on me that we were not allowing these guys to practice their skills during the drills,” he says.
When the County hired Charles Kmet to lead the emergency management department, Carlton says one of his first suggestions to him was to increase the realism of County drills by employing moulage, or the art of fabricating realistic wounds for simulation purposes.
“When they come off the fire truck and they think this is just another exercise and they see this wound, they say ‘Oh, oh, no, this is, yeah, we’ve got to help this person, see what’s wrong with them.’ And you see the looks on their faces changing,” he says.
Carlton was more than game to add this role to his list of responsibilities accumulated over 30 years at the County — he’d always been fascinated by the use of moulage in forensic applications. After taking one eight-hour class, Carlton has been teaching himself, finding it to be a natural extension of his 40-year-plus model railroading hobby.
He’s spent the last five years learning how to mold material and makeup into realistic-looking bullet wounds, burns, bruises, broken bones, skull fractures, internal injuries, and any other kind of severe injury that can be applied to a volunteer or a manikin.
“I’ll moulage (the manikins) up as dead people. A lot of people don’t like playing dead, for some reason,” Carlton says.
He consults with fellow County emergency planner Barbara Elliott, who is a paramedic, on how to get the details of the festering “wounds” and oozing “blood” as accurate as possible for training purposes.
He’s found many relatively inexpensive materials that can be used for his art, starting with Elmer’s glue, which can be molded into fake wounds or alter a person’s appearance by decades.
Silicon is his go-to for most wounds to be applied to volunteer “patients.” Latex is easier for him to work with, but allergies to it are common enough that it can’t be used a lot of the time. He’s used PVC pipe as bones, but he’s found a hard silicon product he likes much better.
“I definitely love it for bones, you’ve got the coarseness outside and little air pockets inside of the bones. This material will duplicate that for me, and it really makes it more realistic for the guys and gals out there,” he says.
Many of the wounds worn by volunteers cost only about $2 each, while full prosthetics intended to be reused can run a bit higher but are still a bargain. Take for instance a severed foot he created for a little less than half the $1,500 it would cost a movie studio to buy it.
Funding for the moulage and other disaster drill costs comes to the County through the Federal Emergency Management Agency and other federal sources and not the County’s coffers, Carlton says.
Given the complexity and planning required for a full-scale mass casualty training exercise, Pinal County often does only one of them a year. But Carlton has led and participated in others around the state, and his reputation precedes him.
Carlton says one of the participants at a 2019 exercise in Cochise County recognized his work.
“For a doctor at a small hospital in Benson to say, ‘You must have Art Carlton doing your moulaging,’ that tells me that the word is getting around, and people like it and it’s helping in some way,” he says.