HONOLULU (KHON2) — While injuries from turbulence are rare, officials said they train to respond to emergencies with multiple injuries. And, it paid off in Sunday’s incident.

Officials said the pilot of Hawaiian Airlines Flight 35 radioed in immediately after passengers and flight crew members were injured. So by the time it landed in Honolulu, emergency personnel from American Medical Response Hawaii, Honolulu Emergency Medical Services and Airport Rescue Firefighters were able to get on the plane and assess the situation.

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“Having the airport paramedic and the firefighters right there on the airport property enter the plane immediately upon arrival is key and then calling for more resources,” said Dr. James Ireland, director of the Honolulu Emergency Services Department.

Eight ambulances were ready and waiting, seven from AMR and one from EMS. AMR has a contract with the state to respond to emergency situations at the airport. Twenty people were taken to the hospital.

“Seven patients to Queens by bus and 13 patients by ambulance to Queens, Pali Momi and Straub,” said Speedy Bailey, AMR Hawaii General Manager.

Ireland said the flight crew also did a good job keeping passengers fairly calm and seated to avoid any chaos.

“There was some care given on the plane, so they did that initial sweep to the plane, identified who was most significantly injured and then extricated them from the plane, continued treatment in the lobby area,” said Ireland.

Ireland said the most serious were head injuries on passengers. He stresses the importance of keeping your seatbelt on as much as possible. Bailey stresses the importance of doing exercises regularly for mass casualties.

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“We drill on these things, and we work together in anticipation, and I think it really showed yesterday the collaboration and handling this incident,” said Bailey.