Knowing the lessons of past disasters is necessary in disaster planning. Such knowledge paves the way for creating a plan that anticipates the patterns, as well as the impediments, of behavior and injuries encountered in most events. On September 4, 1904, a head-on butting collision of two Southern Railway passenger trains traveling at high speeds occurred near New Market, Tennessee, killing 56 passengers and crew and injuring 106. It was the worst civilian disaster of its kind in eastern Tennessee, according to one Knoxville newspaper. An historical analysis of the events of this mass casualty incident and the medical and community response may serve as a template for modern disaster management and the role of surgeons in that management.
Key Points
* Surgeons are fundamental to disaster management efforts.
* Knowledge of the lessons learned from past disasters is a necessary factor in disaster planning.
* Civilian mass casualty incidents or terrorist attacks may present circumstances where the trauma surgeon needs to work in an austere or hostile environment using limited resources.
* Surgeons will be called on to take the leading role in planning and executing the response to mass casualty events.