Orthopaedic disaster management in the 2015 Amtrak Derailment.

Mass casualty events are a rare phenomenon, which many hospitals, even large trauma centers, have never experienced. A large number of orthopaedic surgeons have not been trained in managing the traumatic injuries that accompany mass casualty events, and as such being prepared for such events becomes difficult. The large number of casualties requires rapid evaluation, treatment and allotment of resources in an otherwise strained environment. Additionally, the most frequently survivable injuries tend to be musculoskeletal, resulting in a large number of patients for the orthopaedic surgeons involved. On May 12, 2015, Amtrak Northeast Regional Rail 188 departed from Washington, DC heading to New York City, NY. Only a few minutes following departure, the train derailed in Port Richmond, Philadelphia, PA. The accident occurred 3 miles from our level 1 trauma center. The number of passengers on the train at the time of the accident was 238, and in the immediate aftermath, 198 of those were treated at local area hospitals, 54 of who were taken to our hospital. We will address how one hospital managed a mass casualty event from the initial triage period, into the emergent surgical management of injuries encountered, through to the long-term management of surgical patients. It will also address the weakness and areas of improvement that this Level 1 trauma center encountered, and how hospitals can better prepare themselves for such an event. (C) 2016 Lippincott Williams & Wilkins, Inc.

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