Books and Other Media Reviews

Abstract

Every year, transportation disasters represent a large percentage of disasters and multiple casualty incidents throughout the world. Pages of every almanac are filled with lists of major incidents annually. They are the stuff of tragedy, the focus of the news media, the headline grabbers, the rare photo opportunity, the plots for movies, and the settings for heroism and folly. They are characterized by suddenness, occurring for the most part without notice, and thus create drama in their accounting and retelling. The amount of material on disasters in the air, on land, and on and under the sea is truly massive. In no way can anyone write a volume on such a vast topic without restricting the focus. To that end, Levinson and Granot have met the challenge and come up with a very readable sharing of their own experiences, as well as some from the annals of disaster history, to repeatedly come up with precepts and notions that repeat themselves enough so that lessons can be learned from these unfortunate events. The authors early on point out that although the focus is transportation, some of the best examples of their ideas may come from general types of disasters. The book perhaps should not be thought of as a handbook, which I generally associate with checklists, tables, examples of forms to use, and things to quickly look up in the heat of the moment, when one might otherwise start to founder at getting organized. Instead, this volume, as a first edition, should be thought of more as a textual reflection on the general and technical aspects of response to such situations. The volume is divided into several sections. Section 1 is an extended introduction to the spectrum of transport disasters and the size of the problem. Section 2, the longest section, discusses general aspects of disaster response, emphasizing disaster planning, and identifies the victims. Key components of the disaster response for transportation disasters are discussed, including the role of government; the need for planning for response capabilities; the roles of the private sector and the military; the role and functions of an Information Center; and the issues that arise when transportation events are the result of terrorism and criminality. True to the history of disaster research, many of the observations about disaster response and responders arise from the sociological aspects of the events that occur, and many of the behaviors that occur during responses can be predicted based on prior observations. Section 3 examines general response principles among communications sectors, police, fire and medical responses. The authors introduce the medical aspects of response with the reminders that medical care is planned in accordance with cultural norms and resource availability. Triage is discussed from the point of view of victim evacuation rather than priorities for care at the disaster site. The authors discuss the phenomenon of self-transfer to hospital by patients who are able to do so, often getting to the hospital before the most seriously injured can be triaged, stabilized and transported. Other subjects discussed include body removal, hospital reception and recording (registration), the media, personal protective equipment and decontamination of hazardous materials, victim tracking, and the walking wounded. The subject of medical equipment is superficial, with the discussion covering only the issue of caring for patients who don’t know the names of their medications, and who may have lost their eyeglasses. Field equipment needed for life-saving interventions is left unmentioned. Section 3 also covers mental health, treated in much greater depth than medical care issues, with several pages devoted to Post Traumatic Stress Disorder (PTSD), its history, recognition and management. Section 4, “Response to specific transportation disasters,” contains chapters on aviation, accidents at sea, and