title: A comparative analysis of the emergency medical services and rescue responses to eight airliner crashes in the United States, 1987-1991.
abstract: BACKGROUND
  Crashes involving commercial airliners stress emergency medical services (EMS) and rescue operations to performance far in excess of everyday activities, and special adaptations of everyday responses need to be implemented. Fortunately, these events are infrequent and usually do not occur more than once in any location. The responses that occur must be highly coordinated and efficient. Little is known about the responses to such events. This study examines the EMS and rescue responses associated with eight recent crashes involving commercial airliners in the United States.
  
  
  OBJECTIVE
  To identify common factors for which alterations in responses may enhance the survival and decrease the morbidity to victims involved in commercial aviation crashes.
  
  
  METHODS
  Eight commercial airliner crashes in the United States from 1987 through 1991.
  
  
  METHODS
  Case review using: 1) press and media accounts; 2) U.S. National Transportation and Safety Board testimony and reports; and 3) structured interviews with airport, fire, EMS, and hospital personnel. Data were collated and common factors identified for the cases. Findings are classified into: 1) conditions at the crash sites; 2) initial responses; 3) scene management; 4) scene status; 5) patient transport; 6) hospital responses; and 7) preplanning exercises.
  
  
  RESULTS
  Common factors that impaired responses for which some remediation is possible include: 1) new methods for training including computerized simulations; 2) improvements in rescue-extrication equipment and supplies; 3) stored caches of EMS equipment and supplies at airports; 4) ambulance transport capabilities; and 5) augmentation of patient transport capabilities.
  
  
  CONCLUSIONS
  Many lessons can be learned through structured studies of commercial aircraft crashes. These findings suggest that simple and relatively inexpensive modifications may enhance all levels of emergency responses to such events.
authors.affiliation: Rural Emergency Medical Services Institute, Lincoln Medical Education Foundation, Nebraska 68510, USA.
authors.forename: P B
authors.initials: PB
authors.lastname: Anderson
mesh_terms: D000060:Accidents, Aviation / Q000401:mortality; D004632:Emergency Medical Services / Q000458:organization & administration*; D006302:Health Services Research; D006801:Humans; D009017:Morbidity; D011787:Quality of Health Care; D018635:Rescue Work / Q000458:organization & administration*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology