Therefore, the NTSB recommends that the PPD, the PFD, and the OEM collaborate and develop a plan that effectively integrates rapid police transport of patients into the emergency medical response plans for large mass casualty incidents, including a means of coordinating hospital destinations regardless of the method of transport (R-16-39). Having an MCI response plan that integrates police, fire, and EMS activities is only the first step. It takes practice for the plan to function in the real world. Therefore, the NTSB recommends to the PPD, the PFD, and the OEM that, once the plan specified in Safety Recommendation R-16-39 is developed, they practice the plan periodically, including at least one full-scale drill every 3 years, to ensure that it functions as intended. Because all three of these agencies report to the mayor, the NTSB further recommends that the mayor of the city of Philadelphia facilitate the collaboration among the PPD, the PFD, and the OEM to develop a plan that effectively integrates police transport of patients into the emergency medical response plans for large mass casualty incidents and to practice the plan periodically, including at least one full-scale drill every 3 years. While the principles of MCI response apply to all such events, the management of each event differs in scope, potential risks to first responders, hospital availability (based on geography and capacity), and transport options. Although complicated by the lack of transport coordination, this accident and the response to the movie theater shooting in Aurora, Colorado, demonstrate the utility of using police vehicles to provide patient transport during an MCI, essentially becoming a force multiplier for EMS. This is a concept other municipalities may want to consider incorporating into their mass casualty plans. Therefore, the NTSB recommends that the National Association of State EMS Officials, the National Volunteer Fire Council, the National Emergency Management Association, the National Association of EMS Physicians, the International Association of Chiefs of Police, and the International Association of Fire Chiefs educate their members regarding the details of this accident, including the lessons learned from the emergency medical response, and the potential utility of integrating police transport of victims into mass casualty incident response plans.
1.9.3 Amtrak's Passenger Accountability System
On April 18, 2002, an Amtrak auto train derailed on CSXT track near Crescent City, Florida. [1] At the time of the accident and for several months following the accident Amtrak erroneously reported the number of people on board as 468. In fact, the train was carrying 446 people, but this was not apparent from the paper, on-board record system Amtrak was using at that time. The NTSB noted the importance of a complete and accurate accounting of all people on the train to ensure that emergency responders locate, evacuate, and treat all of the victims and ensure that emergency responders are not exposed to needless risk searching for people who were not on board. As a result, the NTSB issued Safety Recommendation R-03-10 to Amtrak:
Develop and implement an accurate passenger and crew accountability system for all Amtrak long-distance, overnight, and reserved trains that will immediately provide an accurate count of the people on board the train in case of emergency.
In 2012, Amtrak implemented its electronic ticketing (eTicketing) for mobile devices on all trains. Amtrak acknowledged that because of passenger autonomy and the fluidity of rail
- ↑ National Transportation Safety Board, Derailment of Amtrak Auto Train P052-18 on the CSXT Railroad, near Crescent City, Florida, April 18, 2002, Railroad Accident Report RAR-03/02 (Washington, DC: NTSB, 2003).
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