The attack on the World Trade Center realized some of the gravest concerns that many in the medical profession prefer not to entertain. The catastrophic losses from the attack were a continued cascade of worse case scenarios. Although the resources brought to bear on this disaster taxed multiple agencies to their limits, after the first 24 hours no living victims were recovered. This led to enormous frustration and anguish among the rescue personnel whose efforts were thwarted by destruction, fire, and the seemingly immovable wreckage. The police and fire personnel sought painfully and hard for their colleagues, as well as for civilians.
There are many lessons to be learnt from the initial response to the World Trade Center attack. While the incident was dramatic, these lessons are the same as those from pervious disasters, such as the earthquakes in Tanging, Kobe, Taiwan, Turkey and Armenia. First, the majority of survivors are self-rescued. Second, delays in organized rescue are not uncommon and should be an expected component of the process. While this delay should be as short as possible, it should also be recognized that time is needed to organize rescue efforts in such a way that survivors are accessed and treated within the limits of available resources. Third, successful rescue depends on simultaneous search, rescue, and medical support, with patient management primarily focusing on rapid transport to appropriate facilities, such as trauma centers, for definitive care.
CM is also an Assistant Professor of Emergency Medicine at Albert Einstein College of Medicine and an attending physician at Jacobi Medical Center in New York.
DG is also Clinical Professor of Emergency Medicine at Albert Einstein College of Medicine and an attending physician at Long Island Jewish Medical Center, New York.