Disaster response, confined space medicine and safety systems against railway accidents: 2023 Odisha railway accident from India.

Railways are a major mode of transportation for passengers as well as goods. Across the world, minor and major accidents involving railways causing damage to life and property have been reported. The recent triple train derailment and collision near a small railway station in the state of Odisha, India, on 02.06.2023 is a major calamity. The accident resulted in 292 deaths, and more than 1000 injuries were attributed to the accident. In its comprehensive enquiry report, the Commissioner of Railway Safety found lapses in the signalling mechanism and oversight as the reasons for the accident. Immediate rescue, emergency transport and treatment are essential in reducing the mortality and morbidity of such accidents. The relatively newer domain under pre-hospital and disaster medicine is confined space medicine, which deals with patients trapped in places with limited access to conventional intervention and reduced ventilation. Confined space medicine employs a multi-hazard and interprofessional approach to treating individuals who are trapped in a structural collapse. It is also essential to critically evaluate and disseminate the entire disaster response systems that functioned during and after the railway accident to identify the existing system's best practices, bottlenecks, and gaps. The train's speed, lack of track and signal maintenance, absence of safety oversight, driver fatigue and distractions are some major determinants of train accidents, highlighting the need for comprehensive planning and training in rail safety. It is essential to improve the timely implementation of maintenance activities and completion of accident inquiries on time. A comprehensive review of the preparedness, rescue and response must be undertaken at the earliest possible opportunity to prevent and prepare for any such disasters in the future.