On April 19, 1998, at 12:45, area agencies were taxed to the limit as they managed a 65 car pile-up on I-64 at the 99 mile marker. The accident occurred as thick fog suddenly rolled across the top of Afton Mountain, which is a common occurrence this time of year. Here is the first thing rescuers saw and knew they were faced with a mass casualty incident.

This shows what turned out to be very common, one car piled into the back of another. Over 28 patients were transported by ambulance, another +20 were triaged by an trauma physician brought from Augusta Medical Center. The physician was assigned to a school bus brought up to hold priority III patients until the decision was made to transport or to hold in staging.

In the vehicle to the left, the driver was attempting to flee the area when the tractor-trailer slammed into his rear end, causing his leg to be pinned inside the door, (notice the bent metal at the bottom where the metal wrapped around his leg). Bystanders freed the driver using crow-bars.

This guy was very unlucky. Not only did he suffer a broken leg, but his pick-up, (brand new 2 weeks ago), was totaled. The pictures here were taken approximately 1 hour into the incident after the fog had lifted. Bystanders reported the fog was so thick they could not see the road they were standing on!

Notice the thick fog rolling back into the area. Not only were rescuers faced with a huge unknown in terms of number of actual patient, but we had to contend with the weather. During the entire incident, we were hit with driving rain, thunder and lightning. The temperature was around 50 degrees. Many victims were walking aimlessly about with no adequate protection from the weather.

In between the two trucks are the remains of a camper trailer. The entire call lasted 2 hours. Augusta Medical Center received 23 patients via ambulance and another 27 by school bus (they were treated in the Outpatient Surgery Clinic). UVA received 5 patients via ambulance.

It is hard to imagine 65 vehicles in one accident. We counted over 15 state trooper cars, 15 ambulances, 2 heavy squads, 6 engine companies and scores of rescue personnel. Several patients were trapped inside their vehicles, necessitating rescue by squad crews. The worry was that we would miss someone who needed assistance.

The last time we had a similar incident was in the same place 6 years ago to the day! That incident involved 58 vehicles, including 2 responding ambulances that hit head-on at 50 mph. Lucky for everyone involved, we had no fatalities this time and no rescuers suffered injuries.

CARS was the 3rd due EMS agency on this incident, and we responded with 3 medic units, Support 143, the MCI trailer (which was heavily used), and a zone car with 4 additional paramedics. While this incident was unfolding, CARS was dispatched to several other serious EMS related calls, one of which was a MVA into a tree with 1 trapped.

Our MCI trailer is set up for just this type of scenario. As EMT's and firefighters arrived on scene, they were paired into groups of two and then sent to the trailer. There they received enough pre-packaged equipment to immobilize 2 patients. Here, Benjamin Sojka and Wayne Perry start to re-stock returned equipment.

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