Represents the vast experience of the world's leading experts in field hospital deployment in disasters and conflicts.

A guide to the aid stations and field hospitals that served casualties following the Battle of Gettysburg.

“An extremely detailed history of 160 hospital sites that formed to care for soldiers who were wounded at the Battle of Gettysburg.” —Civil War Cycling Nearly 26,000 men were wounded in the three-day battle of Gettysburg (July 1-3, 1863). It didn’t matter if the soldier wore blue or gray or was an officer or enlisted man, for bullets, shell fragments, bayonets, and swords made no class or sectional distinction. Almost 21,000 of the wounded were left behind by the two armies in and around the small town of 2,400 civilians. Most ended up being treated in makeshift medical facilities overwhelmed by the flood of injured. Many of these and their valiant efforts are covered in Greg Coco’s A Vast Sea of Misery. The battle to save the wounded was nearly as terrible as the battle that placed them in such a perilous position. Once the fighting ended, the maimed and suffering warriors could be found in churches, public buildings, private homes, farmhouses, barns, and outbuildings. Thousands more, unreachable or unable to be moved remained in the open, subject to the uncertain whims of the July elements. As one surgeon unhappily recalled, “No written nor expressed language could ever picture the field of Gettysburg! Blood! blood! And tattered flesh! Shattered bones and mangled forms almost without the semblance of human beings!” Based upon years of firsthand research, Coco’s A Vast Sea of Misery introduces readers to 160 of those frightful places called field hospitals. It is a sad journey you will never forget, and you won’t feel quite the same about Gettysburg once you finish reading.

"This simple story of hospital scenes and the unpretending sketches of the ... soldiers to which they allude, is arranged from the meager notes which were hurriedly written at the time they occurred..."--Introduction.

Mass Casualty events may occur as a result of natural or human-caused disasters or after an act of terrorism. The planning and response to disasters and catastrophes needs to take into consideration the distinction between progressive and sudden events. Insidious or slowly progressive disasters produce a large number of victims but over a prolonged time period, with different peaks in the severity of patients presenting to the hospital. For example, radiation events will produce a large number of victims who will present days, weeks, months, or years after exposure, depending on the dose of radiation received. The spread of a biological agent or a pandemic will produce an extremely high number of victims who will present to hospitals during days to weeks after the initial event, depending on the agent and progression of symptoms. On the other hand, in a sudden disaster, there is an abrupt surge of victims resulting from an event such as an explosion or a chemical release. After the sarin gas attack in a Tokyo subway in 1995, a total of 5500 victims were injured and required medical attention at local hospitals immediately after the attack. The car bomb that exploded near the American Embassy in Nairobi, Kenya, killed 213 people and simultaneously produced 4044 injured patients, many requiring medical care at local hospitals. The Madrid train bombing in March 2004 produced more than 2000 injured victims in minutes, overwhelming the city’s healthcare facilities. More than 500 injured patients were treated at local hospital after the mass shooting in Las Vegas. Finally, earthquakes may produce a large number of victims in areas in which the medical facilities are partially or completely destroyed. Sudden events bring an immediate operational challenge to community healthcare systems, many of which are already operating at or above capacity. The pre-hospital as well as hospital planning and response to sudden mass casualty incidents (SMCI’s) is extremely challenging and requires a standard and protocol driven approach. Many textbooks have been published on Disaster Medicine; although they may serve as an excellent reference, they do not provide a rapid, practical approach for management of SMCI’s. The first edition of “Mass Casualty Incidents: The Nuts and Bolts of Preparedness and Response for Acute Disasters” dealt exclusively with sudden mass casualty incidents. The second edition will expand its focus and include planning and response for insidious and protracted disasters as well. This new book is designed to provide a practical and operational approach to planning, response and medical management of sudden as well as slow progressive events. The target audience of the second edition will be health care professionals and institutions, as well as allied organizations, which respond to disasters and mass casualty incidents. Parts I and II are essentially the first edition of the book and consist of planning of personnel, logistic support, transport of patients and equipment and response algorithms. These 2 parts will be revised and updated and include lessons learned from major mass shootings that occurred recently in the United States and other parts of the world Part III will describe the planning process for progressive disasters and include response algorithms and checklists. Part IV will handle humanitarian and mental health problems commonly encountered in disaster areas. Part V will deal with team work and communication both critical topics when handling catastrophes and mass casualty incidents. This new book will be a comprehensive tool for healthcare professionals and managers and should perform demonstrably better in sales and downloads. It will be of value at the pre-hospital as well as the hospital level, to plan and respond to the majority of catastrophes and mass casualty incidents.

The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.

The bloodstains are gone, but the worn floorboards remain. The doctors, nurses, and patients who toiled and suffered and ached for home at the Army of the Potomac's XI Corps hospital at the George Spangler farm in Gettysburg have long since departed. Fortunately, what they experienced there, and the critical importance of the property to the battle, has not been lost to history. Noted journalist and George Spangler farm expert Ronald D. Kirkwood brings these people and their experiences to life in "Too Much for Human Endurance": The George Spangler Farm Hospitals and the Battle of Gettysburg.Using a large array of firsthand accounts, Kirkwood re-creates the sprawling XI Corps hospital complex and the people who labored and suffered there--especially George and Elizabeth Spangler and their four children, who built a thriving 166-acre farm only to witness it nearly destroyed when war paid a bloody visit in the summer of 1863. Stories rarely if ever told about the wounded, dying, nurses, surgeons, ambulance workers, musicians, and others are weaved seamlessly through gripping and smooth-flowing prose.A host of notables spent time at the Spangler farm, including Union officers George G. Meade, Henry J. Hunt, Edward E. Cross, Francis Barlow, Francis Mahler, Freeman McGilvery, and Samuel K. Zook. Pvt. George Nixon III, great-grandfather of President Richard M. Nixon, would die there, as would Confederate Gen. Lewis A. Armistead, who fell mortally wounded at the height of Pickett's Charge. In addition to including the most complete lists ever published of the dead, wounded, and surgeons at the Spanglers' XI Corps hospital, this study breaks new ground with stories of the First Division, II Corps hospital at the Spanglers' Granite Schoolhouse.Kirkwood also establishes the often-overlooked strategic importance of the property and its key role in the Union victory. Army of the Potomac generals took advantage of the farm's size, access to roads, and central location to use it as a staging area to get artillery and infantry to the embattled front line from Little Round to Cemetery Hill and Culp's Hill, often just in time to prevent a collapse and Confederate breakthrough."Too Much for Human Endurance," now in paperback, introduces readers to heretofore untold stories of the Spanglers, their farm, those who labored to save lives, and those who suffered and died there. They have finally received the recognition that their place in history deserves.