Medical communications associated with a collision between a passenger train and three locomotives which resulted in the death of 16 and injury to at least 177 persons quickly overwhelmed the relatively sophisticated EMS communications center (SYSCOM) serving the state of Maryland, U.S.A. Other than traditional talk-by and ambulance-hospital communications, the system was saturated by: 1) communications between seven prehospital sectors; 2) persons moved into the field from their usual in-hospital environment who were not familiar or experienced with the use of radio communications; 3) traffic generated through the operations of 11 helicopters; and 4) the usual confusion that accompanies such events. The use of cellular telephones during this incident, substantially enhanced all levels of communications. Many of the participants expressed preference for this form of communications compared to the use of radios.

Problems associated with the use of cellular telephone communications included an insufficient number of channels made available by the telephonecommunications provider causing competition with non-essential personnel for use, and relatively short battery life. These problems can be solved by the provider opening more channels and by the use of larger power sources such as automobile storage batteries. It is concluded that portable and vehicle-mounted cellular telephones can serve as useful communications tools in mass casualty and disaster situations.