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A friend of mine was an EMT out in Arizona when the Sunset Limited was derailed by sabotage.  It went off the tracks in the middle of nowhere.  Literally.I don't know how the railroad got the word to emergency services, but I do know that the local fire departments and medics had a lot of rough country to traverse to get out there.  My friend told me that part of the problem was evacuating the injured, and coordination of assets.  There were several fire companies that got out there, and from what I understand, the entire west end of the Phoenix metro area was stripped of ambulances.  There was also a problem with medevac helicopters finding a decent place to land, I understand.  But a ground evac took 25 minutes to the nearest paved road.  It says something about a train that it can go off a track, injure dozens, but only have one person killed.  That's a big only, of course- but it could have been much, much, worse.
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