man made disaster. The more catastrophic the disaster, the more impacting it becomes on the community involved. It took over one year for New York to recover after September 11th, and just as long to locate all the victims' bodies. In response to this and other more recent disasters, President Obama initiated the National Health Security Strategy of the United States of America. In this proposal, ten objectives were given to ensure proper preparedness for any and every possible disaster scenario. It is the responsibility of the communities and local governments to implement the plan and ensure proper preparedness in the event of an emergency. One such example that requires exceptional organization on the part of nurses and medical staff is a plane crash in which proper primary, secondary, and tertiary prevention strategies are vital to the survival of the victims.

There are four primary prevention strategies that are necessary for emergency assistance and preparedness. Primary prevention strategies according to the CDC:

Primary prevention is the reduction or control of causative factors for a health problem and includes reducing risk factors -- such as smoking to prevent lung cancer or sex education to reduce sexually transmitted diseases -- and environmental exposures -- such as reducing ambient lead to prevent intellectual impairment. This category also includes health-service interventions, such as vaccinations or such preventive "therapy" tools as fluoridated water supplies or dental sealants.

In the case of a plane crash, the first primary measure that must be carried out is "Ensure that all systems that support national health security are based on the best available science, evaluation, and quality improvement." Modern studies have revealed the most common causes of death associated with a plane crash. This knowledge can aid medical staff in saving more lives. For instance, according to a study by Susan Baker, et al., the most common injury seen in a plane crash is lower limb fracture followed by head injury. Another study conducted by Guohua Li and Baker determined that the majority of fatalities in these crashes are the result of deceleration forces. This knowledge can and should empower further research and development into better seats on airplanes to prevent the injuries. Additionally, this information should prepare hospital staff for entry of those emergency victims to the hospital.

The next primary measure is "Ensure situational awareness." Medical staff entering the crash site must be prepared and aware of any dangers to them or continuing dangers to the victims. For instance, in aviation crashes between the years of 1991 and 1998, 41% of the deaths were related to carbon monoxide poisoning, as revealed in the carbon levels in the blood during autopsy. Measures such as this should translate to medical staff being prepared to remove victims as quickly as possible from the crash site and begin oxygen treatment.

The third primary measure is "Ensure timely and effective communications." It is imperative that ambulances, on scene staff, and hospitals remain in complete and constant communication so that victims can be efficiently transported to the nearest and most qualified hospitals.

The fourth primary measure is "Ensure prevention or mitigation of environmental and other emerging threats to health." Again, this measure plays into the first primary measure. Knowledge is power and the best way to protect passengers on airline flights is to review the data and begin researching and constructing better seating and safety harnessing on the airplanes.

The next level of prevention strategies are secondary strategies. Secondary strategies are those that "involve early detection and treatment, such as…