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Confined space medicine is practiced in areas with limited access and potentially decreased ventilation. The limited space is often secondary to the structural collapse of buildings from natural disasters such as earthquakes, hurricanes, or tornadoes. However, confined space medicine practices may be needed after a terrorist blast, fire, or poor building standards. The number of victims involved may vary, from a small number in a house collapse to a larger number in a mass-casualty event such as the 1995 bombing of the Alfred P. Murrah building in Oklahoma City, which resulted in 168 deaths, or the 2001 World Trade Center attack which resulted in over 3000 deaths.[1][2][3][4]