What is a Mass Fatality event?
Public safety agencies can effectively manage one or two fatalities and do so on a regular basis whether they are from traffic accidents, fires or homicides. But what happens when you are faced with numerous fatalities. A Mass fatality incident can simply be defined as: 'An incident where more deaths occur than can be handled by local resources'. Some jurisdictions could easily handle 5-10 fatalities while others would be quickly overwhelmed. This article is designed to provide an awareness level of understating of Mass Fatality events for Fire and EMS responders.
An event can occur from several types of incidents including transportation incidents, industrial accidents, severe weather/natural disasters, fires or acts of violence. These events can be very complex and intense events that require coordination and communications from multiple agencies. The Incident Management System (IMS) will be crucial to an effective response. A "mass fatality event" needs to be regarded as different from a "Mass Casualty Incident (MCI)". Also, throughout the event it is important to remember reverence for the dead and compassion for the living. "High-impact" incidents will generate a lot of media attention. This in turn will cause many well-meaning people and family members to respond directly to the scene. It must be remembered that this type of event will emotionally charge any jurisdiction and that the public will be following the response and recovery very carefully.
Mass Fatality events can create severe economic, environmental, and emotional impacts on responders and the community. This response will put a tremendous strain on the responders and "the system". In the past, Fire and EMS agencies have received training on Pre-Hospital Triage and have procedures and guidelines to address these issues. What happens when there are more fatalities than victims? Who in your jurisdiction is the lead agency in a mass fatality incident? What is the "benchmark" to declare a Mass Fatality incident? What then becomes the role of local responders? These are just a few items that need to be addressed in your planning.
Your benchmark notification should be addressed in your local guidelines and procedures. Another pre-planning step is to decide what types of events in your community could cause a mass fatality incident. Do you have an airport? Is a there major freeway running through your jurisdiction? What past events have occurred in your community: flooding, hurricanes, tornadoes, terrorism, etc.? All these issues should be addressed in a community hazard assessment. The countywide hazard assessment should be completed by all public safety agencies. Some of the key players in this type of event will include: Emergency Management, Law Enforcement, Medical Examiners/Coroners, Funeral Directors, Fire Service, etc. As you can see this type of event will require a tremendous amount of cooperation among many disciplines.
The next step in the pre-planning phase is to identify your resources available in your community to effectively manage the event. How many fatalities can the local morgue handle? What is the daily caseload of the local Medical Examiner? How quickly will the hospital system be overloaded? What resources are available locally and regionally through mutual aid? How can I notify these resources?
Your first indication of an event may come with the initial 911 dispatches. Is there a bus accident with numerous injuries, a high-impact plane crash with 45 "souls on board", or a mass shooting at a public location? These could all be triggers of a Mass Fatality event. During the initial "windshield survey" the Incident Commander must quickly decide if the event meets the "benchmark" criteria of a mass casualty or mass fatality response. Life safety is critical during the response but we also must remember reverence for the dead. At some point during the "response" the proper notifications must begin to prepare a proper mass fatality response. Your local Emergency Management Office is a valuable resource during this point in time. The response phase could be over very quickly and the recovery phase could go on for some time. After all living victims are removed, the fire is out, rescues completed, scene is secured, etc. the scene will switch from the "response" phase to the "recovery" phase. This is the point at which the complex components of a mass fatality incident begin.