Mass Fatality Response for Fire/EMS

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.


Throughout the response we must remember that it is important to remember reverence for the dead and compassion for the living. There are numerous considerations in this type of event that will need to be addressed as soon as possible The deceased must be left in place until released by the Medical Examiner/Coroners office. The event may also be a crime scene or part of a major investigation and must be treated as such at all times. Scenes are usually videotaped and photographed with bodies in place as a minimum. Also many mass fatality incidents will also be involved with criminal and civil proceedings at a later date.

Bodies and body parts can be scattered everywhere. There could be numerous burned victims. Fatalities could be women, men, elderly and children. Could be a crime scene that covers several square blocks. All bodies, body parts and personal effects will need to be documented. Responders must not touch or move these items unless advised. There is an organized process that will be used to effectively manage these types of events. The quicker the process is completed and the deceased identified, the quicker the healing process can begin for the community.

These events are usually always designated as biohazard areas, requiring the proper amount of PPE (personal protective equipment) and safety guidelines. Your planning must also take into consideration the weather/terrain and the fact that there could be spilled fuel, collapsed structures, confined spaces, building debris, glass, aircraft/vehicle parts, crime scene evidence, etc. scattered about. These issue may require additional safety procedures in place including decon for the living and dead, helmets, specialized teams, etc. This is one event that you MUST have an established an experienced Safety Officer designated in your command structure.

Fire and EMS will be tasked to stand by at the event. Also these agencies may be requested to assist with scene security, site surveys, body recovery and other tasks. These individuals must be asked if they can assist, not ordered. Once the deceased are recovered, the identification and processing process will begin. It is preferable for the normal morgue to be used for this process. If the numbers overwhelm local morgue capabilities then a secured temporary morgue area can be established. At this point it is highly recommended that you contact state and federal resources to assist in this event.

During a mass fatality event a large law enforcement response will be required. There will crime scene issues, investigation procedures, scene security, etc. Security will be a major issue at the scene and at the Family Assistance Centers (FAC), which will be opened to address the needs of the deceased friends and family members.

Resources

During a Mass Fatality Response some of the numerous items you may require consist of a large supply of body bags, disposables suits/gowns, gloves, booties, refrigerated trailers, light trucks, generators and professional removal/transport vehicles. Also the needs of an Incident Command Post, feeding services, latrines, temporary housing for responders, etc. You may be on your own for the first 6-12 hours before state and federal assets arrive on scene, except for planned local mutual aid resources.

One example of available resources in my home state is the North Carolina Chief Medical Examiners Office. They are available 24/7 to assist in a Mass Fatality Incidents with personnel and resources. They can notified though our local or state Office of Emergency Management. The NC CMEO has deployed to numerous high profile events across the state in the past twenty years. As part of your planning process it is important to identify these types of local and state resources that are available to assist your jurisdiction.

A federal resource available for assistance through the Department of Homeland Security (DHS) is the National Disaster Medical System (NDMS) Disaster Mortuary Assistance Team (DMORT). This is a Federal Level Response team designed to provide mortuary assistance in the case of a mass fatality incident or cemetery related incidents. Will work under the local jurisdictional authorities such as Coroner/Medical Examiners, Law Enforcement and Emergency Managers.

KEY POINTS TO REMEMBER

  • Situations will arise where the need to save lives overrides respect for the dead
  • Reverence for the dead
  • Treat dead with dignity/respect
  • The public is watching you