Fire and EMS Response to Mass Fatality Incidents

Some jurisdictions could easily handle five to 10 fatalities while others would be quickly overwhelmed.

Fire and EMS agencies can effectively manage one or two fatalities and do so on a regular basis due to the events that occur every day in our communities. What happens when you are faced with numerous fatalities due to a major incident?

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 five to 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.

A mass fatality event can occur during several types of incidents including transportation incidents, industrial accidents, severe weather or 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 use of the Incident Management System (IMS) and Unified Command (UC) will be crucial to an effective response and recovery.

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. These types of 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 will put a tremendous strain on the responders and the system. These situations can create severe economic, environmental, and emotional impacts on responders and the community. In the past, public safety agencies have successfully planned and trained for mass casualty incidents. 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.

Hazard Assessments & Pre-Planning

Your benchmark notifications should be addressed in your local guidelines and procedures. Another important 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? Is there major industry? Large scale planned events? 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 planning for this type of event will include: emergency management, law enforcement, emergency medical services, medical examiners/coroners, funeral directors, fire service, hospitals, 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. Your local emergency management offices are a good resource to assist in this process as many OEM offices maintain an extensive "Resource Guide". How many fatalities can the local morgues 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 agreements? How can I notify these resources?

Response Operations

Your first indication of an event may come with the initial 911 calls and dispatches. Is there a high-impact plane crash with 45 "souls on board", a severe bus accident with numerous injuries, a massive tornado in a populated area 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 commanders must quickly decide if the event meets the "benchmark" criteria of a mass casualty or mass fatality response.

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