Introduction to Mass Casualty and Mass Fatality Response and Practices: 1st Edition (Hardback) book cover

Introduction to Mass Casualty and Mass Fatality Response and Practices

1st Edition

By Michael Louis Madigan

CRC Press

264 pages

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Hardback: 9780367230067
pub: 2019-07-03
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Description

This book covers both Mass Casualty and Mass Fatality and has been prepared for anyone who wants to know about the process, procedures, and management associated with it. The book details the responsibility to protect the public and is based on the latest emergency education information and physical research on what happens in disasters.

The book offers a step-by-step emergency management process and discusses the purpose of having such a process in place. It describes what the four pillars of emergency management are, and includes how to assess the risk, the crisis, the consequence, and the vulnerability. The book also includes cyber threats.

This book will assist emergency managers, department of defense, fire services, law enforcement, EMS, local, state, and federal governments, and those new to the field, by giving them a step-by-step process to follow and guide them to understanding what emergency management is.

Features

  • Offers a step-by-step emergency management process
  • Discusses the purpose of having an emergency management process in place
  • Describes what the four pillars of emergency management are
  • Covers the methods and requirements of how to apply the management process
  • Illustrates how to develop, practice, and maintain emergency plans that reflect what must be done before, during, and after a disaster

Table of Contents

Table of Contents

Dedication 11

Preface 12-16

Introduction 17-19

Author Biography 20-21

Chapter 1 Mass Casualty 22

Mass Casualty Incident 22

Declaration 22

Initial Size Up 23

Scene Size Up 23

M.E.T.H.A.N.E. 24

Agencies & Responders 24

Emergency Medical Services 24

Fire & Rescue 25

Public Safety 25

Specialized Teams 26

Public Services 26

Hospitals 27-28

Mass Casualty Decontamination Line Flow 29

Triage 30-32

Treatment 32-33

On-Site Morgue 33

Transport 33-34

Definitive Care 34

Interim-Care Center 34-35

Mass Casualty Event 35

Demobilization 35-36

Activating a Mass Casualty Response 36

Size-Up 1 36-37

Size-Up 2 37-38

Pre-Response Element Set-up 38-39

Functional Areas 40-41

Functional Roles 42-44

Mass Casualty Demobilization 45

Summary 46

 

 

 

 

Chapter 2 Decontamination for Mass Casualty/Mass Fatality Event 47

Decontamination 47

Methods 47

Mass Decontamination 48

Mass Hysteria & Security Aspects 48-49

Mass Decontamination Equipment 50

Contamination Run-Off Control 50

Functions of a Decontamination Activities 50

Usage 51

Types of Contamination 52-53

The Effects of Contamination 53-54

Human Decontamination of Injured Victims 54-55

Hospital Decontamination of Injured Victims 56

Decontamination Exercises 56-60

Internal Human Contamination 61

Summary 61

Chapter 3 Civil Support Team Decontamination Operations 62

Decontamination Planning 63

What is the Terrain? 64-65

Decontamination of personal Protective Equipment 65-67

Decontamination Process 67-70

Casualty Decontamination 70-71

Casualty Decontamination Considerations 71

Site Layout 71-72

Mass Casualty Decontamination 72

Decontamination Procedures for Ambulatory Casualties 72-73

Prepare Hypochlorite Solution 73-76

Decontamination Site Clean-up 76

Summary 77

Chapter 4 Template Instructions for Mass Casualty Incident 78

Acknowledgement 79

Table of Contents 80

Overview 81

Purpose 81

Scope 82

Assumptions 82

Pre-Incident Training & Exercise Schedule 83

Supplies & Equipment 84

Activation 85

Authorization 85

Authorization to Activate 85

Notification 86

Coordinate Staffing & Prepare Staff for Activation 87-88

Deploy Supplies & Equipment 89

Hospital Command Center 89

Operations 89

Triage 89-92

Treatment 93-94

Security 94

Traffic Control 95

Internal Security 95

Law Enforcement 96

Patient Processing 96-97

Communications 98-99

At Risk Population 99-100

Family Information Center (FIC) 101

FIC Activation 101

Sample FIC Checklist 102

Mental & Behavioral Health 103-104

Staff Support Services 104

Transition 104

Authority to Transition 105

Notify Stakeholders 106

Transition of Operations 107

Appendices 108

Chapter 5 Triage 110

Triage 110-111

Triage Types 111

Simple Triage 111-112

Triage Tags 112

Advance Triage 112-114

Continuous integrated Triage 114-115

Reverse Triage 115

Under Triage & Over Triage 115

Outcomes 116

Palliative Care 116

Evacuation 116

Alternative Care Facilities 116

Secondary (In-Hospital) Triage 117

Specific System 117

Practical Applied Triage 117-118

Scoring System 118

S.T.A.R.T. Model 119-120

Hospital Systems 120-121

Conventional Classification from Different Countries 121

Australia & New Zealand 122

Canada 122-123

Japan 124

Spain 124

United Kingdom 125

United States 125-127

United States Military 127-128

Limitations of Current Practices 129-131

Ethical Implications 132

Summary

Chapter 6 Guidelines for First Responders to a Mass Casualty CBRN Incident EURO-Atlantic Partnership Council (EAPC) 134

Introduction 134-135

Information Gathering Assessment & Dissemination 135

Scene Management 136

Saving & Protecting Life 136

Additional Specialist Support 136-137

Chart 6.1 Information Gathering 137-138

Chart 6.2 Scene Management 138-139

Chart 6.3 Saving & Protecting Life 140

Chart 6.4 Additional Specialist Support 141-143

Summary 143-144

Chapter 7 Mass Fatality 145

Mass Fatalities Main Categories 145

Significant Mass Fatality Incidents 146

Response Functions 147

Mass Fatality Management Resources 148-149

Disaster Mortuary Operations Response Teams (DMORT) 150

DMORT Organizations 150-151

Identification of Remains 151-152

Disaster Mortuary Operational Response Team (DMORT) 152-153

Disaster Medical Assistance Teams (DMAT) 153-154

Disaster Portable Morgue Units (DPMU) 154-155

National Nurse Response Team (NNRT) 155-156

National Pharmacy Response Teams (NPRT) 157-158

Veterinary Medical Assistance Teams (VMAT) 158-159

Critical Infrastructure Protection 159-160

Sector Vision Statement 160

Healthcare & Public Health Sector Specific Plan 160-161

Logistics 161

Operations 162

Secretary’s Operation Center 162

Response Operations 163

Training Exercise & lessons Learned (TELL) 164

Preparedness Planning 164-165

Manmade Disasters 165-166

Natural Disasters 166-169

Summary 170

Chapter 8 Mass Fatality Planning 171

Mass Fatality Management 171

Mass Fatality Checklist 171

Mass Fatality Management Plan Template 172

Overview 172

Plan Maintenance 173

Activation 174-175

Operations 175-176

Demobilization 176

Public Information 177

Liaison Officer 177

Operations Section 177

Planning Section 177

Logistics Section 178

Chart 8.1 Example Complex Mass Fatality Operation 178

Mass Fatality management Adherence 179-180

Local Agencies/Jurisdictional Support 180

Summary 181

Chapter 9 Mortuary Logistic Challenges of a Mass Fatality Incidents 182

The Complex Problem 182-184

Decedent Remains Planning & Educational Resources 184-185

Table 9.1 Possible Options for Mortuary Operations 185

Summary 186

Chapter 10 Defense Support to Civil Authorities (DSCA) 187

Defense Support to Civil Authorities (DSCA) 187

Military Aid to Civil Power 187-188

DSCA Authority 188

DSCA Activation 189

FEMA 190

DSCA History 190-191

Summary 191

Chapter 11 General Guidelines for Hospital Mass Casualty/Mass Fatality Decontamination 192

Procedures 193

General Procedures 5 steps process 193

Step 1 Set up Decontamination & Support Areas 193

Decontamination Corridors 194

Decontamination System Design 195

Safe Refuge/Observation Area 195-196

Medical Triage 196

Step 2 Conduct Decontamination Triage 196-197

Step 3 Decontaminate Victims 197

Steps to take while Victims are waiting 197-198

If contamination is involved 198-199

Step 4 Segregate Victims for Observation/Treatment 199-200

Step 5 Release Victims 200

Cold Weather Observation 200-201

First Responder Considerations 201

Exiting the Hot Zone 202

Infant/Children & Adolescent (Pediatrics) Considerations 202-203

Elderly, Pregnant Women & People with Chronic Conditions 203

Recent Planning Guidance 203-204

Summary 204

Chapter 12 Animal Decontamination: Natural and Manmade

Animals & Disasters

Animals & Disasters Concerns

Owners Concerns for Animals

Animal Care & Incident Management 1

Animal Care & Incident Management 2

Emergency Operation Plans & Animals

ESF#11 Agriculture & Natural Resources

Safety & Well-Being of Household Pets

Response Policies

Disaster Readiness

Farms & Natural Disasters

Protection: Veterinary Care

Response: Disease

Response: Hazardous Materials

Summary

Animal Decontamination Flow Chart

Case Study 1 Mass Casualty Management (RANA Plaza Tragedy) 205-207

Case Presentation 207

Case Study 1 Table 1 Patient Matrix Emergency Room 207

Hospital Resources/Execution of Services 208-209

Case Study 1 Table 2 Surgical Operative Procedures 210

Case Study 1 Figure 1 Patterns of Anesthetic Procedures 210

Discussion & Evaluation 211-214

Summary 214

Case Study 2 Mass Fatality Tsunami Disaster on 26 December 2004, Thailand, Indonesia 215

Methods & Findings 215-216

Background Information 216

Purpose of this study 217-218

Case Study 2 Table 1 Estimated Casualty/Fatality 218

Body Recovery & Storage 219

Case Study 2 Table 2 Number of Bodies Buried 219-220

Identification of Victims 220

Coordination & Preparedness 221

Discussion of Actions 221

Storage, Identification & Burials 222

Coordination & Preparedness 222

Summary 223

Case Study 3 Mass Casualty Event Involving CBRN Incidents 224-225

CBRN Challenges 225-226

Decontamination Considerations 226

The Principles of Decontamination 227

Responding to a CBRN Event 227

Scene Management 227-228

CBRN Casualty Management Zones 228-229

Personal Protective Equipment 229-230

Hazard Monitoring Strategies 230

Mass Casualty Triage 231

Triage Zones 232

Onsite Triage Zones (Level 1) 232-233

Medical Triage Cold Zone (Level 2) 233

Evacuation Triage & Loading Zone (Level 3) 234

Triage Tagging 234-235

Example Triage Tags 235

Summary 236

Lessons Learned 1 Challenges of the Management of a Mass Casualty Event 237

Introduction of the Event 238

Methodology of the Event 239

Results of the Event 239

Mechanisms of the Injuries Table 1 240

Body parts Injured Table 2 241

Challenges Encounter Table 3 242-244

Lesson Learned & Discussion of the Event 244-250

Summary 251

Lesson Learned 2 International Lessons to Improve Mass Casualty/Fatality Management 2008 252

Table of Contents 252

International Lessons to Improve Mass Casualty Management 252

Pandemic Influenza Event December 2008 252

Abstract of the Event 253

Introduction 254-255

Methodology 255

Specific Objectives & Analysis 255-257

Analysis review of the Mass Casualty/Fatality Events 257

Lesson Learned 2 Table 1 Largest Mass Fatality Events 258-259

Major Events Selected & Key Reviews 259

Lesson Learned 2 table 2 Major Events Examined 260-261

Lesson Learned 2 Table 3 Successes & Failures 261-263

Lesson Learned 2 Table 4 Lesson Identified 264-265

Review of Benchmark Countries 266

Lesson Learned 2 Table 5 Mass Fatality Management (MFM) Operation 266-268

Lesson Learned 2 Table 6 National MFM Documents Accessible on the Internet 269

MFM Planning in the Unites States 270

Lesson Learned 2 Table 7 State & Territory Mass Fatality Management 270

Summary 271-272

Lesson Learned 2 table 8 Mass Fatality management Planning 272

Appendices 1 Acronyms 273

Appendices 2 Questionnaires 273-274

Mass Casualty Challenge Scenarios Questions 277-283

Answers to Scenario Questions 284-288

Glossary 289-324

Bibliography 325-336

About the Author

Michael Madigan is a master instructor for the Department of Homeland Security for Mass Casualty & Mass Fatality process, procedures, and management to include the Civil Support Teams and Hazardous material emergency response operations on weapons of mass destruction, installation emergency management, and threat assessments to the United States Army Chemical, Biological, Radiological and Nuclear School (USACBRN) on Fort Leonard Wood in Missouri. He is also retired from the United States Army and served as a senior chemical operation specialist to the USACBRN School, CENTCOM, and the Multi-National Forces Command (MNFI) in IRAQ. Mr. Madigan is also a certified fire instructor Level II, hazardous material technician train the trainer, incident command system train the trainer, installation emergency management instructor, WMD/terrorism response instructor, certified ICS/NIMS instructor, and advanced chemical biological instructor.

Subject Categories

BISAC Subject Codes/Headings:
POL037000
POLITICAL SCIENCE / Political Freedom & Security / Terrorism
SOC040000
SOCIAL SCIENCE / Disasters & Disaster Relief
TEC007000
TECHNOLOGY & ENGINEERING / Electrical
TEC017000
TECHNOLOGY & ENGINEERING / Industrial Health & Safety