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Morgue Operations in Mass Fatality Incidents

Morgue Operations in Mass Fatality Incidents. What is a mass fatality event What is your prime federal resource Purpose of morgue operations Recovery Mobile morgue Refrigeration Antemortem data collection Security Cemetery operations No infrastructure situations. Technological Accident.

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Morgue Operations in Mass Fatality Incidents

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  1. Morgue Operations in Mass Fatality Incidents

  2. What is a mass fatality event What is your prime federal resource Purpose of morgue operations Recovery Mobile morgue Refrigeration Antemortem data collection Security Cemetery operations No infrastructure situations

  3. TechnologicalAccident

  4. Terrorist Act

  5. Human negligence

  6. Acts of Nature

  7. Mass Fatality Incidents Simply put – they are simultaneous multiple deaths which: • Overwhelm local resources • Require outside professional and logistical help

  8. DisasterMortuaryOperationalResponseTeams

  9. DMORT U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR) Office of Emergency Management (OEM) National Disaster Medical System (NDMS)

  10. What can DMORT do? Recovery Expertise Postmortem Examinations Antemortem Data Collection Victim Identification Custodial Management

  11. Activated through Federal disaster declaration (Stafford Act) Aviation Disaster Family Assistance Act Memorandum of Understanding (MOU) Public Health Act

  12. Morgue Operations In Mass Fatality Incidents

  13. Medical Examiner/Coroner is in charge of human remains

  14. Role of Morgue Operations • To receive, • Identify, • Determine manner and cause of death, • Possibly prepare for final disposition, • And return decedents to their next of kin, • In the utmost dignified and professional manner possible.

  15. Team Management Team Commander Deputy Team Commander Administrative Officer Forensic Personnel Pathologist Odontologist Dental Assistant Anthropologist Fingerprint specialist Photographer/videographer Morgue Personnel Mortuary Officer Body tracker Xray technician Medical records technician Supply officer Support Personnel Mental Health/CISD Specialist Communications manager Safety Officer Equipment operator Team Physician/PA/Nurse Security officer Computer operator Morgue personnel positions

  16. Morgue Operations • Should be simple • Standard stations for documentation, examination, and release • Success relies on teamwork and focus on consistency in documentation and examination • Morgue organization and flow is modified to meet the needs of the disaster

  17. Morgue Flow • Morgue flow depends on • condition/completeness of the remains • morgue facility/layout • Modular system allows flexibility for the incident and the incident morgue

  18. Morgue Flow Remains Documentation Photography Body/remains radiography Personal Effects Body/Remains Storage Remains Triage Admitted,Number assigned Family Assistance Center Antemortem data collection DNA reference sample collection Postmortem Data Collection Autopsy/Pathological exam Anthropological examination Fingerprint examination Dental examination DNA specimen collection VI data entry Identification Section Compares antemortem and postmortem information Family notification Release

  19. Identification Method postmortem information antemortem information comparison Unique biological information identification

  20. Positive ID Methods DNA Finger/Foot Print Odontology Pathology/Medical Implants, medical devices Radiology Fractures Bone pattern Exclusion Presumptive ID Methods Personal Effects Portable Visual Grief Tattoos, body piercing Common now Identification Methods

  21. Incident Morgue • Located as close to the scene as possible • Hot and cold running water, showers, restrooms and appropriate drainage • Heat/air conditioning and ventilation • Electricity • Parking, communications capability, space for privacy and breaks • Capable of being secured

  22. Possible Incident Morgue Sites • Coroner/ME Office • Hangars • Warehouses • National Guard armories • Portable buildings/tents

  23. Incident Morgue St. Gabriel, LA Town Hall, Former School, Warehouse

  24. Incident Morgue Carville, LA Custom Built

  25. Recovery

  26. Disaster Portable Morgue Unit

  27. DPMU • Contains all major components for identification and return of human remains

  28. DPMU • Portable modular morgue • Equipment for forensic disciplines • Support equipment • generators, hot water heaters, sinks, telephones • Site search/recovery equipment • Computers for administrative support

  29. Containerized and palletized Transportable by truck or plane Mission ready at all times DPMU Features

  30. 8000 sq ft facility Non porous flooring or disposal flooring Two 400-600 sq ft offices Rest rooms Water source Electrical feed 110 volt 300 amps total Drainage 8000 lb forklift 6 ft forks 10’x10’x10’ 2000 lb forklift inside facility Tractor trailer accessible site DPMU requirements

  31. Partitions and supports Electrical/plumbing Information Resources Family Assistance Center Morgue Operations Admitting / Triage Photography Personal Effects Personal Protective / Biohazard Equipment Anthropology Odontology Fingerprint Radiology Dental X-Ray Full Body X-ray Pathology Embalming Casketing and Release DNA Credit Card DPMU Section Equipment

  32. Refrigeration

  33. Refrigeration

  34. Family Assistance Center • Provide comfortable place for families to gather • Away from disaster site • Easily accessible • Easy to find • Provide creature comforts to family • No media in closed areas

  35. NTSB FBI SEMA FEMA ME/Coroner DMORT/mortuary Insurance representatives Police agencies Red Cross Salvation Army Clergy organizations Counseling organizations Political representatives Company representatives Others Agencies at the FAC

  36. Mortuary Functions atFamily Assistance Center • Conduct interviews for antemortem data collection • Collect DNA reference samples • Notification of positive identification to survivors through the medical examiner/coroner • Coordinate release of remains to next of kin

  37. Information Resources

  38. Victim Identification Program • Computer program to coordinate: • Antemortem data collection • Postmortem data collection • Identification reports • Body tracking • With dental identification package

  39. Victim Identification Program • Antemortem section • Interview form • Track identifying characteristics • Provides reporting for: • Morgue Section Leaders • Local Authorities (Coroner/ME, EMA) • Federal Authorities (NTSB, FBI, FEMA) • Provides reports on: • Age/Sex data • Unique biological/personal features • Scars, tattoos, surgeries, implants • Personal effects/jewelry

  40. Victim Identification Program • Postmortem section • Provides section forms to be completed during operation • Collects postmortem findings from all sections • Provides long term storage for collected data • Including digitized photos and x-rays

  41. Victim Identification Program • Data Comparison • Compare antemortem and postmortem identifying characteristics • Dental program compares the teeth • Neither program makes an identification

  42. Operational Security • Protect your outer perimeter • Secure your inner perimeter • What happens in the morgue, stays in the morgue • Allow no unauthorized photographs • Restrict access to morgue workers only

  43. Cemetery Operations

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