Mass Disaster - Definition, classification, Objectives, Management, NMDA, TNSDMA

1. MASS DISASTER

2. MASS DISASTER
• The WHO has defined disaster as an occurrence that
causes
• Damage
• Ecological Disruption
• Loss Of Human Life
• Deterioration Of Health And Health Services
on a scale sufficient to warrant an extraordinary
response from outside the affected community.

3. MASS DISASTER
• A "Mass Disaster" is considered to have occurred when the
number of casualties occurring in a single event exceeds
twelve.
• It is the number of deaths that exceeds the capacity of
local death investigation system to handle it.

4. Mass Disaster - Classification

5. Mass Disaster
Natural Man-made

6. Natural
Non-biological Biological

7. Natural Non-biological

8. Natural Non-biological
EARTHQUAKE
CYCLONE
LANDSLIDE
FLOOD

9. Natural Non-biological
• Earth Quake
• Cyclone
• Flood
• Drought
• Heat Wave
• Volcanic Eruption
• Landslide
VOLCANIC ERUPTIONS
DRAUGHT

10. Natural Biological

11. Natural Biological
DISEASE EPIDEMIC
MASS POISONING
(FOOD/LIQUOR)

12. Natural Biological
• Disease epidemic
• Mass poisoning (food/liquor)

13. Mass Disaster
Natural Man-made

14. Man Made Disasters
• Accidental
• Industrial
• Civil disturbances
• Warfare

15. Accidental
• transportation (road, rail, sea, river, and air), building collapse, mining
accidents, dam-bursts, food poisoning, fires.
Transportation Building Collapse

16. Mining accidents Fire accidents

17. Industrial
• fires, explosions, leakage of toxic substances/gases.

18. Civil disturbances
• riots and demonstrations.

19. Warfare
• Conventional (bombardment, exchange of fire, shelling)
• Non-conventional (nuclear, biological and chemical
warfare, terrorism).

20. Management
• It is primarily a teamwork of the civil administration and its
agencies on one hand and a multi-disciplinary medical task
force usually comprising of clinicians, nurses, paramedical
staff, odontologists, radiologists, forensic scientists,
mortuary assistant, and funeral officials, etc., on the other
hand
• Resources of the Armed Forces may be called-in to reinforce
efforts.
• Over the past couple of decades, many countries have
established protocols for the management of disasters, often
with the setting up of Disaster Victim Identification (DVI)
teams. ’

21. Management
• Indian Government also constituted the National
Disaster Management Authority
• This authority aims at bringing about a change in
orientation from a relief-centric approach to a
holistic multi-disciplinary and multi-sectoral
approach.
• Protocols need be ‘simple and flexible’

22. Objectives in a Mass Diaster
• Retrieval, reconstruction, examination and early
disposal of the bodies
• Establishing identity.
• Conducting autopsy, wherein practicable, and to
establish the cause of death.
• Seeking evidence in the form of some foreign
material/ fragment (of bomb or detonator) that may
be embedded in the bodies

23. Objectives in a Mass Diaster
• First stage - at the accident site
• Second stage- in the mortuary
• Third stage-comparison of records:

24. First Stage - At The Accident Site
• Isolation, Demarcation and Protection
• Identification and Investigation
• Management of Survivors

25. 1. Isolation, Demarcation And
Protection
• Isolation, demarcation and protection of the site by
the security cordon and entry of the team through
some predetermined route.
• Involvement of by-standers and other officials need
be checked.

26. 2. Identification and
Investigation
• In accidental cases, identification of the individual
may contribute towards cause of the accident in case
the deceased had the history/record of having some
pre-existing disease or some toxicological problem.
• Visual recognition may not be helpful because of
severe disfigurement (due to trauma, burning or
decomposition, etc.).
• Belongings can be helpful and may include
clothing, jewellery, and personal documentation.

27. 2. Identification and
Investigation
• Clothing found on a body can be of great value in
establishing identity but must not be accepted as a
positive proof in isolation.
• The corpse needs be searched and undressed very
carefully
• Jewellery being relatively fire-resistant can be very
helpful, especially when some unusual and strongly
identifiable fragment is available.
• However, it being secondary evidence must not
always be assumed that the item belongs to the
deceased or will be recognized by relatives.

28. 2. Identification and
Investigation
• Personal documents carry potential value but again,
being secondary evidence, should not in their own be
used to assume the identity of the deceased.
• The compact and protective way of carrying documents
can often afford a great protection from fire and water,
and every tiny fragment can be useful and therefore be
handled with care.
• Medical and X-ray evidence may contribute or
confirm identification.
• Clearly, the more unusual the medical or postsurgical
condition is, the more positive will be the identification
of the body.

29. 2. Identification and
Investigation
• Odontology has proven to be very helpful, especially
when fire or putrefaction has destroyed the soft tissues.
Obviously, the method needs obtainable dental records.
• Fingerprinting is another method of personal
identification with well-established criteria for
reliability. Obviously, fingers or fingerprints may be
destroyed in the event of fire or severe mutilation.
• It is for this reason that some recommend retaining of
heel print records too, the heel being relatively better
protected from fire or decomposition by shoes or boots.

30. 2. Identification and
Investigation
• DNA-profiling has been shown to be of great value
in identifying a wide range of human fluids and
tissues
• It is chiefly because DNA molecules remain highly
stable in stains, are present in virtually all human
cells and are extremely polymorphic.

31. 3. Management of Survivors
• Establishing a System Of Triage to determine
priority for evacuation is the need of the hour.
• Colour-coded tokens may be hung around the neck
of the injured.

32. 3. Management of Survivors
The colours recommended are the
following:
• Category Black - survival not
likely
• Category Red - requiring
resuscitation and emergency
lifesaving surgery,
• Category Yellow - requiring
possible resuscitation and early
surgery,
• Category Green -less serious injury
not endangered by delay

34. Objectives in a Mass Diaster
• First stage - at the accident site
• Second stage- in the mortuary
• Third stage-comparison of records:

35. Second stage- in the mortuary
• External
• Internal

36. Second stage- in the mortuary
Note state of body-entire, mutilated or fragmentary
remains.
For each unknown remains, as well as for multiple
remains, prepare photographs, diagrams and tables
for comparison between the unknown and known
features.
Note presence or absence of P.M. changes.
Note injuries-size, site, number, nature, age, and
special features, if any.

37. • Examine for comparison with medical records
eyeglasses, including frames and lenses
• Review reports of missing persons, statements of
witnesses and relatives in mass disaster situations
and content of passenger manifests provided by
representatives of airlines, bus, train, etc. following
aircraft accidents.
• Examine, describe, record, and photograph the
clothing and other physical evidence.
• Describe the size, colour, condition, and type of
each garment.
• Record descriptions of laundry marks, labels, and
name tags.

38. • Examine personal effects, such as rings, watches,
belt buckles, and bracelets for engraved markings
• Determine if keys found on the remains provide
access to the home or vehicle of the missing person.
• Obtain fingerprints for comparison.
• Remove and examine dentures if present.
• Examine teeth for comparison with antemortem
dental records and X-rays.
• Age can be determined by examination of ground
sections of teeth.
• Examine denture for name and identification
number.

39. • Examine skeletal remains to determine race, sex,
age, evidence of prior disease or injury, etc.
• Occupation marks, moles, tattoos, operation scars,
congenital defects, pre-existing disease, old injuries
and fractures.
• Radiological examination of entire body for foreign
bodies, which is particularly useful in mutilated
bodies.
• Compare hair with known hair.
• Confirm gross pathological findings by microscopic
examination.
• Determine the age of antemortem injuries.
• Establish and maintain a chain of custody for
physical evidence.

40. Second stage- in the mortuary
Internal:
• Stage of putrefaction of internal organs.
• Surgical removal of any organ carried out in life.
• Evidence of preexisting disease. Nails, plates, etc. due
to surgery.
• Nature, extent and degree of organ injury.
• Evidence of organic disease causing sudden death such
as coronary occlusion, cerebro-vascular accident, etc.
• Evidence of poisoning.
• Presence of foreign bodies.

41. Specimens to be collected and preserved.
The exact specimen required to be collected would
depend on the nature of the disaster.
They could be:
• Clothes if charred or blood stained.
• Foreign bodies.
• Viscera, blood and urine for chemical analysis.
• Obtain blood for grouping, Rh typing, sex chromatin,
karyotyping and DNA tingerprinting, alcohol, drugs,
CO, etc.
• Retained products in stomach.
• Internal organs for histopathological examination.

42. Third Stage-Comparison Of
Records
• Compare all evidence collected with information
made available by relatives and establish the
identity of the deceased.
• It is essential that record of all medical and dental
examination including X-ray films be filed for
future reference.

43. National Disaster
Management Authority
(NDMA)

44. National Disaster Management
Authority (NDMA)
• The National Disaster Management Authority
(NDMA), headed by the Prime Minister of India, is
the apex body for Disaster Management in India.
• Setting up of NDMA and the creation of an enabling
environment for institutional mechanisms at the
State and District levels is mandated by the Disaster
Management Act, 2005.
• NDMA is mandated to lay down the policies, plans
and guidelines for Disaster Management. India
envisions the development of an ethos of
Prevention, Mitigation, Preparedness and Response.

46. National Disaster Management
Authority (NDMA)
NDMA Vision
• "To build a safer and disaster resilient India by a holistic,
pro-active, technology driven and sustainable development
strategy that involves all stakeholders and fosters a culture of
prevention, preparedness and mitigation."

48. Functions and Responsibilities
• NDMA, as the apex body, is mandated to lay down the
policies, plans and guidelines for Disaster Management
to ensure timely and effective response to disasters.
Towards this, it has the following responsibilities:-
• Lay down policies on disaster management.
• Approve the National Plan.
• Approve plans prepared by the Ministries or
Departments of the Government of India in accordance
with the National Plan.
• Lay down guidelines to be followed by the State
Authorities in drawing up the State Plan.

49. Functions and Responsibilities
• Lay down guidelines to be followed by the different
Ministries or Departments of the Government of
India for the Purpose of integrating the measures for
prevention of disaster or the mitigation of its effects
in their development plans and projects.
• Coordinate the enforcement and implementation of
the policy and plans for disaster management.
• Recommend provision of funds for the purpose of
mitigation.

50. Functions and Responsibilities
• Provide such support to other countries affected by
major disasters as may be determined by the Central
Government.
• Take such other measures for the prevention of
disaster, or the mitigation, or preparedness and
capacity building for dealing with threatening
disaster situations or disasters as it may consider
necessary.
• Lay down broad policies and guidelines for the
functioning of the National Institute of Disaster
Management.

51. TamilNadu State Disaster
Management Authority
(NDMA)

54. THANK YOU