3. 1 - Definitions
2- Types of mass disaster
3- Magnitude of the problem
4- Disaster management plan
5- Triage
4. Disaster is an event of serious magnitude causing severe
damage to life and property. Loss of life of ten persons or
more may be considered as Mass Disaster
WHO has defined disaster as an event;
natural or man-made, sudden or progressive,
which impacts with such severity that the affected
community has to respond by taking preventive
measures.
7. Mass disaster could be of the following types:-
a) Natural – Floods, cyclones, earthquakes, drought
b) Accidents – Rail, Air, Road, Sea, fire
c) Industrial – gas leaks, explosions
d) Man made – riots, war, terrorist attack
8.
9. In the last decade more than 2.6 billion persons have
become casualties of natural disasters. Acute events such
as earthquakes, cyclones, heat waves, floods and severe
cold weather can result in significant numbers of
casualties.
An estimated 1.2 million person killed and as many as 50
million are injured each year in road crashes, of which a
large number are mass casualty incidents. Projections
indicate that these figures will increase by about 65%
over the next 20 years.
10. Unfortunately such disasters are becoming increasing
due to increase terrorism , expansion of travel facilities
, large size of means of passenger transport and bizzare
climatic conditions
11.
12. Include two main items
1- Preparation for disaster
2- Response to disaster
13. The effectiveness of the response for disaster is greatly
enhanced by regular training , exercise , continous
updating of the plan and modification of the plan
14.
15.
16. The investigation carried out by a well coordinated team,
such a team should
consist of:
1- Police service
2- Ambulance service
3- Fire service
4- Forensic examiners team
5- Social workers , volunteers
17. Forensic examiners team consists of
a. Forensic Pathologist
b. Forensic Odontologist
c. Finger print experts
d. Other experts, relevant to the nature of the disaster
18. The Disaster plan should have following
features:
• It should be simple and understandable by all.
• It should be flexible and fit in different types of
disasters.
• It should clear and concise
19. A temporary mortuary should be constructed with
facilities for refrigeration . Tables or make shift tables,
instruments, gloves, cotton, packing and labeling
materials, preservatives, disinfectants, antiseptic, whole
body size polythene bags or paper bags , sutures,
needles and additional supply of water and light etc.
Communication systems like telephones, computers,
internet
Adequate security arrangements should be there to avoid
secondary disaster
20. 1- Examination of the scene of disaster
2- Examination of the victim
3- Identify the cause of death
4- Assist in reconstruction of the cause of disaster
21. Ensure the following measures:-
a) Secure the disaster site
b) Prepare a sketch plan of the site, showing parts of the
wreckage and position of the bodies
c) Take photographs of the site.
d) Locate each body and label it with a “Mass casualty card”,
giving it serial number
Note: - Mutilated bodies and fragmentary remains should also
be labeled and numbered.
22. Search for blood stains , finger print , identity card
remains of explosive materials in case of explosions
The site may be required to be attached for radiological
examination which help in identification and detection
of foreign bodies impacted in clothes or inside the
body
23. 1- Clothes examination
2- Identification
3- Diagnosis of the types of injuries
4- Diagnosis of the cause of death
24. Clothes examined in details , photographed and takes the
same serial number of the victim and keep them in safe
custody for further identification by relatives
Personal properties such as identity card , any papers help in
identification . Jewelleries such as rings , ear rings may be
useful .
If the body is mutilated or burned jewelleries may be found
inside the body ex . Necklace in the thorax
25. Why identify remains ?
Three main reasons:
1.Help reconstruct the crime scene by determining
everyone that was present
2.For the official death certificate to be issued
requires positive proof that the remains were found and
identified
3.Giving the victim’s family members closure and
information
26. Any human remains should be collected and takes
serial number
The main identifying criteria
First option: Visual identification
Second option : General and Dental features
Third option : Fingerprint
Fourth option : Radiological examination
Final option : DNA fingerprinting
27. 1- Visual identification : useful in case of intact bodies
but is useless in case of mutilated , fragmented remains
and burned bodies
2- General and dental data :-
Age , sex , ethnic featuresa)
b) Height and Weight
28. c) Colour of eyes.
d) Hair : colour, length and other features with regard to
both scalp and body hair.
e) Special marks : scars, moles, tattoo marks , deformities
F) Dental data : complete and detailed dental data is to be
recorded. This will be of paramount importance in
establishing identify
this stageA Forensic odontologist may be coopted at
29. 3- Finger prints , Palm print , Foot print :
Compared with prints retained on criminal records or
files of armed forces
4- Radiological examination
Radiology help in identification of age of the individual
especially in children , sex , anatomical abnormalities as
cervical rib , metallic foreign bodies as prostheses , metallic
sutures .
If there is possibility of explosions or gun shot injuries
extensive radiology is used to identify such device and
material impacted inside the body
30. The best material is said to be muscle or the spleen and , if
decomposition is advancing, the bone marrow is
recommended. At least 0.5 g of tissue should be cut from
the parenchyma of an organ and placed in a small plastic
tube with no fixative or preservative. This should be frozen
at -20°C if there is likely to delay intransmission to the
laboratory then compared with samples taken from relatives
or with reference samples from the victim
31. 3- Diagnosis of the types of injuries : type , site ,
number
special character if present. Injuries differs according to
the type of disaster
32. a) According to gross post-mortem findings of majority
of bodies.
b) Study the special investigation results and correlate
with the morbid findings
c) Give opinion as to the cause of death based on the
above and nature of disaster
33. Medical opinion, in this regard can only be partial and
contributory to other investigations.
However, an opinion regarding the cause of disaster may
be given in the case of Airplane disasters, train mishaps
and vehicular accidents, based on the following data:-
a) autopsy findings of the body of pilot/driver
i. Evidence of organic disease, like coronary occlusion,
cerebrovascular accident or any other disease which
could produce sudden collapse or blunting of mental
faculties
34. ii. Evidence of poisoning due to alcohol or other
psychotropic drugs affecting higher mental functions.
iii. Evidence of gun-shot injuries. in case of air piracy
b) Nature of injuries of the victims.
Explosion injuries with evidence of retained explosive
material, suggest explosions
35. Triage is derived from Old French word “trier” which means
“to sort”
A process for sorting injured people into groups based on the
need for or likely benefit from immediate medical
treatment . Triage is used in hospital emergency rooms, on
battlefields, and at disaster sites when limited medical
resources must be allocated (The American Heritage
Dictionary)
37. :Green ( Minimal )
Ambulatory patients ( no impaired function, can self-treat
or be cared by non-professional )
Walking Wounded
Abrasions, contusions , minor lacerations etc.
Yellow ( Delayed )
Can wait for care after simple first aid
( I.e., wounds dressed, splints applied )
Clearly need medical attention, but should not
decompensate rapidly if care is delayed.
38. Red ( Immediate )
Critical ( seriously injured, but have a reasonable chance of
survival )
Obvious threat to life
Complications in their ABC’s
Black (Deceased or Expectant)
Expectant; This patient shows obvious signs of death.
–unresponsive patients with no pulse
–or with catastrophic head injuries and / or chest injuries.
