Mass Disaster Management at scene

 Disaster is an event of serious magnitude, causing severe damage to life and property. Casualties numbering more than 10 individuals at given time and place is considered as ‘Mass Disaster’. This definition can be modified according to local criterias of a particular country or city.

 Types-

Role of Medical Man at the Scene

 Mass disaster management is basically a team work consisting of police, army, home guards, civil authorities and medical experts like Forensic pathologist, forensic odontologists, finger print experts ballistic expert etc. Forensic pathologist is responsible for proper investigation of such episodes comprising of:

1. Identification of the site of occurrence and prepare a sketch diagram showing geographical location.
2. Reaching the spot along with team and necessary equipment
3. Immediate isolation, demarcation and protection of the site.
4. Photography of the site from various angles i.e. forensic photography.
5. Identification of bodies as far as possible.

Identification from remains as achieved by the description for each person as follows-

[I]       Appearance – This is discussed under the following heads-

1. Complexion – A Description of colour, length and waviness of hair offers useful contributory evidence in identification.

1. Photograph – Photographs are helpful provided minute details are considered.
   1. Superimposition photography – If the skull of the deceased is x-rayed. The photographs of the front and side view of the head of the deceased taken while he was alive are enlarged to same size and are superimposed the negatives of skull to tally contours of the face and skull.
   2. Restoration of facial features – When skull is available it serves as a basis for modeling of soft parts of the face in clay and other plastic material.

[II] Clothing, Pocket contents and other personal effects-

Clothing itself and the clues in the clothing such as the maker’s tag, laundry marks or dyer’s mark help in identification of individual. The pocket contents like identity care, driving license, purse etc. offer good circumstantial evidence for identity. But these are not considered for absolute identification.

[III] Deformities, birth marks, occupational marks, scars and tattoo marks-

These may be helpful in the establishment of identity to a certain extent.

[IV] Race

If soft parts are available, the determination of race is possible on careful examination of clothes, complexion, hairs, eyes and lips. In absence of such data, if the remains are bones, it may be possible to determine the race from examination of the skull, mandible and teeth, and relative measurements of limb bones.

[V] Sex-

In case of mutilated remains, identity is simple when those parts bearing sexual characters are available. The normal non pregnant uterus resists putrefaction longer and its identification is proof of female sex. The prostate gland like-wise resists putrefaction and its presence indicates male sex. The general appearance of the parts, the disposition of the hair, the presence of hair on face, the presence or absence of mammae and any parts of the external genitals are helpful in identification of sex. When sexual characteristics of the soft parts are not available, the diagnosis of sex can be based on the characters displayed by the skeleton. The important bones for this purpose are pelvis, skull, mandible, sternum and long bones.

[VI] Age-

The age of an individual can be determined with a certain degree of accuracy from a combination of data provided by teeth, bones, height and weight and miscellaneous particulars like birth record, changes occurring at puberty and changes due to old age.

[VII] Stature-

If a complete skeleton is available, stature is determined by the length of the skeleton plus 2.5 cm for thickness of soft parts. If the body is mutilated, its stature is determined from the following data.

1. It is approximately equal to length from tip of the middle finger to the tip of the opposite middle finger when arms are fully extended.
2. From 20^th or 25^th year onward, stature is twice the length from the vertex or heel to the top of the symphysis pubis.
3. The height can be ascertained from one arm by multiplying its length by 2 and adding 34 cm.
4. The length of forearm measured from tip of olecranon process to the tip of middle finger is a equal to 5/19 of stature.
5. The length from the sternal notch to pubic symphysis is 1/3 of stature.
6. The vertical distance from the top of the head to the tip of chin is about 1/7 of stature.

[VIII] Finger prints, foot prints and tip prints

The safest and most accurate means of identification is by finger prints.

[IX] Miscellaneous Data

This relates to diverse information such as presence of disease, biliary calculi, renal calculi, uterine fibroid, appendecectomy scar, exceptional growth of hair, old fractures etc. which are very valuable for establishing identity.

F. Identifying and isolating cases according to seriousness of injuries merit wise for first aid and referral treatment by color coding system white and yellow ones with stripes for more serious and emergent cases..

G. Setting up of temporary mortuaries.

H. Proper scientific numbering and tagging of the dead bodies for future identification purpose by the relatives.

I. Arranging transport facilities both for dead and alive for treatment purposes to hospital or mortuaries.

J. Comparison of records.

I. Compare with the information and records furnished by the relatives and establish identity.

II. 7-8 points must tally.

III. Dental filling/Antemoretem record to be prepared with dental film.