Disaster Management will be incomplete without Emergency Mortuary Services.The primary responsibilities of the Emergency Mortuary services(EMS) is to help in Identifying fatalities and dispose of the remains,if needed depending on the type and enormity of the explosion more than one temporary morgue may me formed.

The Emergency mortuary services should continue till the last victim is identified.

The EMS Team Leader should maintain roster of his Office personnel, and volunteers who will assist in Disasters. The Members of the team should include Doctors with required

Qualification,Radiologist,Odontologist,Pathologist,technical and Administrative supporting Staff.

The Autopsy Surgeon:

A doctor(Government/nongovernment) with required PostGraduate qualification( Forensic Pathology) should be Leader of the Team along with Medical graduates as Members for assistance.

The Supporting staff:

The doctors should have required personnel,mortuary assistants,technicians,clerks,photographer,finger print expert,odontologist,radiologist. Etc.. for work assistance along with volunteers for Identification of  victims and their disposal of the remains.

The Emergency Mortuary Services:-

LOCATION:

Should  preferably Operate away from the  Explosion site and  the site to be should have easy access to Road or Train.

The Potential sites for the Mortuary Services

1. Play ground.
2. School premises.
3. Factory premises
4. Garage
5. Parking space

Team Responsibilities:

The Team Leader in assistance with the Police is responsible for notifying his personnel and determining if the situation warrants 24-hour operations.

The team needs to work in shifts for the around-the-clock operations so as to facilitate speedy Identification and Disposal of the Victims.

The list of Doctors qualified should be maintained and the need of the Emergency should be well addressed and if possible suitable legislation framed to make service compulsory in Mass Disasters (National interest).A recommendation in this regard may be forwarded to the Medical council.

The Police work,fire work,rescue agencies and Insurance agencies should all work in coordination with the EMS and all functioning to be centralized to avoid unnecessary delay in identification or disposal of the victim.

The victims of the Disasters dying within 48-72hrs ,their bodies to be referred to the EMS unit to avoid any delay, confusion in Identification or Disposal.

The Team leader will be the sole representative to the police, press….

State responsibilities:

1. The Proper care and Preservation of the dead from the time it is recovered until it is handed over to their legal heirs.
2. The Deceased’s custody will be on the state and the right of handing over the body after all the formalities should lie only with the Investigating Officers.
3. Proper amendments to be made in Law in relation to custody of the deceased, identification and disposal.
4. The Deceased’s relatives will temporarily loose all right until the IO is satisfied with the formalities for their release.
5. State to provide necessary logistical support for food, water, emergency power, lighting, fuel, etc.
6. The Doctors should be compensated for their duty time by the government as a temporary government employee and so are the other supporting staffs.
7. The state government should do proper legislation to make duty compulsory for doctors and other staff necessary for the EMS,necessary penalization should be worked out in consultation with Medical council and other agencies.

The functions of EMS:

1. Locating the Site for Temporary Morgue.
2. Provide Public Information Officer with necessary information.
3. Proper preservation and Storage of the Dead until disposal by Temporary Refrigeration units, Mobile refrigeration units/Ice blocks.
4. Temporary Embalming center should be part of the Mortuary services
5. Arrangements to be made for Recovery of the Dead and mutilated remains.
6. Conducting meticulous Autopsy examination, so as to identify the victims, their number and the exact cause of death.

Support cleanup and recovery operations during Explosions.

a. Decontaminate mortuary, equipment and the site.

b. Continue mortuary services until last identification is made and remains released to next of kin.

c. Arrange for appropriate disposal of unidentified remains.

DUTIES of Administrative Supporting Staff:

Men and Materials:

a. Protective clothing,

1. Equipment and instruments
2. Mortuary Tables.
3. Security.
4. Mortuary technicians and Assistants.
5. Clerks, Public relation Officer,
6. Photographer
7. Good lighting, watersource, drainage, power.

Office:

1. Process all the Information (Doctors, Police and Relatives) and  confirm identification.
2. Prepare all certificates for Disposal.
3. Obtain NOC from the Police.
4. Preserve all the records as per the Mass causality /Autopsy Number including Photgraphs,X;rays,Finger prints..etc.
5. Coordinate with the Media,NGOs,IO,Crisis Management Group  for smooth and hassle free functioning.

SPECIFIC DUTIES OF AUTOPSY SURGEONS:

1. Registering each one with Mass causality Number which should be the future Autopsy number
2. Adopting procedures for the Identification as per the standard protocol.

This process of Identification and disposal should be with the following :

1. The belongings(includes valuables and clothing) of the deceased.
2. The Identification milestones on the body like height,weight,scars,tattoo,colour,hair,finger print,….
3. DNA fingerprinting
4. Alleged Attendants information, which should be compared with the above findings.
5. The role of radio,TV, and the NGOs make this more easier).
6. The Coordination with the Government Crisis management is must in all  functioning of the EMS.

Radiological examination of all the Victims(in blast cases),by Portable radiological unit.Photographs and Sketches to be taken.Clothing’s to be described and handed over to the IO with all care to maintain the Chain of custody.Complete forensic Autopsy of all the deceased keeping in view of the blast effects to know the exact cause of death.Confirm the number of VictimsPrompt Efforts to be put on to maintain the utmost Cosmetic integrity of the victim.Differentiate the Victims of(Explosions) shock,stampede,accident ,etc..from those due to Blast.Maintaining the Cosmetic integrity of the dead in case of severe mutilation.Histopathological and Toxicological examination should be a must for all victims. The histopathological examination sections to be taken involving all the organs as per the basic Hospital Autopsy protocol.Efforts to help the IO to gather Evidence to know the cause of Disaster, Position of the Victim and differentiating a perpetrator from a peaceful citizen.The Provisional Death certificate, Body transportation certificate, Embalming certificate to be handed over along with the dead body.The Autopsy report to be handed over within 24hours.

The statistics and analysis in relation to the victims of the Blast, pattern of Injury,Position,Cause of Death to be analyzed and submitted to the State within few weeks after the Disaster, so as to enable further Research interims of Management of the specific disaster related cases and also treatment of the causalities.