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-
A] | Natural- | Earthquakes/Landslides |
Floods | ||
Hurricanes | ||
Cyclones | ||
Epidemic outbreaks e.g.H1N1. | ||
B] | Accidental- | Aviation accidents |
Train accidents |
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Vehicular accidents |
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Ship accidents | ||
Food poisoning | ||
C] | Industrial- | Gas leakage |
Poisonous Substance Contamination | ||
Explosion | ||
D] | Man Made- | Riots |
War |
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:
Identification from remains as achieved by the description for each person as follows-
[I] Appearance – This is discussed under the following heads-
[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.
[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.