It Can’t Happen Here?

1. It Can’t Happen Here? Mass Fatality Planning in Rural Communities June 10, 2014

2. Looks like it can!

3. Remember Henryville? What if school was still in session?

4. American Eagle Flight 4184 October 31, 1994

5. “Show me the manner in which a nation cares for its dead, and I will measure with mathematical exactness, the tender mercies of its people, their loyalty to high ideals, and their regard for the laws of the land.” Sir William Ewart Gladstone, Victorian Prime Minister, Great Britain

6. What is a Mass Fatality? • One Thousand? • Five Hundred? • One Hundred? • Fifty? • Ten? • Five? • Three? That which overwhelms local resources

7. Who Decides? • EMS? • EMA? • Hospitals? • Law Enforcement? • Fire Department? • Health Department? • Coroner? All disasters begin and end locally

8. ESF 8—Health and Medical In Indiana— Local Health Departments Hospitals Emergency Medical Services Mental Health Coroner Emergency Management Red Cross

9. Work with Your Partners It takes a village to bury the dead • Cemetery Managers • Funeral Directors • Hospitals • Health Departments • Law Enforcement • Local Emergency Management Agency • Red Cross

10. Help is Available • Neighboring counties • State I-DPMU and I-MERT • Federal DMORT, NORTHCOM, DoD • National Transportation and Safety Board • FBI, ATF

11. Indiana dpmu • Needs 15,000 sq.ft. with a concrete floor, overhead door, large parking lot • Has tables, chairs, signage, cubicle dividers • X-ray, photography, DNA, and finger print materials • Everything needed except the staff

12. Mission Preserve to the extent possible the respectful handling and identification of human remains in unusual and overwhelming circumstances.

13. The Goals • To get through all the recovery and identification processes as quickly as possible to be able to return the remains to families • Without disturbing criminal evidence • Preserving responder safety and health • Maintaining dignity and respect for all involved

14. Yes, It Is a Big Task How would you feel if it happened to you and someone said—“I’m sorry, we won’t know anything for two days until the feds get here.” All disasters begin and end locally

15. No Resources • We have no hospital • The LHD has 4 staff, 2 are part time • We have only a town marshal • We don’t have a doctor • There is no ambulance service • The fire department is all volunteer—all 10 of them

16. Yes Resources • Funeral Home • Four churches • Three restaurants • Grocery store • School • Hundreds of caring residents • Retired people with hidden talents • Amateur radio operators

17. So, What Can You Do? • Notify the County Coroner and EMA • Bring in a refer • Find a place for the morgue • Find a place for the Family Assistance Center • Secure the scene • Rescue, treat, and transport all the live victims • Make arrangements for food and water

18. Get Organized • Someone has to be “in charge” • At the scene • At the morgue • At the Family Assistance Center • Round up all your ESF 8 partners • Find the people trained to work in the Family Assistance Center (FAC) • Get the word out about where the FAC is located

19. More Organized • Call out all the ministers and chaplains • Organize the offers of meals into a schedule • Find the social workers, mental health providers and childcare staff • Get all the technology experts together to set up phone and internet capabilities

20. Who Could Work in the Morgue? • Retired dentist • Retired sheriff • The x-ray technician who works in the hospital in the next county • Local photographer • School teachers • Embalmers

21. Who Can Work in the FAC? • Clergy • Social Workers • Mental Health • Child Care Providers • Funeral Directors • School Teachers • Nurses • Red Cross

22. Who Does Body Recovery? • Well trained • Experienced • Able to handle grotesque situations • Compassionate • Careful • Follows directions • Is mindful of crime scene evidence • Even a small piece of tissue is handled with respect • Under the direction of the coroner • Not everyone can do this

23. Recovery of Human Remains • Specialized task • Must be pre-trained • Usually • Coroner • Deputy Coroner • EMS • Grid the scene • Lots of photographs • Personal effects • Look for evidence

24. Family Assistance Center • Where all the families go for information • Regular briefings • Gather antemorten information • Spiritual, medical, and mental health support • Provides healthy meals • Death notifications • Protects families from the media

25. Yes, You Can • When the state and the feds arrive everything will be ready to go • You can tell them the “quirks” of your community • You can work along side them • You can give them a list of places to stay • You can provide meals or the locations of restaurants • You know the people in your community

26. It Can Happen Here and You Can Do It! • Hoosier Hospitality is never stronger than in the rural communities. • It is your house, you can be a great host • Compassionate • Helpful • Understanding • You can get it started • You can finish it up • Show them this is how its done in Indiana!

27. Let me know if I can help Janet McCutchan, MSN, RN Chief Nurse Consultant Public Health Preparedness and Emergency Response Indiana State Department of Health 2 North Meridian Street, 7K Indianapolis, IN 46204 jmccutchan@isdh.in.gov 317-234-3915