CoshoctonCounty Emergency Operations Plan
MASS CASUALTY / FATALITY PLAN
I. PURPOSE
The purpose of this annex is to document the steps CoshoctonCounty will take for a coordinated emergency response to a mass casualty/fatality incident. Provisions listed here are intended to augment other portions of the County Emergency Operations Plan (EOP).
II. SITUATION AND ASSUMPTIONS
A. SITUATION
1. Mass casualty/fatality incidents may occur without notice and may require a major response effort and cover more than one operational period.
2. Because of the number of casualties/fatalities involved, theneed for rapid assessment and treatment is critical.
3. Response and recovery from a mass casualty/or fatality event could result in the closure of affected buildings, including facilities such as medical treatment, governmental or businesses, limiting local response capability.
4. The Coshocton County Coroner will coordinate the response to a mass fatality situation and arrange for assistance by coordination with adjacent counties, State and Federal Agencies and other organizations to provide the necessary support and assistance for the incident.
5. Events such as chemical spills/releases, biological, or terrorist incidents could be the cause of a mass casualty/fatality event. Other threats that must be considered are:
○Severe summer or winter storms
○Major fires
○Intruder(s) with weapons
○Hostage situations
○Transportation accidents involving a truck, airplane or bus.
Terrorist incidents in schools and public buildings have occurred all too often in the recent past. Emergency plans for these facilities address emergency response and preventive measures like:
○Enhance security measures
○Identification systems
○Control and limited entry
○Procedures for lockdown
○Procedures for reporting health issues.
Each year there are many pre-planned events in the county. The officials in charge of there pre-planned events are being encouraged to be proactive and to address the possibilities of emergencies and ensure their plans and procedures current.
B. ASSUMPTIONS
1. There are potential creditable natural and man-made threats that could cause a mass casualty / fatality incident in CoshoctonCounty at any time.
2. That the various management personnel within the county who are responsible for emergency planning for their facilities (schools, medical facilities, government buildings, business and industrial companies, public events, etc.) have fulfill their obligations by developing appropriate emergency plans, coordinating the plans with the appropriate local response agencies and test the plan regularly.
3. In the event of a mass casualty/fatality situation, there would be a rapidresponse by local emergency response agencies, departments and organizations and mutual aid support will be requested and provided by other emergency response departments and organizations
4. The need to provide staff for emergency shelters and other types of emergency operations for long periods of time will place a strain on volunteers and additional resources may be needed.
5. During major emergencies or disasters, the County Emergency Operations Center (EOC) will be activated. The EOC staff would report to the EOC and begin coordination activity for the response agencies.
6. The Coshocton County EMA Director will obtain a local Declaration of Disaster if needed, report the situation and request assistance from the Ohio Emergency Management Agency (OEMA) as needed. The OEMA is the designated coordination agency for the Governor for all emergencies within Ohio and coordinates state agencies response, handles the state emergency declarations, disaster reports and requests for State and Federal response.
7. The Coshocton Chapter of the American Red Cross (Red Cross) maintains shelter information for the entire county. The Red Cross staff has identified appropriate facilities in the county and has completed a shelter agreement with each facility.
8. The Red Cross will request assistance from other Red Cross Chapters within the State or from National Red Cross when the situation when additional resources (personnel, equipment or supplies) are needed.
9. CoshoctonCounty has adopted NIMS and the Incident Command System (ICS). All incidents will be managed by the Incident Command System in accordance with the provisions of NIMS.
10. The following information addresses the “four phases of emergency management for mass
casualty/fatality planning”. This information will be used by each agency, department, and organization with a role for developing their specific plans for mass casualty / fatality.
III PHASES OF EMERGENCY MANAGEMENT
A. MITIGATION
Identify possible hazards that could cause mass casualties and (or) mass fatalities in CoshoctonCounty. For each hazard identified address any possible actions that could be taken to eliminate the event or reduce its impact on the county if it occurred.
○Determine the agencies, departments and organizations that would have a response role in any of the identified hazards.
○Identify resources forpersonnel, equipment and supplies which will support
emergency operations.
B. PREPAREDNESS
1. The agencies, departments and organizations that were identified, under mitigation, must understand their roll and develop a plan addressing their response to the event. The plans will address, protocols, operational procedures, identify responsibilities, and the resources they have and those resources they will need to obtain and where the resources can be obtained.
2. Training on the plans, protocols and operations procedures must be conducted. Tests and exercises must be scheduled and conducted regularly in order to validate the documents and to train personnel in their use.
3. Wherethere is a needmutual aid agreements will be made with the organizations that are expected to provide the needed resources. Notification procedures, call down lists and other methods, must be established and kept up-to-date.
C. RESPONSE
An Incident Command Post will be established on scene and the IC will identify staging and EMS areas.
The CountyEmergencyOperationsCenter may be activated.
○Upon initial notification of a serious incident with many causalities possible and an
unknown number of fatalities,each agency, department and (or) organization will respond in accordance with their plan.
○Establish casualty collection, triage and treatment centers, and transport victims to appropriate medical facilities.
○In the event population must be evacuated and sheltered, the Red Cross will be requested to activate sufficient shelters to handle the evacuees.
○Deceased will not be moved unless it is necessary to treat and remove an injured person.
○The Coroner will be notified if there are fatalities.
○The Coroner will establish an “On Scene Sector” to conduct operations from a “Temporary Morgue Sector” to handle the deceased and a “Family Assistance Center” in order to provide a secure place for families to gather and await information.
○Notify Ohio EMA and other agencies and organizations of the situation and request
appropriate assistance. If the incident is determined to be a terrorist incident, notify appropriate law enforcement agencies.
○The Coronerwill notify the State Funeral Directors Association Disaster Team and request DMORT and/or DMORT-WMD assistance as needed.
○Complete appropriate paperwork and death certificates for the deceased.
○Commence public information activities to inform the public of the situation. County EMA may open Joint Information Center (JIC).
○All agencies, departments and organization will document all notifications, response activities, casualties and fatalities and other items as necessary.
D. RECOVERY
○The Coroner, and assisting organizations, will continue to work with the victim's families until all tasks are accomplished.
○The Family Assistance Center will remain open until all activities are complete.
○In the event state and/or federal disaster assistance is requested, theirDisaster
Assistance Centers will remain open until the applications of all families and
businesses have been received.
○If there were evacuations the Incident Commander will determine the affected area(s)
are safe for the evacuated population to return to their homes and businesses.
○When the all-clear indicating it is safe to return to an area,appropriate public announcementswill be made to the responding agencies, departments and organization and the public.
○Shelters will remain open until all persons requiring sheltering have been taken care of
and are able to return to their homes or to temporary housing.
○All documents and records of the event will be completed and stored in a secure place.
○The County EMA office will schedule and conduct an after action briefing andcritique
involving all agencies, departments and organization involved in the event.
IV. CONCEPT OF OPERATIONS
As most of the Emergency Operations Plan have been developed to address conditions that are likely to occur in the county, it is equally important to plan for mass casualty/fatality incidents where services must be expanded in scope very quickly. This annex addresses this need when an incident is first identified as being or likely to be a mass casualty/fatality incident.
As the primary responsibility in a mass casualty event is to locate, treat, and transport victims, this annex is dividedinto three sections, Initial Response, Mass Casualties and Mass Fatalities. Typically the last two sections will occur at the same time with most of the response and deployment of resources being utilized for causalities before fatalities.
A. INITIAL RESPONSE
1. Regardless of the location, nature or extent of the disaster, the first unit to arrive on the scene shall have initial command and control authority, and should:
○Establish the Incident Command Post (ICP)
○Assess the incident scene and check for unusual hazards.
○Advise the 911 communications center of the situation, including:
○A description of the incident
○Location of the Incident Command Post
○Identify hazards that would affect a response
○Estimate of the number of mass casualties
○Estimate of the severity of the casualties
○Estimate of the number of fatalities
○Provide an estimate of what initial resources are needed.
2. Maintain command and control of the incident location until properly relieved of command.
○Secure the incident site
○Establish perimeter security and restrict access as quickly aspossible.
○The Incident Commander may set up the following functional areas as needed
to accomplish management of the incident:
Staging Area
Public Information Area/JointInformationCenter
B. MASS CASUALTIES
1. As the Emergence Medical Service (EMS) arrives they will report to the Incident Commander and will designate an EMS Officer in Charge (OIC). The EMS OIC will in turn determine the location of the following areas if necessary and assign a leader to each:
○Triage Area
○Treatment Area
○Medical Transportation Area
2. The EMS OIC will remain in this command position until properly relieved.
3. The details can be found in Tab 1 of this Annex. Mass Casualty Incident Emergency
Medical Service Checklist
4. The Transportation leader will maintain a log of each casualty including at a minimum; name, address, type of transportation used, and where they were taken. The Transportation leader will forward this information to the EOC for distribution to the American Red Cross representative or person responsible for determining the location of victims and notifying family members.
5.Any victim that dies after being treated in the triage, treatment, or transportation area will be moved to a secure area aside from these areas and out of public view to await review and removal by the coroner or his staff.
6. Fatalities are identified where they are found and will be tagged and left in place unless it is necessary to move them to treat the living. Record on the triage tag that the deceased has been moved.
Medical Helicopters
When the EMS OICdetermines that conditions exist for the use of air evacuation services, the requests for support will be forwarded through existing communication’s channels to Medical Flight Office, Columbus 1-800-222-5433 (1-800-222-LIFE).
○ The Flight Office will schedule flights and advise of the arrival time.
○ The Flight Office will need one contact person and phone number.
○ Incident Command (typically fire service or sheriff) will define the landing site, mark and secure the site.
○ Helicopter landing sites should be lighted for night-time rescue.
Criteria and Procedure for Requesting Mutual Aid
1. When it is determined by the Incident Commander that other assistance is required and the
on site responders have deployed and they have or are about to utilize all their available resources mutual aid will be requested.
2. The Incident Commander will determine what type mutual aid required and the level of mutual aid necessary to respond to the situation and communicate this to the 911 communications center or the activated EOC.
3. Requests for assistance shall include:
○The nature and location of the emergency and an estimate of persons injured or affected.
○The number of and type personnel requested
○Required supplies and resources
○The location of the staging area for arriving assisting units.
EMS Standing Orders of Operation
1. When communications with area hospitals or other medical advisors cannot be used effectively or when there is an unavoidable delay in the transport of patients to a medical facility, standing orders for EMS operations may be used.
2. These standing orders will allow advance life support (ALS) and basic life support (BLS) units providing mutual aid outside of their jurisdiction to administer all drugs and perform all procedures as contained in their own jurisdictional written protocols.
C. AIRCRAFT ACCIDENT
Control the movement of casualties and fatalities at the scene of an aircraft accident by:
○Sealed off the crash scene from the public and debris should not be movedunless it is
absolutely necessary to treat casualties.
○Site security is very important and must include all area wheredebris is located.
○Ascasualties are located they will be removed and attended to, however, a tag must
be left to mark the position where they where found.
○When fatalities are located they will be left where they are until the appropriate federal
authority arrives.
○A fatality will only be moved in order to treat a casualty. If a fatality is moved,it will be
tagged to indicate itsinitial location.
D. MASS FACILITIES
When Mass Fatalities are determined to be present the Incident Commander will request the Coshocton County Coroner to respond. Upon reporting to the site the Coroner will confer with the Incident Commander to determine:
○Where the fatalities are located
○How many fatalities have been identified
○Is the area where the fatalities are located safe to enter
○What resources are available
○The Coroner will determine if any or all three major sectors are opened and if so assign
a supervisor to each.
The Coroner will proceed to implement the three Sectors of mass Facilities.
Sector 1 ON-SCENE SECTOR
This sector is the primary responsibility and defines the duties of the Coshocton County Coroner in an incident with Mass Fatalities.
○ Determine when the fatalities can be moved from the scene.
○Work with the Incident Commander to ensure scene securityand control.
○Identify the remains of the fatalities.
○Preserve and collect evidence of a medical nature.
○Observe standard procedures in the event the incident is suspected, or declared as a
crime scene.
○Notify the relatives of the fatalities.
○Collect, tag and secure the valuables of the deceased victims.
If the incident is determined to be a crime scene:
○Request law enforcement assistance with scene documentation and photography
when possible.
○Mark all human remains at the site when possible.
○Document all activities.
○Request DMORT or other organizations as needed.
○Collect all the remains and possessions marking the location where they were found.
○Notify and request activation of the Ohio State Funeral Director’s Association Disaster
Team as needed.
○Work with the investigating agency to recreate the accident scene.
○Arrange for CISD services including rotation and break schedules for all workers
relatedto the Coroner’s functions.
○After all human remains are recovered; turn the scene over to the appropriate law
enforcement agency.
Sector 2 - TEMPORARY MORGUE SECTOR
This sector is the primary responsibility and duties of the Morgue Supervisor in an incident with Mass Fatalities.
○Coordinate activities with the CountyCoroner or his representative.
○Coordinate all activities related to record collection and documentation of all morgue
operations.
○Responsible for all activities to the reception, cataloging, storage, and disposition of all
personal effects as they arrive at morgue site.
○Establish a reliable and secure communications link with the Coroner.
○Ensure adequate number of non-technical staff to serve as morgue assistance, runners,clerks, etc.
○Ensure that all preparation activities are coordinated with receiving funeral directors/
next-of-kin preferences for final disposition.
○Coordinate shipping details with receiving funeral directors.
○Maintain a resource staging area at the morgue site.
○Coordinate all pertinent records and personal effects to be shipped with body.
○Maintain a resource staging area at the morgue site.
○Maintain a log of all equipment and supplies used at morgue site.
○Ensure that all morgue operations staff functional unit leaders understand their duties and reporting relationships.
○Fill out death certificates for deceased victims prior to release.
○Determine equipment and resource needs.
Sector 3 - FAMILYASSISTANCECENTER
The FamilyAssistanceCenter is a temporary facility established by the Coroner's office to provide a place, away from themedia and other persons who may attempt to prey on the family members, and where the family of the deceased can await word and make necessary arrangements.
○The Coroner designatesthe location for the Center.