Once the number of fatalities exhausts your resources, you must determine if your capability is appropriate for the risks that face your jurisdiction. This is the role of the HVA. What is a reasonable number of fatalities your system may encounter? How many fatalities have you encountered in the past from a single incident? Planning to the concept “more than can be handled” may leave you questioning your capability to respond. Exercising that concept is also difficult, as measuring performance against a vague concept is nearly impossible. A more concrete expectation needs to be developed to establish both your agency and jurisdictional expectations for performance.
Emergency incidents involving mass fatalities have the potential to be some of the most hectic and dynamic scenes EMS agencies will encounter. Recent events in Japan showed that traditional response entities and authorities have seen expanded roles when large-scale incidents arise. The logistics behind responding to exceptionally large-scale mass-fatality incidents are way outside the scope of most mass-fatality plans but need to be in the forefront of EMS agencies’ minds.
Understand that knowing your partners in advance and utilizing those relationships to assist in developing well-researched response plans can result in an efficiently run response to what has the potential to be a very difficult emergency scene.
Raphael M. Barishansky, MPH, is chief of public health emergency preparedness for Prince George's County (MD) Health Department. A frequent contributor to and editorial advisory board member of EMS World Magazine, he can be reached at firstname.lastname@example.org.
Dennis C. Wood, MS, NREMT-P, is the major of Emergency Medical Services for the Prince George’s County Fire/EMS Department in Maryland. He has been in the fire and emergency medical services for more than 20 years. He can be reached at email@example.com.