Mass fatality preparedness among medical examiners/coroners in the United States: a cross-sectional study

Abstract

BackgroundIn the United States (US), Medical Examiners and Coroners (ME/Cs) have the legal authority for the management of mass fatality incidents (MFI). Yet, preparedness and operational capabilities in this sector remain largely unknown. The purpose of this study was twofold; first, to identify appropriate measures of preparedness, and second, to assess preparedness levels and factors significantly associated with preparedness.MethodsThree separate checklists were developed to measure different aspects of preparedness: MFI Plan Elements, Operational Capabilities, and Pre-existing Resource Networks. Using a cross-sectional study design, data on these and other variables of interest were collected in 2014 from a national convenience sample of ME/C using an internet-based, anonymous survey. Preparedness levels were determined and compared across Federal Regions and in relation to the number of Presidential Disaster Declarations, also by Federal Region. Bivariate logistic and multivariable models estimated the associations between organizational characteristics and relative preparedness.ResultsA large proportion (42%) of respondents reported that less than 25 additional fatalities over a 48-hour period would exceed their response capacities. The preparedness constructs measured three related, yet distinct, aspects of preparedness, with scores highly variable and generally suboptimal. Median scores for the three preparedness measures also varied across Federal Regions and as compared to the number of Presidential Declared Disasters, also by Federal Region. Capacity was especially limited for activating missing persons call centers, launching public communications, especially via social media, and identifying temporary interment sites. The provision of staff training was the only factor studied that was significantly (positively) associated (p < .05) with all three preparedness measures. Although ME/Cs ranked local partners, such as Offices of Emergency Management, first responders, and funeral homes, as the most important sources of assistance, a sizeable proportion (72%) expected federal assistance.ConclusionsThe three measures of MFI preparedness allowed for a broad and comprehensive assessment of preparedness. In the future, these measures can serve as useful benchmarks or criteria for assessing ME/Cs preparedness. The study findings suggest multiple opportunities for improvement, including the development and implementation of national strategies to ensure uniform standards for MFI management across all jurisdictions.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2458-14-1275) contains supplementary material, which is available to authorized users.

Mass-Fatality Incident Preparedness Among Faith-Based Organizations

“…These strategies are supported by study data and literature on the role of FBOs in general emergency preparedness and response efforts. 12 Similar to results from MFI infrastructure studies, [10][11][12] it was found that participation in drills was associated with operational capabilities as well as with resource sharing partnerships. Improved clarity of role function and enhanced integration of FBOs in the overall MFI mission can be achieved through coordinated drills and training with their partners in the private and public sectors.…”

“…Using a cut-off point of 70%, which was based on previous staff surge capacity modeling for other types of disaster events, 10 , 11 only 20% of respondents thought that 70% or more of their FBO staff would be able to respond to MFIs, with or without CBRNE. A larger proportion (45%) thought that 70% or more of the FBO’s would be willing to respond to MFIs, although that proportion decreased to 37% if CBRNE agents were involved.…”

mLearning Versus Paper and Pencil Practice for Telling Time: Impact for Attention and Accuracy

“…Findings from the present study echo several studies found in the recent literature using iPad technology. Past research regarding mathematics interventions with technology have been focused on task on behavior (Flower, 2014 ; Riley et al, 2014 ) and correctly completed math problems (Haydon et al, 2012 ).…”

“We've Cared for the Dead since We Started Caring”: COVID‐19 and Our Relationship to Public and Private Deathcare

“…Medical examiners, coroners, and cemetery managers have much more to do during a disaster than identifying and interring victims. Gershon et al () identify tasks such as body management and security, crisis communication, morgue operations, volunteer management, and victim release to funeral homes or other entities. Depending upon the need, Disaster Mortuary Operational Response Teams can be deployed through the federal government's National Response Framework to aid with deathcare and death management.…”

“…Depending upon the need, Disaster Mortuary Operational Response Teams can be deployed through the federal government's National Response Framework to aid with deathcare and death management. Based on a survey of mortuary operators, Gershon et al () found that most staff would need additional training, capacity, and funding to properly handle mass fatality incidents; the COVID‐19 pandemic is highlighting those needs. Merrill et al () had similar results, with survey respondents indicating that biological contaminants (such as the COVID‐19 virus) complicate their disaster response abilities.…”