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| By Raphael M. Barishansky, MPH, & Dennis C. Wood, MS, NREMT-P Defining EMS’ response to mass-fatality events You are the director of Tri-County EMS, a third-service EMS agency, and are heading into the offi ce one morning when you hear the call come over the radio: “Dispatch to units EMS 1, EMS 7, Medic 2, Medic 3 and Rescue 311. We have reports of a school bus into a tractor trailer on Interstate 47 north- bound. Numerous callers are reporting multiple injuries and fatalities.” You think, Thank goodness we hammered out that mass fatality plan, then get on the air and advise dispatch that you are responding as well. EMS agencies have the potential to respond to high-impact incidents of all varieties, including transportation incidents, industrial accidents, severe weather or natural disasters, fires or acts of violence and/or terrorism that result in mass fatalities. There is a definitive need for EMS to be an active element of the planning process as well as the response component for these incidents. Just the term “mass fatalities” conjures up images of chaotic scenes with multiple agen- cies having distinct responsibilities that may or may not be related to their day- to-day operations. When thinking about the various elements involved in mass- fatality management, it is important to keep in mind recent examples of inci- dents that produced mass fatalities, such as the earthquake/tsunami combination that hit Japan and the tornadoes that recently devastated several areas in the United States. Prior to discussing the planning elements that must go into incidents involving mass fatalities, a definition is in order. One of the more expansive definitions comes from California Health Emergency workers take notes by the dead bodies in a basement of a Japanese Red Cross hospital full of people evacuated from the area hit by tsunami in Ishinomaki, March 13, 2011. REUTERS/Damir Sagolj and Safety Code Section 103451, titled “Mass Fatalities Incident: Definition,” which states: “(a) For purposes of this plan, ‘mass fatalities incident’ means a situation in which any of the following conditions exist: 1. There are more dead bodies than can be handled by local resources 2. Numerous persons are known to have died, but no bodies were recovered from the site of the incident 3. Numerous persons are known to have died, but the recovery and identifi- cation of the bodies of those persons is impractical or impossible. (b) The county coroner or medical examiner may make the determination that a condition described in subdivision (a) exists.” For the purposes of this article, a mass-fatality incident can simply be RAY BARISHANSKY is a featured speaker at EMS World Expo 2011, Aug. 29–Sept. 2, at the Las Vegas Convention Center, Las Vegas, NV. For more information, visit EMSWorldExpo.com. EMSWORLD.com | JULY 2011 49