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

BMC Public Health

Martin F Sherman³  Halley EM Riley⁴  Daniel Y Chen¹  Jacqueline A Merrill¹  Qi Zhi²  Mark G Orr⁵  Robyn RM Gershon² 

[1]School of Nursing and Department of Biomedical Informatics, Columbia University, 617 W. 168th Street, Georgian, 226, New York, NY 10034, USA

[2]Department of Epidemiology and Biostatistics and Institute for Health Policy Studies, School of Medicine, University of California, San Francisco, San Francisco, CA 94118, USA

[3]Department of Psychology, Loyola University Maryland, Baltimore, MD 21210, USA

[4]Association of Schools and Programs of Public Health (ASPPH), Atlanta, GA 30333, USA

[5]Virginia Bioinformatics Institute, Virginia Tech, 900 N Glebe Rd, Arlington, VA 22203, USA

关键词: Ability and willingness;    CBRNE;    Death care;    Coroners;    Medical examiners;    Preparedness;    Mass fatality incident;    Disasters;   

Others  :  1092306
DOI  :  10.1186/1471-2458-14-1275

 received in 2014-09-03, accepted in 2014-12-08,  发布年份 2014

【 摘 要 】

Background

In 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.

Methods

Three 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.

Results

A 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.

Conclusions

The 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.

【 授权许可】

   
2014 Gershon et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

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