Planning for Worst Case Scenarios

Mass fatality incidents are not a pleasant subject, nor one upon which few people would want to dwell. But like all disastrous events, failure to plan for catastrophes like mass fatalities may result in additional confusion, trauma and distress to those involved.

So we plan, we train and we exercise what we’ve learned. Exercises are an essential element of disaster preparedness, allowing us to practice skills, discuss potential issues, and appScreen Shot 2016-03-04 at 3.23.59 PMly our knowledge to real-world scenarios. But how do you exercise a mass fatality event?

The Texas Department of State Health Services, Health Services Region 8 (HSR 8) contracted with BCFS Health and Human Services’ Emergency Management Division (BCFS EMD) to hold a full-scale mass fatality exercise in San Antonio. A full-scale exercise allows participants to apply the skills acquired at training sessions in scenarios that are meticulously crafted to be as realistic as possible.

The exercise was a collaborative effort between HSR 8, BCFS EMD, the Texas Department of Public Safety’s Highway Patrol State Crash Reconstruction Team Section and the San Antonio Fire Academy.

The exercise involved a constructed scenario of a crash between a 15-passenger van and a Southern Pacific train. The train, part of the Fire Academy’s training center, provided the real- world “feel” for the exercise. To add to the reality, bodies (plastic mannequins) had disaster injury make-up (moulage) applied by BCFS Health and Human Services’ moulage artists.

Participants, including the Bexar County Medical Examiner’s Office which played an active leadership role during the exercise, were tasked with performing a search and recovery effort. Victims were located, appropriately handled, and carried to a storage location. Evidence such as personal effects were gathered and categorized to be returned to the victims’ family members.

Screen Shot 2016-03-04 at 3.24.09 PMThe Crash Reconstruction Team led a training prior to the exercise on protocols for scene investigation and evidence collection. The BCFS EMD forensics team led a presentation of search and recovery protocols, and facilitated the train crash simulation to ensure a safe learning environment. Participants represented a variety of disciplines, including fire, law enforcement, public health, justices of the peace, healthcare and EMS.

“Collaboration is essential when dealing with a large-scale event like this,” said Kari Tatro, EVP/COO– Administration, Education & Emergency Operations. “Ensuring that everyone knows their roles and responsibilities, and practices together before a crisis, allows us to respond seamlessly in real events.”

Even in death, we seek to serve with respect and care to those in need.


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