Abstract
Background: Any healthcare facility must be prepared to handle a dramatic increase in deaths that can be produced by a catastrophic disaster. A mass fatality incident (MFI) will significantly increase the usual number of deaths that hospitals or forensic science services can manage on a daily basis. A survey was conducted to assess the hospital emergency department level of preparedness to deal with an MFI. Objective: To examine healthcare facilities level of preparedness for an MFI and morgue capacity. Methods: A total of 39 out of a sample of 44 hospitals participated in the study. Seven questionnaires were administered to explore: hospital general characteristics; emergency plans; equipment and infrastructure; collaborative agreements; personnel trainings; emergency communications; laboratory facilities; treatment protocols; security; and, epidemiologic surveillance. Results: Three-fourths (79.5%) of the healthcare facilities reported having a morgue, their average storage capacity was of three bodies. More than two-thirds (66.7%) of the institutions stated that they could not increase their morgue’s capacity. Most installations without a morgue do not possess an agreement with any other institution for the management of bodies. Hospitals have a very limited number of body bags utilized for the handling and transport of bodies. Conclusion: Most of healthcare facilities have morgues, but there are limitations with the current capacity and the lack of resources to increase their capacity in case of a disaster. Management of an MFI must be part of every hospital’s emergency plan, and must include collaborative agreements with forensic authorities, emergency management and public health agencies, and the community.
Highlights
Disaster events, caused by natural hazards or manmade, can occur anywhere in the world at any time
The selection of the hospital emergency rooms that participated in the study were obtained from a list of hospitals provided by the Puerto Rico Department of Health Office of Public Health Preparedness and Response (OPHPR)
Additional questions about the characteristics of the morgues were asked of the healthcare facilities that stated that they had a morgue (Table 1)
Summary
Disaster events, caused by natural hazards or manmade, can occur anywhere in the world at any time. Recent major disasters have yielded important evidence regarding how the number of mass casualties and fatalities can overwhelm the capacity of a country’s public health and healthcare system to effectively respond to the emergency [7,8,9,10]. One of the most difficult aspects of a catastrophic disaster is related to the management of a large number of dead bodies, due to the processes involved in the recovery, identification, and disposal, as well as the effectiveness of disaster preparedness plans and communication between respective agencies and the affected population [11]. A mass fatality incident (MFI) will significantly increase the usual number of deaths that hospitals or forensic science services can manage on a daily basis. Objective: To examine healthcare facilities level of preparedness for an MFI and morgue capacity. Management of an MFI must be part of every hospital’s emergency plan, and must include collaborative agreements with forensic authorities, emergency management and public health agencies, and the community
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