Mass fatalities

Department of Justice and Department of Defense. Medical Examiner I Coroner Guide For Mass Fatality Management of Chemically Contaminated Remains. May 15,2003. 

Guidelines for Mass Fatality Management During Terrorist Incidents Involving Chemical Agents. 

The following two recent examples of food contamination indicate the ease with which toxic chemicals can be used to cause casualties, but also the difficulties associated with causing mass fatalities by this method. 

Jensen, R.A. Mass Fatality and Casualty Incidents a Field Guide. CRC Press, 1999. 

Because of the fear among the general public about chemical agents, it is essential that medical teams take a positive response in their approach to patient management and to emphasise that it is possible to treat toxic trauma effectively and that mass exposure does not mean mass fatalities. 

Enterotoxins (which normally cause food poisoning) pose the least risk. Mortality rates with the other toxins mentioned such as aflatoxins and the enterotoxins would not have a high mortality, but the morbidity of the release would be quite high. Such toxins should be regarded as essentially agents of mass morbidity but not of mass fatality. 

In 2004, the Home Office established a programme to coordinate the management of mass fatalities, the Mass Fatalities Workstream. This programme allows local authorities and services access to ... 

The national Disaster Victim Identification Team (DVI), a police-led response coordinated by the Association of Chief Police Officers which deploys to mass fatality incidents in the UK and abroad at the request of the Foreign Office. 

Snyder JW, Safir EF, Summerville GP, et al. 1995. Occupational fatality and persistent neurological sequelae after mass exposure to hydrogen sulfide. Am J Emerg Medl3 199-203. 

Medical [Centers for Disease Control and Prevention (CDC), case definition, differential diagnosis, signs and symptoms, mass-casualty triage recommendations, casualty management, fatality management]... 

NING, C., KUHARA, T INOUE, Y, ZHANG, C.H., MATSUMOTO, M., SHINKA, T., FURUMOTO, T., YOKOTA, K., MATSUMOTO, I., Gas chromatographic mass spectrometric metabolic profiling of patients with fatal infantile mitochondrial myopathy with De Toni-Fanconi-Debre syndrome, Acta Paediatrica Japonica, 1996,38,661-666. 

IMMEDIATE A casualty classified as immediate has an injury that will be fatal of he does not receive immediate care. In a non-mass casualty situation, he would be the first casualty to receive care. However, in a mass casualty situation, particularly in a far-forward medical treatment facility, he may not receive this care. The required care may not be available at that echelon (e.g., a casualty may need major chest surgeryjor the time needed to provide the care may be so prolonged that other casualties would suffer. 

Boisier, P., et al.. Fatal mass poisoning in Madagascar following ingestion of a shark (Carcharhinus leucas) clinical and epidemiological aspects and isolation of toxins, Toxicon, 33, 10, 1359, 1995. 

O2 is supplied to the surfece waters of the ocean through two processes photosynthesis and the dissolution of atmospheric O2 across the air-sea interfece. Because both processes are restricted to the surfece waters, the only source of O2 to the deep sea is through the sinking of surface water masses. If the rate of deepwater formation was to slow or stop, so would the transport of O2 to the deep sea, with potentially fatal consequences for deep-dwelling aerobic organisms. 

The fatality rate was also analyzed in the group of 97 randomly-selected patients with acute pancreatitis, treated in Minsk hospitals prior to 1988 by a similar treatment program using HS over uncoated activated carbon sorbents of the SKN type [5], Eighteen healthy donors served as control. It should be noted that patients in both groups were treated with intravenous infusion of the protease inhibitor from bovine lung (Contrykal, Dresden, Germany 5,000 U per body mass per day). 

Methanol is widely used as a solvent and as a denaturing agent for ethanol and is also found in antifreeze. Mass poisonings have occurred because of ingestion in alcoholic drinks made with contaminated ethanol as well as from accidental exposure. Inhalation and skin absorption may cause toxicity. In humans, about 10 mL can cause blindness and 30 mL is potentially fatal, but there is variation in the lethal dose. 

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