Types of mass fatality emergencies: intensive and extensive

Many different types of emergency may result in mass fatalities, including:

• serious transport accidents
• building collapses
• flooding, fire and other weather-related incidents
• accidents resulting from explosions or the release of harmful substances
• serious stadium or crowd emergencies
• epidemic and pandemic illnesses
• hostile acts such as terrorism

Some emergencies which result in mass fatalities will require intensive and detailed work to investigate their causes, identify victims or to collect evidence to support a possible prosecution. In particular, forensic pathology and DVI are likely to have a dominant role in emergencies where criminality or negligence is suspected or where the deceased have suffered extensive trauma.

In other types of emergencies the causes and the circumstances of deaths may be largely understood, but the impact may be more extensive, for example public health incidents. Although emergencies may contain both intensive and extensive aspects, in most cases one or other will predominate; this guidance therefore considers these aspects separately in the extensive emergencies and intensive emergencies sections.

Intensive emergencies

• Usually localised (or few locations)
• Sudden impact, unexpected
• Forensic or other investigations needed
• DVI often needed
• Mutual aid arrangements often possible
• NEMA may be required 
• Number of deaths often lower than large extensive emergencies but fragmentation more likely
• Fatality throughput rate limited by investigative processes

Extensive emergencies

• Not localised
• Gradual build-up more likely
• Exhaustive investigation may only be needed for a few cases
• DVI not required
• Mutual aid may not be available
• NEMA not normally applicable
• Large number of deaths may occur but fragmentation less likely
• Fatality throughput rate challenges all agencies involved with care of the deceased

Business continuity management and reserve capacity

Category 1 responders are required under the Civil Contingencies Act to have in place business continuity management (BCM) arrangements to address potential disruptions to the services they provide. Other organisations and private businesses involved in the provision of care of the deceased may have BCM arrangements to a greater or lesser extent. Planners and responders should confirm that BCM arrangements for registration offices, mortuaries, crematoriums and burial grounds are current, robust and address all reasonably foreseeable contingencies.

These arrangements should be based on local risk assessments and should take into account the likelihood that mutual aid arrangements may be unavailable during periods of increased demand and during widespread emergencies such as a pandemic.

Planners and responders should ensure that established business continuity arrangements are compatible with mass fatality plans. Any supplementary resources these identify, along with mutual aid arrangements, should be among the first parts of response plans to be considered if there is a shortfall in capacity.

Principles and priorities

As mass fatality emergencies are, by definition, situations where some normal practices are difficult or impossible to maintain, planners and responders may sometimes have to prioritise some procedures and practices over others. Decisions of this sort may be difficult and their consequences distressing. To assist in making and explaining them, consideration should be given to the principles set out in the UK Influenza Pandemic Preparedness Strategy.

In order to prepare and implement mass fatality plans, particularly those parts requiring prioritisation of services and changes to normal working practices, discussion with appropriate representatives of faith communities will also be required. The Scottish Government will assist with this by consulting with faith communities at national level. Suggestions for subjects that should be discussed with faith communities' representatives locally are given in the section on 'Extensive emergencies - requiring little or no forensic pathology'.

Communications with the public

Decisions about changes to normal arrangements to care for the deceased will have to be communicated to the staff implementing them, bereaved relatives and other members of the public that they affect. The handling of these communications will be vital to the success of the response and the long-term wellbeing of the community. Guidance on this generic emergency response function is available in the Preparing Scotland 'Guidance on responding to emergencies in Scotland: Warning and informing'.