Lessons Learned

  • A disaster victim identification (DVI) unit should be created and written into all disaster response and mass casualty plans.
  • A family reunification plan should be written into all disaster response and mass casualty plans.
  • Members of each law enforcement agency involved in the investigation (as applicable) should have at least one representative present in the DVI room until all victims have been reconciled.
  • The DVI structure should involve public relations, family care unit and information technology experts.
  • According to the Disaster Victim Identification Guide from INTERPOL (2014), do not be dependent on photography only. It is imperative to ask for descriptions of scars, tattoos, birthmarks, jewelry, etc.
  • Share your DVI plan with local and federal officials so that they are aware of your actions. This may assist in avoiding duplication of information.
  • Employees asked to serve on the DVI should have the appropriate skill set. They will be exposed to photos and alarming communications regarding the deceased. These individuals may include those with prior military experience and/or leaders with clinical backgrounds and prior experience with emergency situations and high stress.
  • Create an email address that can be shared with the public to gain photos and other information. Have someone dedicated to only this.
  • Save every piece of communication and correspondence between the DVI and community. This includes emails, photos and spread sheets with victim information. In our case, I saved everything to a secure, encrypted USB flash drive and made printed copies. I gave everything to our corporate manager of emergency preparedness. He then had custody of this information for our after action report (AAR) and in case law enforcement requested it.
  • Prior to sending decedents to the medical examiner, take 3 photos. Our mass fatality incident (MFI) plan states:
    • “Team members in the hospital shall photograph the face and/or unique identifiers, i.e. tattoos, piercings, birthmarks, scars; display Medical Record Number in the photo that is on body bag; place one copy with the body (outside of the body bag) attached to the paperwork referenced in Attachments B through D, retain one for family identification to be posted in the Family Staging Area and one set-aside for the MFI Morgue Unit Leader. Restrict photo usage to three (3) copies”.
  • Consider a web-based application that allows for photos and download in real-time. For a hospital, the ability to take a photo with identification and download to a screen in the DVI room, real-time, shaves minutes and hours off of identification time. This enables physicians to know exactly who they are treating and family members to know their loved one’s status. Existing products offer required privacy protection.
    • Some applications allow for public download of photos as well as other important information. The public-facing website only allows them to enter information. We have been working with a product vendor to investigate its potential to serve these needs.
    • Other organizations have used simple photo printing on paper. The concern in this example is the inability to share the web link with law enforcement or other hospitals who have received disaster victims. You will inevitably leave valuable incident participants out of the information sharing. This is how we managed with this tragedy.
    • If web-based applications are not an option, consider using a program such as Microsoft Share Point where multiple people within the same hospital/organization can access uploaded photos. Specify who can access the site.
  • Finally, do not underestimate the psychological effects that the DVI unit will endure. Select the team ahead of time and provide them with training that helps them identify stress- and anxiety-control during the disaster as well as the ability to identify signs and symptoms of anxiety stress disorder (ASD) after the incident.