OCD 3033 October 1942 Medical Division Bulletin No. J EMERGENCY MORTUARY SERVICES United States Office of Civilian Defense Washington9 D. C. TABLE OF CONTENTS Page General Considerations 1 Preliminary Procedure 1 : Organization „ 2 A. Morgue 2 B. Insignia * 2 C. Transport Facilities 2 Operation 3 A. Marking and Segregation 3 B. Transport. 3 C. Morgue Reception - 3 D. Personal Property 4 E. Morgue Storage 4 F. Identification Procedures 4 G. Release and Disposal of Bodies 4 Special Treatment of Gas-Contaminated Bodies 6 Emergency Mass Disposal of Bodies 6 Casualty Reporting 6 Completion and Storage of Records 6 EMERGENCY MORTUARY SERVICES GENERAL CONSIDERATIONS PRELIMINARY PROCEDURE In some air raids forty percent of the casualties The local Chief of Emergency Medical Servic« may be fatal, but fortunately the total number of should call into conference the following officers casualties is usually small in proportion to the who, besides himself, may have normal or emer- amount of property damage. While the wounded gency responsibilities in the collection and dis- require first attention, the dead should be cared posal of the dead. Under his leadership, this for promptly and inconspicuously, and always group should create the necessary organization with proper reverence and respect. The mortuary and clarify the lines of responsibility for handling service is an essential part of the casualty organi* the fatalities. A careful survey of existing morgue, zation and of the war effort, and must be con- mortuary and cemetery facilities should be the ducted with tact and efficiency. Detailed in- first step in planning for emergencies. structions for all communities are impossible be- 1. Medical Examiner, Coroner or similar cause of wide variations in local legal practices official who has legal responsibilities in connection and responsibilities, but general principles and with the investigation of deaths from violence and procedures may be indicated. disposition of remains. Normal funeral services, including embalming, 2. Chief of Police, who usually has legal re- caskets and individual burial or cremation, should sponsibilities for identification of the dead and be provided by private morticians insofar as disposal of their personal effects. circumstances permit, and every opportunity 3. Health Officer, who has public health re- should be given for appropriate religious observ- sponsibilities in the disposal of bodies and record- ances. There must be sufficient mortuary and ing of deaths. burial accommodations as well as sufficient staff 4. Representative of the private funeral and transport to deal with the number of bodies directors and cemeteries, to act as liaison officer which may reasonably be expected in view of the with that profession in planning for the collection, size and density of the population and the degree transportation and temporary storage of the dead of exposure to enemy attack. It is essential to and for the preparation of bodies few burial. provide for prompt removal of bodies from the Several national and local organizations of funeral scene of the incident to a mortuary, followed by directors have made plans to cooperate with local identification and rapid clearance of the mortuary. civilian defense authorities. Speed and efficiency must be coupled with con- These officials in conference should provide for: sideration for the feelings of bereaved relatives. a. Location of the morgue and of supplementary A breakdown in this important service may have morgue facilities. a serious effect upon public morale and the prose- b. Administration of these facilities by the cution of the war. police, medical examiner or coroner under whom To facilitate identification, each civilian in they are customarily operated. target areas of the country should be encouraged c. Training of supplementary mortuary per- to carry an identification bracelet or necklace, or sonnel in adequate numbers for emergency duty a metal identification pocket piece. These may at morgue and on mortuary vehicles. be obtained at jewelry stores, five-and-ten-cent d. Responsibility for the collection and prep- stores, novelty shops and from public vending aration of the dead and for burial. machines. Lucky pocket pieces and key tags e. Rules governing the emergency issuance of with names are examples of useful vending ma- death certificates and burial permits for both chine products. Metal “charga-plates” issued by identified and unidentified casualties. some department stores for credit purposes make f. Type of inquests, if any, to be required. satisfactory identification tags. Although inquests should not be required for 483691°—42 deaths due to enemy action, autopsies are of great 3. Recorder, to supervise the reception and value in planning better means of future protec- disposal of bodies and to keep the Morgue Record tion and should be encouraged whenever possible. Book. g. Safeguarding of personal property of the 4. Property Officer, to keep personal property identified and of the unidentified dead. and the records pertaining thereto. h. Manufacture of board coffins in adequate 5. Identification Officer, who controls the numbers. viewing of bodies and completes the identification i. Pooling of equipment and personnel of private record, including fingerprinting, photographing mortuaries in emergencies. and recording identifying marks or anatomical j. Identification procedures: Viewing by rela- features. A police officer, experienced in identi- tives and friends, photography, fingerprinting, fication procedures, serves well in this capacity. and other means of identification. He may require assistance in the making of finger- k. Location and preparation of burial places for print records and identification photographs, and unclaimed and unidentified bodies. the services of a dentist to make dental charts. l. Preparation of mortality lists and determina- 6. A Coroner's or Medical Examiner’s Rep- tion of policy concerning their publication or post- resentative, who has authority to sign death ing by the police, the health officer, or other cas- certificates and order disposal of unidentified ualty information officer. bodies. m. Arrangements with neighboring communi- 7. Morgue Attendants, for handling bodies; ties for mutual aid, which should include provision one per 10,000 population with a minimum of for the loan of mortuary personnel and equipment. four part time attendants in each morgue. 8. Clerical Assistants, at least one per 50,000 ORGANIZATION population with a minimum of two per mortuary. 9. Receptionists, tactful and intelligent female A, Morgue attendants, who should be available for interview- ing and consoling the relatives and friends. cities, In large the morgue facilities and equip- In small cities, several of these functions may ment should not be concentrated in one place. be assumed by one person. Fewer personnel are (designated “A”) The main morgue should be needed in less exposed areas. located centrally; it will usually be the regular public morgue of the community. Tentative B. insignia arrangements should be made for the use of skating All volunteer members of an emergency mortu- rinks, gymnasiums, auditoriums, or similar build- ary organization are to enroll with the Civilian ings for use as supplementary morgues (designated Defense Volunteer Office and be registered offi- B, C, D, etc.) as necessary to provide space to lay cially by the Director of the Mortuary Service as out bodies in the ratio of two per thousand popu- members of the United States Citizens Defense lation, in target areas. Corps. They are then entitled to wear the arm- The normal morgue personnel should be supple- band and insigne of the Emergency Medical Serv- mented with auxiliaries who have been trained by ice, of which the Mortuary Service is a part. instructors furnished by the morticians of the f. Transport community. Some of the morgue personnel may Facilities be employees of the police department or of the To insure the most economical use of transport medical examiner’s office, assisted by trained vol- vehicles, the hearses, flower cars and other vehicles unteers from private funeral establishments who of private mortuaries should be in the transport are accustomed to handling the dead. pool of the Emergency Medical Service and be The staff of the Emergency Mortuary Service under the direction of the transport officer during in large cities should consist of the following during and after a raid. If other vehicles are used, the emergency periods: floor and a short distance up the sides should be 1. Director, in charge of morgue operations. lined with some suitable non-absorbent material 2. Physician, to confirm deaths. that may readily be washed down. OPERATION in hospitals or homes, ifreleased by the coroner or medical examiner or by the health officer, may be . Marking and A Segregation transferred directly to private mortuaries. Un- The dead should be tagged in the field with identified dead should always be sent to the identification tags in the same manner as the morgue. wounded, covered with clothing or sheets if It may at times be necessary to employ the possible, and segregated from the living while same vehicle for the dead as for the wounded, awaiting transport. A record of the site where although some cities prohibit such use. the body was found is important, for it may pro- C. Morgue Reception vide a clue to identification. The dead should not be brought by stretcher Immediately after arrival at the morgue, a teams to a first aid post, casualty station or hos- physician should again examine each body to con- pital. Those who die after reaching these places firm state of death; ifthere is any possibility of life, should be placed in a separate room or yard from the body should be removed at once to a hospital. which they are later removed, preferably by When a body is received, a metal tag showing a separate exit. letter to identify the morgue and a serial accession Whenever possible, a physician should examine number should be fastened around the neck with the body before it is moved to the morgue so as to a wire.