question: How do hospitals and other similar emergency services know who your next of kin is if you are brought in unconscious or dead?
comment: Well they will try and identify you based on ID you may have, finderprint records etc, but if they're unsuccessful (which doesn happen regularly) you are just listed as a John/Jane Doe and sometimes never claimed
passages: BULLET::::- : Individuals listed as black have died. The person's pulse and breathing is checked to confirm no vitals present. In low scale disaster with few victims involved, immediate CPR is started in attempt to revive the vital signs. In larger events with more victims, the head is positioned to open the airway, the body is rolled onto its side and the responder will move on to the next victim. The positioning is done so if the body's vitals return, vomiting will not be as likely to choke the victim. The bodies will not be collected until all surviving individuals have been removed from the immediate disaster area. There will be a body collection staging area set up away from any medical staging areas. Usually this will begin the recovery phase.
   Preliminary assessment of injuries is usually done by the first ambulance crew on scene, with this role being assumed by the first doctor arriving at the scene. As a rule, there will be no cardiopulmonary resuscitation, so patients who do not breathe on their own or develop circulation after their airways are cleared will be tagged "deceased". Also, not every major injury automatically qualifies for a red tag. A patient with a traumatic amputation of the forearm might just be tagged yellow, have the bleeding stopped, and then be sent to a hospital when possible. After the preliminary assessment, a more specific and definite triage will follow, as soon as patients are brought to a field treatment facility. There, they will be disrobed and fully examined by an emergency physician. This will take approximately 90 seconds per patient.
   BULLET::::- Norris Hall - A BVRS medic was on the Blacksburg Police Emergency Response Team (ERT) team that went into Norris Hall, and he and a Virginia Tech Rescue Squad Medic initiated triage and of the victims.
  
  BULLET::::- ICS and Unified Command established.
  
  BULLET::::- After Norris Hall was cleared and secured, three BVRS members went in assess casualties and confirm status of deceased victims.
   Hospitals typically have internal intercom codes used for situations when someone has suffered a cardiac arrest or a similar potentially fatal condition outside of the emergency department or intensive care unit (where such conditions already happen frequently and do not require special announcements). When such codes are given, hospital staff and volunteers are expected to clear the corridors, and to direct visitors to stand aside as the crash cart and a team of physicians, pharmacists and nurses may come through at any moment. ("See" Code Blue.)
  
  Section::::History in the United States.
   BULLET::::- Hospitals with emergency departments will have a mass casualty incident protocol which they initiate as soon as they are notified of an MCI in their community. They will have preparations in place to receive a massive number of casualties, like calling in more staff, pulling extra and spare equipment out of storage, and clearing non-acute patients out of the hospital. Some hospitals will send doctors to the scene of the incident to assist with triage, treatment, and transport of injured persons to the hospital.
  
  Section::::Agencies and responders.:Hospitals.:Trauma centers.
   For military notifications, there are usually multiple persons involved: the notifying officer, a chaplain who accompanies the notifying officer throughout the process and who may also assist in delivering the news, a medic (in case the family member faints), and an officer who stays in the car in case the family members react violently.
  
  The US Army Manual states that
  
  "The Next of Kin will be notified promptly in an appropriate dignified and understanding manner by a uniformed service representative. He/she will wear the Class "A" uniform and present a soldierly appearance when making notification."
   With some systems, an alert arrives in the offices of the alert system operator (which may be a public rescue service or a private security company) and the data of the affected person (address, medical condition, family contacts) are displayed. With others, there is no system operator, and the user simply programs the numbers of family members, neighbors, or local emergency responders.
  
  If present, a responder can speak with the user through the microphone/speaker in order to clarify the type and severity of the emergency and discuss further measures.
   Responders arriving to the scene of a mass casualty incident may first ask that any victim who is able to walk relocate to a certain area, thereby identifying the ambulatory, or walking wounded, patients. Non-ambulatory patients are then assessed. The only medical intervention used prior to declaring a patient deceased is an attempt to open the airway. Any patient who is not breathing after this attempt is classified as deceased and given a black tag. No further interventions or therapies are attempted on deceased patients until all other patients have been treated. Patients who are breathing and have any of the following conditions are classified as immediate:
   Specific to emergency medicine, incoming patients in immediate danger of life or limb, whether presenting via ambulance or walk-in triage, are paged locally within the emergency department as "Resus" [ri:səs] codes. These codes indicate the type of emergency (general medical, trauma, cardiopulmonary or neurological) and type of patient (adult or pediatric). An estimated time of arrival may be included, or "now" if the patient is already in the department. The patient is transported to the nearest open trauma bay or evaluation room, and is immediately attended by a designated team of physicians and nurses for purposes of immediate stabilization and treatment.
   Section::::Declaration.:Scene assessment.
  
  After the proper agencies have arrived, a more detailed assessment of the scene will be performed using the M.E.T.H.A.N.E method, which summarizes information necessary for responders:
  
  BULLET::::- Mass incident declared
  
  BULLET::::- Exact location
  
  BULLET::::- Type of incident
  
  BULLET::::- Hazards present
  
  BULLET::::- Access and egress
  
  BULLET::::- Number of casualties and severity
  
  BULLET::::- Emergency services required
  
  Section::::Agencies and responders.
  
  There are multiple agencies involved in most mass casualty incidents, which means there are many individuals that require training for these specific situations. The most common types of agencies and responders are listed below.
  
  Section::::Agencies and responders.:Emergency medical services.
   The first-arriving crew will conduct triage. Pre-hospital emergency triage generally consists of a check for immediate life-threatening concerns, usually lasting no more than one minute per patient. In North America, the START system (simple triage and rapid treatment) is the most common and is considered the easiest to use. Using START, the medical responder assigns each patient to one of four color-coded triage levels, based on their breathing, circulation, and mental status. The triage levels are:
  
  BULLET::::- : Patients who have major life-threatening injuries, but are salvageable given the resources available
   Casualty notification
  
  Casualty notification is the process of notifying relatives of people who have been killed or seriously injured unexpectedly (for example, in a car crash). The notification may be done over the phone or in person, but is normally done by a police officer in person when possible, at least for the next of kin.
   BULLET::::- Medical service personnel on site normally do not have the time to contact relatives. Information stored in a phone is thus useless for medical care prior to hospital.
  
  BULLET::::- Contacting relatives of a seriously injured person is a sensitive task that is not carried out by telephone in the first place.
  
  It is recommended that one carries contact information and relevant medical information in writing inside one's wallet, and not rely on ICE contacts as a primary means of identification. 
   The concept of implied consent can protect first responders in emergency situations. A first responder may not legally touch a patient without the patient's consent. However, consent may be either expressed or implied:
  
  BULLET::::- If a patient is able to make decisions, they must give expressed, informed consent before aid is given.
   BULLET::::- Jill Browne as Nurse Carole Young, Staff Nurse
  
  BULLET::::- Rosemary Miller as Nurse Pat Roberts, Staff Nurse
  
  BULLET::::- Charles Tingwell as Doctor Alan Dawson, Senior House Officer
  
  BULLET::::- Frederick Bartman as Doctor Simon Forrester, Senior House Officer
  
  BULLET::::- Pamela Duncan as Sister Doughty, Charge Sister
  
  BULLET::::- Desmond Carrington as Doctor Chris Anderson, Consultant in Emergency Medicine
  
  BULLET::::- John Carlisle as Mr Lester Large, Consultant General Surgeon
  
  BULLET::::- Peter Howell as Doctor Peter Harrison, Pre-registration house officer
  
  BULLET::::- Anne Lloyd as Nurse Pat Roberts, Staff Nurse
  
  BULLET::::- Glyn Owen as Doctor Patrick O'Meara, Medical Registrar in Cardiology
   Every second counts when it comes to stopping a bleed. According to the American College of Surgeons, "Civilians need basic training in bleeding control principles so they are able to provide immediate, frontline aid until first responders are able to take over care of an injured person. Due to many situations, there may be a delay between the time of injury and the time a first responder is on the scene. Without civilian intervention in these circumstances, preventable deaths will occur."
  
  Section::::Significant Events.:2018 PulsePoint Launch.
   In the case of the United States armed forces, the notification is done by a specialist known as a casualty notification officer (CNO), normally within four hours of learning of the casualty (but only from 6:00 a.m. to 10:00 p.m. local time) or, for the Navy, by a casualty assistance calls officer (CACO).
  
  Denny Hayes, who spent fifteen years as a chaplain for the FBI’s critical response team, says:
  
  BULLET::::- Always deliver bad news in person.
  
  BULLET::::- Always bring a partner (“95 percent of them defer to me to do the actual speaking of the words—nobody wants to experience sad”).
   Each colored triage category will have its own treatment area. Treatment areas are often defined by colored tarpaulins, flagging tape, signs, or tents. Upon arrival in the treatment area, the casualties are re-assessed and they are treated with the goal of stabilizing them until they can be transported to hospitals; transported to the morgue or medical examiner's office; or released.
  
  Section::::Flow.:Treatment.:On-site morgue.
  
  Some mass-casualty incidents require an on-site morgue, for several reasons:
  
  BULLET::::- To await transfer of these victims to a permanent morgue;
  
  BULLET::::- When the deceased must be removed to access injured victims;
   Two to three trained professionals arrive at the room of the Emergency, and will work together with staff to assist the patient, as well as doctors, nurses and anyone who is able to help. Jobs are allocated including someone to record the nature of emergency and what they are doing to fix the problem. 
  
  Some patients may be transferred to ICU post MET.
   Depending on the organization of the service and the type of emergency help required, relatives or neighbors can be informed. If necessary, health care services or personal physicians can be notified or emergency medical services can be alarmed. Some monitoring services also provide the client with a USB medical alert device so that arriving emergency personnel can have immediate access to vital medical information.
  
  Some units can call user selected numbers, so relatives or neighbors can be called directly, avoiding the expense of a monitoring service.
   The next stage involves casualty assessment based on results driven by simulated engagements under the MILES system. Any and all casualties are transferred to the ORCA stage, given initial wound assessments, put into an initial medical state (severe, critical, dead), and finally passed on to the JMSL. Under the JMSL, all casualties generated by MILES and assessed initially by ORCA are sent through transition phases in order to accurately simulate a casualty progressing to a more and more deadly state while awaiting treatment under average circumstances.
   BULLET::::- Code black: hospital at capacity – no available beds for new admissions from A&E. A code black is declared by the hospital's general bed manager, who then relays this to the local ambulance service and posts updates for local healthcare services such as GPs and district nursing teams.
  
  Otherwise, non-colour codes are mostly used across the NHS:
   Section::::Review.
  
  It is common practise with emergency procedures to have review processes where the lessons learnt from previous emergencies, changing circumstances, changes in personnel, contact details, etc. can be incorporated into the latest version of the documentation.
  
  Section::::Examples.
  
  Some typical emergency procedures are:
   During the early stages of an incident, first responders may be overwhelmed by the scope of patients and injuries. One valuable technique is the Patient Assist Method (PAM). The responders quickly establish a casualty collection point (CCP) and advise, either by yelling, or over a loudspeaker, that "anyone requiring assistance should move to the selected area (CCP)". This does several things at once, it identifies patients that are not so severely injured, that they need immediate help, it physically clears the scene, and provides possible assistants to the responders. As those who can move, do so, the responders then ask, "anyone who still needs assistance, yell out or raise your hands"; this further identifies patients who are responsive, yet maybe unable to move. Now the responders can rapidly assess the remaining patients who are either expectant, or are in need of immediate aid. From that point the first responder is quickly able to identify those in need of immediate attention, while not being distracted or overwhelmed by the magnitude of the situation. Using this method assumes the ability to hear. Deaf, partially deaf, or victims of a large blast injury may not be able to hear these instructions.
   In cases of medical emergency, where a person is incapable (either legally because of age or mental infirmity, or because they are unconscious) of making decisions for themselves and they have no spouse or children, the next of kin may participate in medical decisions made by medical personnel, subject to the specific laws of the jurisdiction.
  
raw_presuppositions: Hospitals are successful in finding next of kin. If you are brought in unconscious or dead, the hospital can not find out who your next of kin is.
raw_corrections: Hospitals can be unsuccessful at finding next of kin.  The hospital can identify you, such as through fingerprint records.