Disasters with significant numbers of burn-injured patients create incredible challenges for disaster planners. Although not unique to burn care, high-intensity areas of speciality such as burns, pediatrics, and trauma quickly become scarce resources in a disaster.All disasters are local, but regional support is critical in burn disaster planning. On a day-to-day basis, burn bed capacity can be problematic. A review of the literature and our experiences, including mathematical modeling and real events, reaffirm how rapidly we can overwhelm our resources.This review includes the Southern Burn Plan, created by the burn centers of the American Burn Association's Southern Region, should there be a need for additional hospital burn beds (capacity) and burn care (capability) in response to a disaster. This article also explores planning and preparedness developments and describes options to improve our efforts, including training and education.It is incumbent upon everyone in the healthcare profession to become comfortable managing burn-injured patients until the patients can be moved to a burn center. Understanding the regional capacity, capability, and when a surge of patients may require the practice of altered standards of care is essential for those involved in medical disaster preparedness.
"The process used to manage a surge of burn injured patients in the region is detailed in the Southern Region Burn Disaster Plan (SRBDP)  . The burn patients needing evacuation posed a challenge since the first wave of evacuated American and Haitian burn patients had already pushed the Miami area burn center beyond conventional capacity . "
[Show abstract][Hide abstract] ABSTRACT: Response to the 2010 Haitian earthquake included an array of diverse yet critical actions. This paper will briefly review the evacuation of a small group of patients with burns to burn centers in the southeastern United States (US). This particular evacuation brought together for the first time plans, groups, and organizations that had previously only exercised this process. The response to the Haitian earthquake was a glimpse at what the international community working together can do to help others, and relieve suffering following a catastrophic disaster. The international response was substantial. This paper will trace one evacuation, one day for one unique group of patients with burns to burn centers in the US and review the lessons learned from this process. The patient population with burns being evacuated from Haiti was very small compared to the overall operation. Nevertheless, the outcomes included a better understanding of how a larger event could challenge the limited resources for all involved. This paper includes aspects of the patient movement, the logistics needed, and briefly discusses reimbursement for the care provided.
Burns: journal of the International Society for Burn Injuries 01/2014; 40(6). DOI:10.1016/j.burns.2013.12.015 · 1.88 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In 2005, the American Burn Association published burn disaster guidelines. This work recognized that local and state assets are the most important resources in the initial 24- to 48-hour management of a burn disaster. Historical experiences suggest there is ample opportunity to improve local and state preparedness for a major burn disaster. This review will focus on the basics of developing a burn surge disaster plan for a mass casualty event. In the event of a disaster, burn centers must recognize their place in the context of local and state disaster plan activation. Planning for a burn center takes on three forms; institutional/intrafacility, interfacility/intrastate, and interstate/regional. Priorities for a burn disaster plan include: coordination, communication, triage, plan activation (trigger point), surge, and regional capacity. Capacity and capability of the plan should be modeled and exercised to determine limitations and identify breaking points. When there is more than one burn center in a given state or jurisdiction, close coordination and communication between the burn centers are essential for a successful response. Burn surge mass casualty planning at the facility and specialty planning levels, including a state burn surge disaster plan, must have interface points with governmental plans. Local, state, and federal governmental agencies have key roles and responsibilities in a burn mass casualty disaster. This work will include a framework and critical concepts any burn disaster planning effort should consider when developing future plans.
Journal of burn care & research: official publication of the American Burn Association 07/2013; 35(1). DOI:10.1097/BCR.0b013e31829afe25 · 1.43 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In some circumstances, burn care must be delivered in a simple manner without the luxury of modern resources. Such circumstances include care in low- and middle-income countries, war zones, and mass casualty incidents. Triage decisions need to be made carefully, allowing the focus of limited personnel and equipment on those most likely to survive. Simple techniques can be used to help many burn victims, such as utilizing oral resuscitation formulas for burn resuscitation. Although even the best attempts at preparation often fall short, there are many benefits from planning and training.
Surgical Clinics of North America 08/2014; 94(4). DOI:10.1016/j.suc.2014.05.011 · 1.88 Impact Factor
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