The resources needed to deliver modern burn care may be overwhelmed by mass casualty disasters. In 2021, the World Health Organization (WHO) recommended that countries prepare teams of deployable burn experts to assist with responding to a mass casualty disaster. The aim of this scoping review was to identify existing literature regarding burn mobile response team organization, describe the reported effectiveness of these teams, identify challenges in adopting the WHO recommendations, and consider how the recommendations may be reconsidered. We conducted a scoping review of all literature types published up to January 2022. Searches of MEDLINE, EMBASE, Scopus, and CINAHL databases were conducted to identify reports informing or reporting the use of mobile burn care specialty teams that respond to events resulting in multiple burn-injured victims, including pediatric victims and military response to civilian events. Of 6,132 identified reports, 26 publications were reviewed. Three types of mobile burn response teams were identified: 1) teams organized by burn care networks, 2) government-organized medical disaster teams with burn-specific experts, and 3) the US Army Burn Flight Team. Teams have responded to events such as terrorist attacks by providing specialized burn supplies and personnel. These teams have demonstrated expert triage and stabilization advantages but are limited by the number of deployable specialists. Although the WHO recommends increasing the number of mobile burn response teams available around the world, few countries have implemented this recommendation. A hybrid model where responders on scene communicate with burn centre experts to manage triage may address these challenges.

Introduction Advancements in the treatment of burns have reduced morbidity. However, the resources needed to deliver up-to-date care may be overwhelmed by mass casualty disasters. In 2021, the World Health Organization (WHO) recommended that countries prepare teams of deployable burn experts to assist with responding to a mass casualty disaster including burn patients. The aim of this scoping review was to identify existing literature regarding burn management mobile response team organization, describe the reported effectiveness of these teams, identify challenges in adopting the WHO recommendations and consider how the recommendations may be evolved. Methods We conducted a scoping review of all literature types published up to February 2021. Searches of MEDLINE, EMBASE, Scopus, and CINAHL databases were conducted to identify reports informing or reporting the use of mobile burn care specialty teams that respond to events resulting in multiple burn-injured victims, including pediatric victims and military response to civilian events. Results Of 5,737 identified reports, 24 publications were reviewed. Three distinct types of mobile burn response teams were identified: 1) teams organized by burn care networks; 2) government-organized medical disaster teams with burn-specific experts, and 3) the US Army Burn Flight Team. Teams have responded to events such as terrorist attacks by providing specialized burn supplies and personnel. Mobile burn response teams have demonstrated expert triage and stabilization advantages but are limited by the number of deployable specialists. A challenge in deploying a mobile team is the removal of experts from a burn centre. Conclusions Although the WHO recommends increasing the number of mobile burn response teams available around the world, few countries have implemented this recommendation. A hybrid model where responders on scene communicate with burn centre experts to manage triage may address these challenges.

Introduction Burn mass casualty incident (BMCI) response planning includes involving relevant stakeholders, assessing regional burn care capacity, and addressing the specialized needs of burn patients. An essential component of these processes is an evaluation of existing resources and plans. In this study, a province with three important elements—a singular health authority to plan for, two burn centres, and updated health technology—was selected for evaluation. Aim What are the current policies, protocols, and practices that address a provincial response to a BMCI? Methods In this ethics approved case study, qualitative description methodology was used for data analysis. Data were gathered from documents outlining the health system response to a mass casualty incident from the health system internal emergency response plans. Health care professionals directly involved in the response were recruited for interviews. Participants were recruited from prehospital emergency management services, hospital emergency departments, inpatient burn units, and a provincial patient transport department. Interviews were conducted online, recorded, and transcribed. Qualitative description was used to code common themes across documents and transcripts. Results Thirteen documents and nine participant interviews were included. Only two documents included burn-specific considerations. Current policies and protocols were limited to all-hazards mass casualty incident planning and did not address specialized needs of burn care. Current plans were based on assumptions that all burn patients would be triaged and transported to burn centres and that surge capacity would be adequate to accommodate for increased demands. Prehospital participants (n=3) felt that existing plans would adequately manage a BMCI. Six participants stated the current plans were not sufficient to manage a BMCI. A comprehensive description of the complex health system response to a potential BMCI was obtained. Some major deficiencies identified included a lack of strategies to bolster burn care staffing capacity such as just-in-time training resources for non-burn trained staff or utilization of outpatient burn clinic staff. Considerations for increased operating room and wound care resources were absent. Conclusions Current provincial all hazards response plans are not sufficient to support adequate response to a BMCI and need to be amended to address the specialized needs of burn patients. Strategies for expanding capacity such as care of burn patients at non burn facilities and utilization of outpatient clinics must be integrated into future plans. Applicability of Research to Practice The provincial health authority needs to support BMCI response planning efforts to better address this unique hazard prior to an incident occurring for best patient outcomes.