Beyond surge: Coping with mass burn casualty in the closest hospital to the Formosa Fun Coast Dust Explosion

Chuang, Sheuwen; Chang, Kuo Song; Woods, David D.; Chen, Hsiao Chun; Reynolds, Morgan; Chien, Ding-Kuo

doi:10.1016/j.burns.2018.12.003

Cited by 12 publications

(8 citation statements)

References 15 publications

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“…1 (overload patterns) and Tables 3 , 4 and 5 for the planning to capture an overall understanding of what challenges could occur over time and how hospitals responded to these difficulties to extend emergency care in each category. Also, emergency planners can consult the responses described in more detail in individual publications regarding two hospitals at an extreme and high level [ 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Next, the researchers conducted extensive, in-depth, semi-structured interviews with 34 participants across multiple levels of each of the four hospitals. The content of the interviews is described in more detail in individual publications regarding two of the hospitals [ 6 , 7 ]. Finally, the data were corroborated with detailed patient information from hospital records.…”

Section: Methodsmentioning

confidence: 99%

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Rethinking preparedness planning in disaster emergency care: lessons from a beyond-surge-capacity event

et al. 2021

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Background Large-scale burn disasters can produce casualties that threaten medical care systems. This study proposes a new approach for developing hospital readiness and preparedness plan for these challenging beyond-surge-capacity events. Methods The Formosa Fun Coast Dust Explosion (FFCDE) was studied. Data collection consisted of in-depth interviews with clinicians from four initial receiving hospitals and their relevant hospital records. A detailed timeline of patient flow and emergency department (ED) workload changes of individual hospitals were examined to build the EDs' overload patterns. Data analysis of the multiple hospitals' responses involved chronological process-tracing analysis, synthesis, and comparison analysis in developing an integrated adaptations framework. Results A four-level ED overload pattern was constructed. It provided a synthesis of specifics on patient load changes and the process by which hospitals' surge capacity was overwhelmed over time. Correspondingly, an integrated 19 adaptations framework presenting holistic interrelations between adaptations was developed. Hospitals can utilize the overload patterns and overload metrics to design new scenarios with diverse demands for surge capacity. The framework can serve as an auxiliary tool for directive planning and cross-check to address the insufficiencies of preparedness plans. Conclusions The study examined a wide-range spectrum of emergency care responses to the FFCDE. It indicated that solely depending on policies or guidelines for preparedness plans did not contribute real readiness to MCIs. Hospitals can use the study's findings and proposal to rethink preparedness planning for the future beyond surge capacity events.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Rethinking preparedness planning in disaster emergency care: lessons from a beyond-surge-capacity event

et al. 2021

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“…Another study examined how hospital staff adapted to the overwhelming surge in patients and workload and the concomitant shortage of clinicians, beds, and medical materials. 16 However, their findings were practical responses for mobilization, rather than emotional responses to the experience.…”

Section: Introductionmentioning

confidence: 95%

Calling nurses to care for burn victims after color-dust explosion

Tsai¹,

Chiang

et al. 2021

Nurs Ethics

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Background: Healthcare professionals follow codes of ethics, making them responsible for providing holistic care to all disaster victims. However, this often results in ethical dilemmas due to the need to provide rapid critical care while simultaneously attending to a complex spectrum of patient needs. These dilemmas can cause negative emotions to accumulate over time and impact physiological and psychological health, which can also threaten nurse–patient relationships. Aim: This study aimed to understand the experience of nurses who cared for burn victims of the color-dust explosion and the meaning of ethical relationships between nurse and patient. Research design: A qualitative descriptive study using a phenomenological approach. Participants and research context: Clinical nurses who provided care to the patients of the Formosa color-dust explosion of 2015 were selected by purposive sampling (N = 12) from a medical center in Taiwan. Data were collected using individual in-depth semi-structured interviews. Audiotaped interviews were transcribed and analyzed using Colaizzi’s method. Ethical considerations: This study was approved by the institutional review board of the study hospital. All participants provided written informed consent. Findings Three main themes described the essence of the ethical dilemmas experienced by nurses who cared for the burn-injured patients: (1) the calling must be answered, (2) the calling provoked my feelings, and (3) the calling called out my strengths. Conclusions: Healthcare providers should recognize that nurses believed they had an ethical responsibility to care for color-dust explosion burn victims. Understanding the feelings of nurses during the care of patients and encouraging them to differentiate between the self and the other by fostering patient–nurse relationships based on intersubjectivity could help nurses increase self-care and improve patient caregiving.

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“…A previous study reported that more than 700 tanker truck explosions occurred in China from 2004 to 2011, resulting in numerous burn-related casualties [ 5 ]. The accidental explosions that happen casually worldwide also cause a mass of burn-related injury and death [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Use of the Braden Scale to Predict Injury Severity in Mass Burn Casualties

Zhu

Shao

et al. 2021

Med Sci Monit

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Background Mass burn casualties impose an enormous burden on triage systems. The triage capacity of the Braden Scale for detecting injury severity has not been evaluated in mass burn casualties. Material/Methods The New Injury Severity Score (NISS) was used to dichotomize the injury severity of patients. The Braden Scale and other potentially indicative measurement tools were evaluated using univariate analysis and multivariate logistic regression. The relationships between the Braden Scale and other continuous variables with injury severity were further explored by correlation analysis and fitted with regression models. Receiver operating characteristic (ROC) curve analysis was used to validate triage capacity and compare prognostic accuracy. Results A total of 160 hospitalized patients were included in our study; 37 were severely injured, and 123 were not. Injury severity was independently associated with the Numerical Rating Scale (adjusted OR, 1.816; 95% CI, 1.035–3.187) and Braden Scale (adjusted OR, 0.693; 95% CI, 0.564–0.851). The ROC curve of the fitted quadratic model of the Braden Scale was 0.896 (0.840–0.953), and the cut-off value was 17. The sensitivity was 81.08% (64.29–91.44%) and the specificity was 82.93% (74.85–88.89%). Comparison of ROC curves demonstrated an infinitesimal difference between the Braden Scale and NISS for predicting 30-day hospital discharge (Z=0.291, P =0.771) and Intensive Care Unit admission (Z=2.016, P =0.044). Conclusions The Braden Scale is a suitable triage tool for predicting injury severity and forecasting disability-related outcomes in patients affected by mass burn casualty incidents.

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Beyond surge: Coping with mass burn casualty in the closest hospital to the Formosa Fun Coast Dust Explosion

Cited by 12 publications

References 15 publications

Rethinking preparedness planning in disaster emergency care: lessons from a beyond-surge-capacity event

Rethinking preparedness planning in disaster emergency care: lessons from a beyond-surge-capacity event

Calling nurses to care for burn victims after color-dust explosion

Use of the Braden Scale to Predict Injury Severity in Mass Burn Casualties

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