Burn Disaster Response Planning: An Urban Region’s Approach

Abstract

The objective of this study was to describe a draft response plan for the tiered triage, treatment, or transportation of 400 adult and pediatric victims (50/million population) of a burn disaster for the first 3 to 5 days after injury using regional resources. Review of meeting minutes and the 11 deliverables of the draft response plan was performed. The draft burn disaster response plan developed for NYC recommended: 1) City hospitals or regional burn centers within a 60-mile distance be designated as tiered Burn Disaster Receiving Hospitals (BDRH); 2) these hospitals be divided into a four-tier system, based on clinical resources; and 3) burn care supplies be provided to Tier 3 nonburn centers. Existing burn center referral guidelines were modified into a hierarchical BDRH matrix, which would vector certain patients to local or regional burn centers for initial care until capacity is reached; the remainder would be cared for in nonburn center facilities for up to 3 to 5 days until a city, regional, or national burn bed becomes available. Interfacility triage would be coordinated by a central team. Although recommendations for patient transportation, educational initiatives for prehospital and hospital providers, city-wide, interfacility or interagency communication strategies and coordination at the State or Federal levels were outlined, future initiatives will expound on these issues. An incident resulting in critically injured burn victims exceeding the capacity of local and regional burn center beds may be a reality within any community and warrants a planned response. To address this possibility within New York City, an initial draft of a burn disaster response has been created. A scaleable plan using local, state, regional, or federal health care and governmental institutions was developed.

Urban–Rural Dichotomy of Burn Patients in Georgia and South Carolina

“…5 In the aftermath of 9/11, the need to focus more on burn-related emergency planning received renewed attention. 1 During the last couple of decades, a number of measures have been attributed to reduce life-threatening fatalities caused by burn injuries, including improved firefighting techniques, improved emergency medical care, use of smoke detectors, and public awareness. 6,7 However, studies focusing on epidemiology of burn injury and its prevention, particularly with regard to the geographic location of the burn accident, given socioeconomic characteristics of the population, have received very little attention.…”

“…Severe burn injuries require specialized care and hospitalization through one of the 132 burn care and rehabilitation centers in the United States with 1897 burn beds nationwide. 1 The distribution and severity of burns fall unevenly on populations with low-socioeconomic status (SES) conditions because of inadequate preventive measures and/or inadequate education about emergency care. 2 Understanding the spatial distribution and types of burn injuries can give important insights to risks associated with burns.…”

Disaster Planning

“…This "heads up" to create situational awareness assists the effort should additional intrastate or interstate resources be needed. [51][52][53][54] Burn resources are limited in North Carolina, as they are in most states.…”

Disaster Planning

“…This surge capacity is identified in several plans: the New York City Plan, 84 the Los Angeles County Plan, 48 and the North Carolina State Plan. This surge of patients may overwhelm local first receivers and include surging into area hospitals and testing the capacity and capability of the local hospitals.…”