Disaster Preparedness and Response for the Burn Mass Casualty Incident in the Twenty-first Century

Abstract

The effective and efficient coordination of emergent patient care at the point of injury followed by the systematic resource-based triage of casualties are the most critical factors that influence patient outcomes after mass casualty incidents (MCIs). The effectiveness and appropriateness of implemented actions are largely determined by the extent and efficacy of the planning and preparation that occur before the MCI. The goal of this work was to define the essential efforts related to planning, preparation, and execution of acute and subacute medical care for disaster burn casualties. This type of MCI is frequently referred to as a burn MCI."

Keywords: Burn injury; Disaster preparedness; Mass casualty incident; Surge capacity.

Fig. 1

The target is to reach surge equilibrium and provide care based on traditional standards of care. The 3 time phases may vary slightly based on quantity of available resources and proximity to the site of the BMCI (or burn disaster). Thus, as ranges in other state and regional plans are reviewed, they may not have the same precise 3 blocks of time. Nevertheless, the 3 general periods, immediate, intermediate (loosely defined as 6–120 hours), and extended (the 120 hours post disaster), are general windows for what is identified as a type III burn disaster. These windows of time may grow when the BMCI is competing for resources, such as with an explosion (type II), or there is impact to the infrastructure, such as an earthquake that damages the hospital or limits highway access for patient transport (type I). Surge Equilibrium: all competing influences of the disaster are balanced at the point of where the patients are being managed, disaster scene or at the hospital.