Management of mass casualty burn disasters

Abstract

Abstract : Mass casualty burn disasters are potentially challenging, in part because the majority of health care providers are inexperienced in the care of thermally injured patients and in part because of the multisystem response elicited by the thermal injury. Management expertise is generally concentrated in burn centres, whereas in a true mass casualty event, personnel at other hospitals may need to provide burn care for extended periods of time. In addition, burn care is time-, manpower- and resource-intensive. Finally, the risk of terrorist attacks which can result in large numbers of burn casualties persists; inhalation injury and burns were the leading causes of injury among survivors of the 11 September 2001 attacks in New York City (1) and the 12 October 2002 bombing in Bali (2). This reflects the observation that terrorists prefer simple, easily accessible weapons, such as fertilizer, cellular telephones, box cutters, and jet fuel, to complex and hard-to-deploy weapons such as biologic and chemical agents (3). The purpose of this article is to review recent experience with burn disasters worldwide, to recommend a set of general principles for burn disaster management, and to describe the current status of burn disaster planning at the national level in the USA.