The Journal of burn care & rehabilitation
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In October 2002, a terrorist attack on a nightclub in Bali resulted in an explosion and fire, causing the deaths of more than 200 people, including 88 Australian citizens. After first aid and primary care, the injured were repatriated to Darwin for triage and continued treatment and were then disseminated to various burn units throughout Australia. ⋯ There were no deaths and, with two exceptions, all patients were discharged within 6 weeks. This incident had profound effects on our unit, particularly related to the management of high-velocity shrapnel injuries, serious ongoing septic complications, and the psychological effects on both patients and staff, all of which are detailed and discussed.
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J Burn Care Rehabil · Mar 2005
The Pentagon attack of September 11, 2001: a burn center's experience.
On September 11, 2001, an airplane flown by terrorists crashed into the Pentagon, causing a mass casualty incident with 189 deaths and 106 persons treated for injuries in local hospitals. Nine burn victims and one victim with an inhalation injury only were transported to the burn center hospital. ⋯ Eight of the nine burn patients survived. Lessons learned include 1) A large-volume burn center hospital can absorb nine acute burns and maintain burn center and hospital operations, but the decision to keep or transfer burn patients must be tempered with the reality that several large burns can double or triple the work load for 2 to 3 months. 2) Transfer decisions should have high priority and be timely to ensure optimum care for the patients without need for movement of medical personnel from one burn center to another. 3) The reserve capacity of burn beds in the United States is limited, and the burn centers and the American Burn Association must continue to seek recognition and support from Congress and the federal agencies for optimal preparedness.
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J Burn Care Rehabil · Mar 2005
Burn support for Operation Iraqi Freedom and related operations, 2003 to 2004.
Thermal injury historically constitutes approximately 5% to 20% of conventional warfare casualties. This article reviews medical planning for burn care during war in Iraq and experience with burns during the war at the US Army Burn Center; aboard the USNS Comfort hospital ship; and at Combat Support Hospitals in Iraq and in Afghanistan. Two burn surgeons were deployed to the military hospital in Landstuhl, Germany, and to the Gulf Region to assist with triage and patient care. ⋯ Ten Iraqi burn patients underwent surgery and were hospitalized for up to 1 month aboard the Comfort, including six with massive wounds. Eighty-six burn casualties were hospitalized at the 28th Combat Support Hospital for up to 53 days. This experience highlights the importance of anticipating the burn care needs of both combatants and the local civilian population during war.
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J Burn Care Rehabil · Mar 2005
Tracking the daily availability of burn beds for national emergencies.
Medical planning for Operation Iraqi Freedom included predictive models of expected number of burn casualties. In all but the best-case scenario, casualty estimates exceeded the capacity of the only Department of Defense burn center. Examination of existing federal-civilian disaster plans for military hospital augmentation revealed that bed availability data were neither timely nor accurate. ⋯ A system to track daily nationwide burn bed availability was successfully implemented. Although intended for military conflict, this system is equally applicable to civilian mass casualty situations. We advocate adoption of this or a similar bed tracking system by the ABA for use during burn mass casualty incidents.
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The Advanced Burn Life Support Course has been used to train military physicians and nurses for more than 16 years. Although it useful for teaching the fundamentals of burn care, the course is designed for a civilian audience, covers only the first 24 hours of burn care, and presumes the availability of a burn center for patient transfer. In preparation for hostilities in Iraq, we developed several add-on modules to the standard Advanced Burn Life Support course to meet specific needs of military audiences. ⋯ Student feedback was largely positive and is being used for further course refinement. The Combat Burn Life Support Course is designed to augment, rather than replace, the Advanced Burn Life Support Course. Although intended for a military audience, the course material is equally applicable to civilian terrorist or mass casualty situations.