The Journal of burn care & rehabilitation
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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.
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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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This report describes the initial hospital and burn center management of a mass casualty incident resulting from an aircraft crash and fire. One hundred thirty soldiers were injured, including 10 immediate fatalities. Womack Army Medical Center at Fort Bragg, North Carolina, managed the casualties and began receiving patients 15 minutes after the crash. ⋯ All patients of the US Army Institute of Surgical Research survived to hospital discharge, and 34 returned to duty 3 months after the crash. The scenario of an on-ground aircraft explosion and fire approximates what might be seen as a result of an aircraft hijacking, bombing, or intentional crash. Lessons learned from this incident have utility in the planning of future response to such disasters.
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J Burn Care Rehabil · Jan 2005
Case ReportsSuccessful management of adult smoke inhalation with extracorporeal membrane oxygenation.
Pulmonary complications remain one of the leading causes of mortality in patients with burns. We report two cases of adult patients with thermal and inhalation injuries who were placed on extracorporeal membrane oxygenation (ECMO) and survived. Patient 1 was a 42-year-old male who suffered 15% TBSA and a severe inhalation injury requiring intubation upon arrival to the emergency department. ⋯ She was decannulated 288 hours later. Both patients were discharged home shortly afterwards and have managed well. ECMO should be considered when patients are facing a respiratory death from inhalation injury on conventional mechanical ventilation.