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Fuchko D, King-Shier K, Gabriel V. Burn mass casualty incident planning in Alberta: A case study. Burns 2024; 50:1128-1137. [PMID: 38461081 DOI: 10.1016/j.burns.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 12/21/2023] [Accepted: 02/21/2024] [Indexed: 03/11/2024]
Abstract
Burn mass casualty incident (BMCI) preparedness is lacking across Canada. A focused exploration of the current policies, protocols and practices in Alberta that address the response to a BMCI was conducted. In this case study, data were gathered from documents outlining the health system response to a mass casualty incident and health care professionals directly involved. Interviews were conducted online, recorded and transcribed. Qualitative description was used to code common themes across documents and transcripts. Fifteen documents and nine participant interviews were included in this study. Overall, the current policies, protocols and practices in place were limited to all-hazards mass casualty incident planning and did not address the specialized needs of burn patients. Deficiencies included no burn-specific plan at each of the two burn centres, a lack of provincial-level recognition of the unique challenges associated with a BMCI and no established Canadian burn disaster communication plan. Suggestions of strategies for a burn plan included forward triage, patient movement, use of telemedicine, partnering skilled and non-skilled staff, and procuring additional supplies. For best patient outcomes the provincial health authority needs to provide dedicated time for burn care experts to develop BMCI response plans to better address this unique hazard.
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Affiliation(s)
- Danielle Fuchko
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada.
| | - Kathryn King-Shier
- Faculty of Nursing and Department of Community Health Sciences, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
| | - Vincent Gabriel
- Departments of Clinical Neurosciences and Surgery, Foothills Medical Centre, 1403-29 Street NW, Calgary, AB T2N 2T9, Canada
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King B, Cancio LC, Jeng JC. Military Burn Care and Burn Disasters. Surg Clin North Am 2023; 103:529-538. [PMID: 37149388 DOI: 10.1016/j.suc.2023.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Mass-casualty incidents can occur because of natural disasters; industrial accidents; or intentional attacks against civilian, police, or in case of combat, military forces. Depending on scale and type of incident, burn casualties often with a variety of concomitant injuries can be anticipated. The treatment of life-threatening traumatic injuries should take precedent but the stabilization, triage, and follow-on care of these patients will require local, state, and often regional coordination and support.
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Affiliation(s)
- Booker King
- North Carolina Jaycee Burn Center, University of North Carolina Chapel Hill, Burnett Womack Building, Campus Box 7206, Chapel Hill, NC 27599-7206, USA
| | - Leopoldo C Cancio
- U.S. Army Burn Center, U.S. Army Institute of Surgical Research, Fort Sam Houston, San Antonio, TX 78234-6315, USA
| | - James C Jeng
- University of California Irvine, 3800 West Chapman Avenue, Suite 6200, Orange, CA 92868, USA.
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Fuchko D, King-Shier K, Gabriel V. Mobile Burn Disaster Response Teams: A Scoping Review. J Burn Care Res 2023; 44:179-191. [PMID: 35731628 DOI: 10.1093/jbcr/irac081] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Indexed: 01/11/2023]
Abstract
The resources needed to deliver modern burn care may be overwhelmed by mass casualty disasters. In 2021, the World Health Organization (WHO) recommended that countries prepare teams of deployable burn experts to assist with responding to a mass casualty disaster. The aim of this scoping review was to identify existing literature regarding burn mobile response team organization, describe the reported effectiveness of these teams, identify challenges in adopting the WHO recommendations, and consider how the recommendations may be reconsidered. We conducted a scoping review of all literature types published up to January 2022. Searches of MEDLINE, EMBASE, Scopus, and CINAHL databases were conducted to identify reports informing or reporting the use of mobile burn care specialty teams that respond to events resulting in multiple burn-injured victims, including pediatric victims and military response to civilian events. Of 6132 identified reports, 26 publications were reviewed. Three types of mobile burn response teams were identified: (1) teams organized by burn care networks, (2) government-organized medical disaster teams with burn-specific experts, and (3) the U.S. Army Burn Flight Team. Teams have responded to events such as terrorist attacks by providing specialized burn supplies and personnel. These teams have demonstrated expert triage and stabilization advantages but are limited by the number of deployable specialists. Although the WHO recommends increasing the number of mobile burn response teams available around the world, few countries have implemented this recommendation. A hybrid model where responders on scene communicate with burn center experts to manage triage may address these challenges.
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Affiliation(s)
| | - Kathryn King-Shier
- Faculty of Nursing and Department of Community Health Sciences, University of Calgary, Alberta, Canada
| | - Vincent Gabriel
- Departments of Clinical Neurosciences, Pediatrics and Surgery, Foothills Medical Centre, Calgary, Alberta, Canada
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Łabuś W, Kitala D, Navarro A, Klama-Baryła A, Kraut M, Sitkowska A, Smętek W, Kamiński A. The urgent need to achieve an optimal strategic stock of human allogeneic skin graft materials in case of a mass disaster in Poland. Cell Tissue Bank 2022; 23:863-885. [PMID: 35355193 PMCID: PMC8967378 DOI: 10.1007/s10561-022-10001-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 02/27/2022] [Indexed: 12/03/2022]
Abstract
A burn is a sudden injury which immediate or long-term consequences may be life-threatening for the patient. A mass disaster event may involve large numbers of severely burned patients. Patients of this type typically have a limited area of healthy, unburned skin from which an autologous split thickness skin graft could be collected. In a clinical situation of this type, it is necessary to use a particular skin substitute. Non-viable allogeneic human skin graft materials might be considered as the most suitable skin substitutes in the treatment of such patients. At present, Poland does not have a sufficient supply of human allogeneic skin graft materials to meet the needs arising from a sudden and unforeseen mass disaster. This study involved an analysis of selected mass disasters. From this an estimate was made from a verified casualty profile of the necessary minimum stock of human allogeneic skin graft materials. An insufficient amount of skin results from an inadequate number of skin donors, which in turn results from the current tissue donation system. Therefore, a proposal has been made for the organizational, legal and systemic changes required to improve the situation in Polish transplantology, with particular emphasis on skin donation. In order to achieve a strategic stock of human skin grafts, a tissue collecting transplantation team should be organized. The rights and obligations of the non-physician transplant team member should be extended. Proposals have been made for awareness campaigns (adverts, posters etc.) and educational schemes (educational video, lectures during transplant coordinator training, etc.). Finally, a proposal has been made for possible methods to deal with the logistic management of the allogeneic skin stock. The required, essential stock of human allogeneic skin in the event of a mass disaster has been estimated at 600,000 cm2.
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Affiliation(s)
- Wojciech Łabuś
- Tissue Bank, Dr Stanisław Sakiel Centre for Burn Treatment, ul. Jana Pawła II 2, 41-100 Siemianowice Śląskie, Poland
| | - Diana Kitala
- Tissue Bank, Dr Stanisław Sakiel Centre for Burn Treatment, ul. Jana Pawła II 2, 41-100 Siemianowice Śląskie, Poland
| | | | - Agnieszka Klama-Baryła
- Tissue Bank, Dr Stanisław Sakiel Centre for Burn Treatment, ul. Jana Pawła II 2, 41-100 Siemianowice Śląskie, Poland
| | - Małgorzata Kraut
- Tissue Bank, Dr Stanisław Sakiel Centre for Burn Treatment, ul. Jana Pawła II 2, 41-100 Siemianowice Śląskie, Poland
| | - Anna Sitkowska
- Tissue Bank, Dr Stanisław Sakiel Centre for Burn Treatment, ul. Jana Pawła II 2, 41-100 Siemianowice Śląskie, Poland
| | - Wojciech Smętek
- Tissue Bank, Dr Stanisław Sakiel Centre for Burn Treatment, ul. Jana Pawła II 2, 41-100 Siemianowice Śląskie, Poland
- Warsaw University of Technology, Warsaw, Poland
| | - Artur Kamiński
- Department of Transplantology and Central Tissue Bank, Medical University of Warsaw, Warsaw, Poland
- National Centre for Tissue and Cell Banking, Warsaw, Poland
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Melmer P, Carlin M, Castater CA, Koganti D, Hurst SD, Tracy BM, Grant AA, Williams K, Smith RN, Dente CJ, Sciarretta JD. Mass Casualty Shootings and Emergency Preparedness: A Multidisciplinary Approach for an Unpredictable Event. J Multidiscip Healthc 2019; 12:1013-1021. [PMID: 31849477 PMCID: PMC6911362 DOI: 10.2147/jmdh.s219021] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/21/2019] [Indexed: 12/26/2022] Open
Abstract
Mass casualty events (MCE) are an infrequent occurrence to most daily healthcare systems however these incidents are the causation for new hospital preparedness and the development of coordinated emergency services. The broad support and operational plans outside the hospital include emergency medical services, local law enforcement, government agencies, and city officials. Modern-day hospital disaster preparedness goals include scheduled training for healthcare personnel to ensure effective and accurate triage for a high-volume of injured patients. This MDT collaboration strengthens the emergency response to optimize the delivery of life-saving care during MCEs. This review identifies the clinical importance of the interdisciplinary team interactions and the lessons learned from past MCE experiences, strengthening healthcare system readiness for such critical incidents.
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Affiliation(s)
- Patrick Melmer
- Grand Strand Medical Center, University of South Carolina, Myrtle Beach, SC 29572, USA
| | - Margo Carlin
- Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA 30303, USA
| | - Christine A Castater
- Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA 30303, USA
| | - Deepika Koganti
- Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA 30303, USA
| | - Stuart D Hurst
- Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA 30303, USA
| | - Brett M Tracy
- Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA 30303, USA
| | - April A Grant
- Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA 30303, USA
| | - Keneeshia Williams
- Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA 30303, USA
| | - Randi N Smith
- Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA 30303, USA
| | - Christopher J Dente
- Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA 30303, USA
| | - Jason D Sciarretta
- Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA 30303, USA
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