Multidisciplinary team response to a mass burn casualty event: outcomes and implications

• Published in: Medical journal of Australia 2011-06, Vol.194 (11), p.589-593
• Main Authors: Cleland, Heather J, Proud, David, Spinks, Anneliese, Wasiak, Jason
• Format: Article
• Language: English
• Subjects: Adult; Aged; Australia - epidemiology; Biological and medical sciences; Burn Units; Burns; Burns - complications; Burns - economics; Burns - epidemiology; Burns - therapy; Disasters; Female; Fires; General aspects; Health Workforce - statistics & numerical data; Humans; Injury Severity Score; Length of Stay - statistics & numerical data; Male; Mass Casualty Incidents; Medical sciences; Middle Aged; Operating Rooms - statistics & numerical data; Patient Admission - statistics & numerical data; Patient Care Team; Resource Allocation - economics; Resource Allocation - statistics & numerical data; Respiration, Artificial - statistics & numerical data; Retrospective Studies; Skin, Artificial - statistics & numerical data; Surgical Procedures, Operative - statistics & numerical data; Traumas. Diseases due to physical agents; Wounds and injuries
• ISSN: 0025-729X; 1326-5377
• DOI: 10.5694/j.1326-5377.2011.tb03110.x

Objectives: To describe the characteristics of patients with burn injury admitted to a major trauma hospital in Melbourne following the Black Saturday bushfires of 7 February 2009, and to provide a detailed analysis of the hospital's response to the crisis. Design, setting and participants: A retrospective chart review of ambulance and hospital records of patients admitted to the Victorian Adult Burns Service (VABS) at The Alfred Hospital (The Alfred) following the bushfires. Main outcome measures: Patient characteristics and outcomes: age, sex, total and full thickness body surface area burnt, type and site of burn, hospital and intensive care unit length of stay (LOS) and receipt of standard burn care practices. Estimated glomerular filtration rate, theatre time and LOS data for the bushfire cohort compared with corresponding data for historical cohorts from VABS and from a similar institution in New Zealand. Results: Nineteen patients were admitted to VABS over the first 48 hours after the bushfires. Of these, nine patients were subsequently admitted to The Alfred's intensive care unit. Most patients (74%) were men with a mean age of 52.7 years (SD, 12.4 years). Seventeen patients (89%) underwent at least one surgical procedure, which resulted in 4355 minutes of theatre time for the bushfire cohort in the first week. Hospital LOS was similar for the bushfire and New Zealand cohorts. Compared with the VABS historical cohort, there was a higher incidence of abnormal renal function among the bushfire cohort patients. Conclusions: Although relatively few patients with severe burns were admitted to VABS, significant increases in resource allocation were required to manage them in terms of additional theatre time, consumables and staffing. The experience of VABS may aid planning for future mass burns casualty events.