In 2005, the American Burn Association published burn disaster guidelines. This work recognized that local and state assets are the most important resources in the initial 24- to 48-hour management of a burn disaster. Historical experiences suggest there is ample opportunity to improve local and state preparedness for a major burn disaster. This review will focus on the basics of developing a burn surge disaster plan for a mass casualty event. In the event of a disaster, burn centers must recognize their place in the context of local and state disaster plan activation. Planning for a burn center takes on three forms; institutional/intrafacility, interfacility/intrastate, and interstate/regional. Priorities for a burn disaster plan include: coordination, communication, triage, plan activation (trigger point), surge, and regional capacity. Capacity and capability of the plan should be modeled and exercised to determine limitations and identify breaking points. When there is more than one burn center in a given state or jurisdiction, close coordination and communication between the burn centers are essential for a successful response. Burn surge mass casualty planning at the facility and specialty planning levels, including a state burn surge disaster plan, must have interface points with governmental plans. Local, state, and federal governmental agencies have key roles and responsibilities in a burn mass casualty disaster. This work will include a framework and critical concepts any burn disaster planning effort should consider when developing future plans.
From the *North Carolina Burn Disaster Program, EMS Performance Improvement Center, School of Medicine, University of North Carolina, Chapel Hill; †Saint Barnabas Burn Foundation, Saint Barnabas Medical Center, Livingston, NJ; ‡ER One Institute, MedStar Washington Hospital Center, Washington, DC; §Emergency Care Coordination Center, Office of the Assistant Secretary for Preparedness and Response, United States Department of Health and Human Services, Washington, DC; ‖Department of Emergency Medicine, School of Medicine, University of North Carolina, Chapel Hill; ¶WFBMC Burn Center, School of Medicine, Wake Forest University, Winston-Salem, NC; #Division of Trauma and Critical Care Surgery, School of Medicine, University of North Carolina, Chapel Hill; **Burn Center, University of Utah Health Care, Salt Lake City; ††Emergency Management and Business Continuity Planning, Health Care System, University of North Carolina, Raleigh-Durham; ‡‡Hospital Preparedness Program, North Carolina Office of EMS, Raleigh; §§Department of Emergency Medicine, School of Medicine, University of North Carolina, Chapel Hill; ‖‖Office of Emergency Management, Office of the Assistant Secretary for Preparedness and Response, United States Department of Health and Human Sciences, Washington, DC; ¶¶North Carolina Jaycee Burn Center, School of Medicine, University of North Carolina, Chapel Hill.
This work is supported in part by the US DHHS/ASPR Hospital Preparedness Program Grant CDC-RFA-TP12-1201 through the North Carolina Office of Emergency Medical Services Contract 00027162.
Address correspondence to Randy D. Kearns, DHA, MSA, CEM, University of North Carolina, Chapel Hill, NC 27514.