A disaster scenario with a significant number of burn-injured patients creates a tremendous challenge for disaster planners. Directing the transport of patients to the most appropriate receiving facility as soon as reasonably possible remains the aim. This review focused on both the overall process as well as an analysis of one specific state (as an example). This included the capability and limitations of the intrastate and interstate resources should a burn disaster occur. Although the results for one state may be interesting, it is the process that is essential for those involved in burn disaster planning. An overview of the quantity and quality of available ambulances and how to access these resources is provided. Ground-based ambulances have an array of capacities and levels of services ranging from basic life support to advanced (paramedic) services and include ambulance buses. This review also included private and hospital-based specialty care ambulances and aeromedical services. Finally, the review identified military or federal resources that may be an option as well. There are various local, state, and federal resources that can be called upon to meet the transportation needs of these critically injured patients. Yet, there are barriers to access and limitations to their response. It is just as important to know both availability and capability as it is to know how to access these resources. A disaster is not the time to realize these hurdles.
From the *Division of North Carolina Jaycee Burn Center, Department of Surgery, School of Medicine, University of North Carolina, Chapel Hill; †Emergency Medical Care Program, School of Health Sciences, Western Carolina University, Cullowhee, North Carolina and ‡Department of General Surgery, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
Address correspondence to Randy D. Kearns, DHA MSA CEM, University of North Carolina, 101 Manning Drive CB 7600, Chapel Hill, NC.