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From Baghdad to Boston: International Transfer of Burned Children in Time of War

Schmidt, Patricia M. RN, BSN, MHS, CPT, AN*; Sheridan, Robert L. MD, FACS, COL, MC†‡; Moore, Christina L. RN, BSN, MAJ, AN*; Scuba, Steve C. RN, BSN, CPT, AN§; King, Booker T. MD, FACS, LTC(P), MC*; Morrissey, Paul M. MD, FAPA, LTC, MC; Cancio, Leopoldo C. MD, FACS, COL, MC*

doi: 10.1097/BCR.0b013e3182a366f1
Original Articles

A large portion of the casualties admitted to military hospitals on the battlefield in Iraq consists of children, of whom 13% had burns. The U.S. Army Combat Support Hospital (CSH) in Baghdad, faced with an influx of such patients, successfully transferred selected burned children by commercial airlines to the Shriners Hospital for Children in Boston, Massachusetts (SHC-B). The authors aimed to document this process, from both an ethical and a procedural standpoint. Care was conducted in six phases: 1) admission to the CSH; 2) selection for transfer; 3) burn care at the CSH; 4) travel to the United States; 5) burn care at the SHC-B; 6) return to Iraq. Transfer and SHC-B care were funded by charitable organizations. A review of patient records was performed. Eight acutely burned pediatric patients participated in this program. All were successfully transferred, treated at SHC-B, and returned to Iraq. They ranged in age from 1.7 to 17 years and in burn size from 6 to 53% of the TBSA. At SHC-B, the hospital length of stay was 14 to 132 days; up to 23 visits to the operating room were performed for acute and reconstructive burn surgery. The cost of war includes the care of injured civilians, and includes burned children. For selected patients, transfer out of the combat zone is one method of fulfilling this obligation.

From the *Burn Center, U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas; Burn Surgery Service, Shriners Hospital for Children, Boston, Massachusetts; Surgical Critical Care, Massachusetts General Hospital, Boston; §Department of Nursing, Walter Reed National Military Medical Center, Bethesda, Maryland; and Department of Pediatrics, U.S. Army Medical Activity, Fort Drum, New York.

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or Department of Defense.

P.M.M. is the president of the Iraqi Children’s Project, a not-for-profit corporation that paid travel and living expenses for the children in this study. He does not receive salary or other benefits from the corporation, and he does not have any ownership interest in it. The other authors declare no conflict of interest.

Presented at the 44th Annual Meeting of the American Burn Association, 24–27 April 2012, Seattle, Washington.

Address correspondence to Leopoldo C. Cancio, MD, FACS, COL, MC, U.S. Army Institute of Surgical Research, 3698 Chambers Pass, Fort Sam Houston, Texas 78234-6315.

© 2014 The American Burn Association