Planning burn disasters

It is essential that communities create their own plans to respond to a burn disaster. 

Identify main components of a burn disaster plan. 

Burns are unique injuries, and planning for a burn MCI may seem overwhelming. By following the basic principles of the disaster life cycle, an effective response plan can be created. For more information on your community or state plan for a burn MCI contact your local and state health departments. 

American Burn Association Board of Trustees and the Committee on Organization and Delivery of Burn Care. (2005). Disaster Management and the ABA Plan, 26(2), 102-106. 

Burn Centers Are a Unique National Resource. Given the unique nature of burn care and the nationwide availability of highly specialized burn care systems established to address the complex nature of burn injuries, burn centers have been specifically recognized in federal bioterrorism legislation, with subsequent action of the U.S. Department of Health and Human Services (HHS) to incorporate burn centers in state and local disaster plans. Furthermore, although most burn surgeons have the expertise and training to treat burn—as well as trauma— victims in the event of a mass casualty, the reverse is not necessarily so, which supports the need for unique benchmarks to ensure that the needs of the burn-injured are met in the event of a terrorist incident. 

Distribution of the publication Burn Care Resources in North America to the disaster planning agency in every state. 

Work with the U.S. Departments of Health and Human Services and Homeland Security to assist in the development of mass burn casualty disaster planning at the federal level to include the following ... 

Encourage incorporation into the hospital-specific disaster plan of ABA-recommended triage plan for burn casualty mass disaster situations and provide outpatient care for nonintubated patients with burns covering <20% TBSA also, address issues of communication with families, psychological support needs, and media control. 

Welcome and thanks go to Christopher Lentz, MD, FACS, FCCM Dixie Reid, PA Brooke Rea, MS, RN and Kerry Kehoe, MS (University of Rochester) for their chapter addressing the recognition and management of burns and guidelines for disaster planning for a surge of... 

There was neither a full-scale emergency response plan nor a tug boat to tow the dangerously burning Grandcamp away from the port. A little after 9.00 a.m., the Texas City Disaster (as it is popularly known) occurred as the ship Grandcamp exploded. A great column of smoke shot up to an estimated 2000 ft, followed in 10s, by another even more violent shockwave. Within minutes of the second blast, the Monsanto Chemical Plant was in flames that resulted from broken lines and shattered containers. Entire buildings collapsed and people were trapped inside. Fire spread to the refineries that made up the Texas City industrial complex. 

There has been considerable concern throughout Europe about the incineration of wastes, yet in Japan about 70% of all MSW is incinerated, and plans are that this should increase to 90% by the year 2000 [33]. Incinerators that are poorly operated may run at temperatures too low to burn potentially hazardous intermediates of the combustion process such as the products from pyrolysis which are believed to be the precursors in the combustion processes [34]. Of particular concern has been the discovery of extremely toxic materials such as dioxins (chlorinated dibenzo-/ -dioxins and benzofuran dioxins), in the flue gases of some incinerators. Such is the level of concern that many European countries have increased the legislative and environmental controls on incinerator operators, and some are moving to ban the incineration of plastics [35], and particularly PVC. In incinerators where the temperature is below about 1400 K, dehydrochlorination of PVC occurs, accompanied by the formation of polyenes. The polyenes can then cyclise and be oxidised, and then be attacked by chlorine-containing species to produce dioxins, the most toxic of which is 2,3,7,8-tetra-chlorodibenzo-/7-dioxin (TCDD), the material at the centre of the disaster at Sveso, Northern Italy, in 1979. More than 70 dioxins are known to exist (Figure 13.11). 

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