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

Heather J Cleland, David Proud, Anneliese Spinks and Jason Wasiak
Med J Aust 2011; 194 (11): 589-593.

Summary

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.

  • Heather J Cleland1
  • David Proud1
  • Anneliese Spinks2,3
  • Jason Wasiak1

  • 1 Victorian Adult Burns Service, The Alfred Hospital, Melbourne, VIC.
  • 2 CSIRO Ecosystem Sciences, Brisbane, QLD.
  • 3 School of Medicine, Griffith University, Meadowbrook, QLD.

Correspondence: J.Wasiak@alfred.org.au

Acknowledgements: 

We thank Richard Wong She, Department of Plastic, Reconstructive and Burn Surgery, Middlemore Hospital, Auckland, New Zealand, for providing us with additional patient data. In addition, many staff members in many departments throughout The Alfred, as well as volunteers, contributed an extraordinary amount of unpaid time and effort to ensure that the Burns Service and the rest of the hospital continued to function smoothly and provide a high standard of care to all patients and their families.

Competing interests:

None identified.

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