Burn mass casualty incidents in Europe: A European response plan within the European Union Civil Protection Mechanism |
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| Institution: | 1. Norwegian National Burn Center, Department of Plastic, Hand, and Reconstructive Surgery, Haukeland University Hospital, Bergen, Norway;2. Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Norway;3. Norwegian Directorate of Health, Department of Preparedness and Emergency Medical Services, Oslo, Norway;4. European Commission, Brussels, Belgium;5. Charleroi Burn Wound Center, Skin-burn-reconstruction Pole, Grand Hôpital de Charleroi, Charleroi, Belgium;6. Linköping Burn Center, Linköping University, Sweden;7. Department for Emergency Situations, Ministry of Internal Affairs, Bucharest, Romania;8. Burn Unit, Hospital Universitario La Paz, Madrid, Spain;9. Department of Trauma and Burn Surgery, Maasstad Hospital, Rotterdam, the Netherlands;10. Trauma Research Unit Department of Surgery, Erasmus MC, Rotterdam, the Netherlands;11. Interburns, International Network for Training, Education and Research in Burns, Swansea, Wales, UK;12. Bart’s Health NHS Trust, London, UK;13. Essex and Herts Air Ambulance Charitable Trust, UK;14. Department of Plastic Surgery and Burns, Vall d''Hebron Barcelona Hospital Campus, Universitat Autonoma de Barcelona, Barcelona, Spain;15. University Hospitals Birmingham Foundation Trust, Birmingham, UK;p. University of Birmingham, College of Medical and Dental Sciences, Birmingham, UK;q. Percy Military Teaching Hospital, Paris, France |
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| Abstract: | BackgroundBurn care is centralized in highly specialized burn centers in Europe. These centers are of limited capacity and may be overwhelmed by a sudden surge in case of a burn mass casualty incident. Prior incidents in Europe and abroad have sustained high standards of care through well-orchestrated responses to share the burden of care in several burn centers. A burn mass casualty incident in Romania in 2015 sparked an initiative to strengthen the existing EU mechanisms. This paper aims to provide insight into developing a response plan for burn mass casualties within the EU Civil Protection Mechanism.MethodsThe European Burns Association drafted medical guidelines for burn mass casualty incidents based on a literature review and an in-depth analysis of the Romanian incident. An online questionnaire surveyed European burn centers and EU States for burn mass casualty preparedness.ResultsThe Romanian burn mass casualty in 2015 highlighted the lack of a burn-specific mechanism, leading to the late onset of international transfers. In Europe, 71% of respondents had existing mass casualty response plans, though only 35% reported having a burn-specific plan. A burns response plan for burn mass casualties was developed and adopted as a Commission staff working document in preparation for further implementation. The plan builds on the existing Union Civil Protection Mechanism framework and the standards of the WHO Emergency Medical Teams initiative to provide 1) burn assessment teams for specialized in-hospital triage of patients, 2) specialized burn care across European burn centers, and 3) medevac capacities from participating states.ConclusionThe European burn mass casualty response plan could enable the delivery of high-level burn care in the face of an overwhelming incident in an affected European country. Further steps for integration and implementation of the plan within the Union Civil Protection Mechanism framework are needed. |
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| Keywords: | Burns Mass casualty incident Burn mass casualty Disaster planning Disaster medicine European Union |
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