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Deployment and operation of a transportable burn intensive care unit in response to a burn multiple casualty incident

COL David J. Barillo, MD, FACS, COL Leopoldo C. Cancio, MD, FACS, COL Richard S. Stack, MD, FACS, LCDR Shamus R. Carr, MD, CPT Kristine P. Broger, RN, MHA, CCRN, SSG David M. Crews, LVN, LTC Evan M. Renz, MD, FACS, COL Lorne H. Blackbourne, MD, FACS

Abstract


In many hospitals, intensive care units (ICUs) operate at or above capacity on a daily basis. Multiplecasualty incidents will create a sudden need for additional ICU beds and hospital planning for disaster response must anticipate the need for rapid ICU expansion.
In this article, the authors describe the management of 6 patients who were burned in Guam and successfully transported a distance of 7,268 miles to San Antonio, TX, for tertiary burn center care. The mission required creation of a temporary burn ICU at Tripler Army Medical Center in Hawaii, approximately midway between the referring hospital and the receiving burn center. A method of creating a temporary burn center is described. Lessons learned, including the need to standardize equipment, and to cross-train and cross-credential medical personnel, are applicable to both military and civilian mass casualty management.


Keywords


burn, mass casualty, aeromedical evacuation, CCATT

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References


Department of the Army, Headquarters, US Army Medical Command: Military Operations: Medical Emergency Management Planning. San Antonio: US Army Medical Command, MEDCOM Pamphlet 525-1, October 2003.

Cancio LC: Airplane crash in Guam, August 6, 1997: The areromdical evacuation response. J Burn Care Res. 2006; 27: 642- 648.

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Barillo DJ, Dickerson EE, Cioffi WG, et al.: Pressure-controlled ventilation for the long-range aeromedical transport of burn patients. J Burn Care Rehabil. 1997; 18: 200-205.

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DOI: https://doi.org/10.5055/ajdm.2010.0001

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