Why would a disaster with significant numbers of burn injuries create a crisis?
A national byproduct of improved economic efficiency across all disciplines of medicine is the lack of sufficient additional "soft space" or a surplus of onsite medical supplies. The "just in time" approach and the real-time staffing ratio approach has left little room for the surge of patients that are produced by a sudden disaster event. Disasters that produce burn and blast injuries will quickly overwhelm the existing healthcare system and particularly the designated burn centers across the nation.
Burn Centers in the Southeastern United States
According to the American Burn Association Website (ABA) burn centers are located in the following states in the Southeastern United States: South Carolina has one burn center that treats pediatric patients, Tennessee, Georgia, Kentucky, and North Carolina all have two burn centers each and Alabama, Virginia, and Florida all have 3 burn centers each. Of these seventeen burn centers, nine are verified burn centers: one in Virginia (Richmond), one in Tennessee (Memphis), two in North Carolina (Chapel Hill and Winston-Salem), two centers in Georgia (Atlanta and Augusta), and three in Florida (Tampa, Miami, and Gainesville). While there may be other centers that provide burn care across the Southeastern United States, they are not currently shown on the ABA webpage.
Verified burn centers will see approximately two-thirds of all burn patients seen in a burn center. Burn Center Verification was originally developed by the American College of Surgeons and modeled using the ACS Trauma Center Verification standards; today, it is administered by the American Burn Association.
Designated burn beds are limited everywhere. While these centers do a great job of triage and moving patients to meet the needs on a regular basis, a surge of patients will quickly overwhelm this system. During a burn or blast disaster event, the closest burn center will coordinate to assure maximum utilization is available to the patients needing critical burn care. One component of this program is to work with the Trauma Centers in the state and region to absorb a portion of the patients whose needs can be met there without further inundating the limited burn resources.
Another component of this program is to provide education to the local EMS programs, as well as the regional and community hospitals to assure appropriate triage and treatment is provided using decision aids that are developed by the burn and trauma programs across the state. Patients that can be managed locally should be managed locally and those with greater severity of injury, will be triaged appropriately to either the Trauma Centers or Burn Centers.