The objective of the study was to evaluate the effectiveness of triage, treatment, and transfer interventions on multiple burn casualties managed in a high volume @entity2613 that does not have a verified in-hospital burn unit. The charts of 11 male @entity1 injured in a 1999 foundry explosion and brought to Baystate Medical Center (BMC), a level I @entity130 center, were reviewed. All @entity1 sustained deep partial and full thickness burns. The injury severity score (ISS) ranged from 9 to 75. Five @entity1 had total body surface area (TBSA) burns of 10% to 50% and 6 @entity1 had TBSA burns of 70% to 95%. Transfer times from the scene to BMC ranged from less than 5 minutes to 22 minutes. All 11 were initially triaged, resuscitated, and evaluated at BMC. Of the 9 @entity1 transferred to verified burn units, 8 were intubated, 6 of 6 had negative abdominal ultrasounds, 4 had undergone escharatomies, and 1 had undergone bronchoscopy before transfer. Nine critically injured burn @entity1 with ISS of 9 to 75 were transferred from BMC to verified burn units. For 8 of these @entity1 , the average time from triage, evaluation, and treatment to transfer was 2 hours. The ninth @entity1 was initially admitted overnight then promptly transferred after re-evaluation of his hand burns indicated a need for more specialized care. Two of 9 transferred @entity1 , both with ISS of 75 died. Although 7 other @entity1 had prolonged and complex courses, none of their subsequent complications were referable to missed injuries from this transferring facility. The resources and expertise of a high volume @entity2613 without an in-hospital burn unit can be effectively used in the initial resuscitation and treatment of multiple burn casualties. Coordinated responses among emergency medicine, @entity130 , anesthesia, and nursing personnel are instrumental to the rapid triage, resuscitation, and treatment of critically injured burn @entity1 . Future disaster planning should incorporate a clearly demarcated, @entity2613 command center led by an easily identifiable "captain of the ship," as well as more accurate @entity1 identification systems and improved communications with family members.

Management of multiple burn casualties in a high volume XXXX without a verified burn unit.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity2613 :: ('MESH:C536181', 'Disease') :: ['ED'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma']
@entity2613 :: (MESH:C536181,Disease) :: ['ED']
