Kearns Randy D, Hubble Michael W, Holmes James H, Cairns Bruce A
From the *Division of North Carolina Jaycee Burn Center, Department of Surgery, School of Medicine, University of North Carolina, Chapel Hill; †Emergency Medical Care Program, School of Health Sciences, Western Carolina University, Cullowhee, North Carolina and ‡Department of General Surgery, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
J Burn Care Res. 2014 Jan-Feb;35(1):e21-32. doi: 10.1097/BCR.0b013e3182853cf7.
A disaster scenario with a significant number of burn-injured patients creates a tremendous challenge for disaster planners. Directing the transport of patients to the most appropriate receiving facility as soon as reasonably possible remains the aim. This review focused on both the overall process as well as an analysis of one specific state (as an example). This included the capability and limitations of the intrastate and interstate resources should a burn disaster occur. Although the results for one state may be interesting, it is the process that is essential for those involved in burn disaster planning. An overview of the quantity and quality of available ambulances and how to access these resources is provided. Ground-based ambulances have an array of capacities and levels of services ranging from basic life support to advanced (paramedic) services and include ambulance buses. This review also included private and hospital-based specialty care ambulances and aeromedical services. Finally, the review identified military or federal resources that may be an option as well. There are various local, state, and federal resources that can be called upon to meet the transportation needs of these critically injured patients. Yet, there are barriers to access and limitations to their response. It is just as important to know both availability and capability as it is to know how to access these resources. A disaster is not the time to realize these hurdles.
大量烧伤患者的灾难场景给灾难规划者带来了巨大挑战。尽快将患者合理地转运到最合适的接收机构仍然是目标。本综述既关注了整个过程,也以一个特定州为例进行了分析。这包括烧伤灾难发生时该州境内和跨州资源的能力与局限。尽管一个州的结果可能很有意思,但对于参与烧伤灾难规划的人员来说,关键是这个过程。本文提供了可用救护车数量和质量的概述以及如何获取这些资源。地面救护车具备一系列能力和服务水平,从基本生命支持到高级(护理人员)服务,还包括救护巴士。本综述还涵盖了私立和医院的专科护理救护车以及空中医疗服务。最后,该综述还确定了军事或联邦资源也可能是一种选择。有各种地方、州和联邦资源可被调用,以满足这些重伤患者的转运需求。然而,获取资源存在障碍,其响应也有局限。了解资源的可用性和能力与知道如何获取这些资源同样重要。灾难发生时可不是发现这些障碍的时候。