Kearns Presentation at the FDA Medical Countermeasures
Medical Countermeasures in the context of:Organization & Delivery of Burn Care in a Mass Casualty Setting ‐ Planning ‐ Randy D. Kearns, DHA MSA CEM Program Director University of North Carolina, School of Medicine September 27, 2012
Burn Center PlanningPlanning from the burn center perspective should reflect (minimally) three levels;• Local: – Intrafacility (your hospital/system)• State: – Interfacility/instrastate (burn and trauma centers) (state ESF‐8)• Regional: – Interstate (burn and trauma centers) NDMS or EMAC through state ESF‐8
Governmental PlanningPlanning from the governmental perspective should reflect:Local: First Responder (EMS system) First Receiver(s) (local hospital[s])State: Mutual Aid EMS, Intrastate regional response teams, burn and trauma centersRegional: Interstate Burn Centers, Regional Response Teams through EMAC or NDMS
Three windows of time in a Burn Disaster:Immediate: best you can with what you have and know who to call for what you need6‐120 hrs: leaning forward with response teams, transport agencies, and push packs of equipment (staff, space, stuff)>72‐120 hrs: high census but normal operation
Three types of events: (NIMS Typing)• Type III Burn Disaster: – Isolated burn disaster such as the Station Night Club Fire – Burn Care System Impact• Type II Burn Disaster: – Multiple aspect disaster, such as an explosion with significant numbers of traumatic as well as burn injured patients such as the 05 London or 04 Madrid Bombings – Healthcare System Impact • Type I Burn Disaster: – Catastrophic/wide spread event, multi‐state such as 9/11 attacks or Earthquakes such as Northridge or Loma Prieta – Infrastructure Impact
Think in terms of Surge Capacity/Capability• Space• Staff • Supplies, Medicine & Equipment (SME) (Stuff) – Leaning Forward what can you bring and where will it come from?
Conclusions• Plans – Relationships – Local, State, Regional• Who to call and what can you bring? – Space, Staff, Stuff – Transport resources• Future Needs – Continue to improve dealing with the basics – Better products from patient care to technology, longer shelf life – Weave caches of equipment into the supply chain
Thanks• Randy_kearns@med.unc.eduBruce_cairns@med.unc.eduJholmes@wakehealth.eduKearns RD, Holmes IV JH, Cairns BA. Burn Disaster Preparedness and the Southern Region of the United States. Southern Medical Journal Dec 2012 (planned):9. (accepted for publication)Hick JL, Barbera JA, Kelen GD. Refining surge capacity: conventional, contingency, and crisis capacity. Disaster Med Public Health Prep. Jun 2009;3(2 Suppl):S59‐67.