Planning for burn disasters: Lessons learned from one hundred years of history
Planning for burn disasters: Lessons learned from one hundred years of history
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DOI：
10.1097/01.bcr.0000236823.08124.1c
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发表时间：
2006-09-01
影响因子：
1.4
通讯作者：
Wolf, Steven
中科院分区：
文献类型：
--
作者：
Barillo, David J.;Wolf, Steven
9·11恐怖袭击引发了人们对制定计划管理数千名烧伤伤员的兴趣.在管理如此规模的灾难方面，美国几乎没有实际经验。作为另一种选择，可以从这个国家以前发生的平民烧伤或火灾的历史经验中吸取教训。对1900至2000年间美国发生的有关平民烧伤或火灾的相关医疗、消防和流行文献进行了回顾。在20世纪，美国发生了73起重大火灾或烧伤灾难。随着每一场灾难都促使消防法规或建筑法规得到加强，每起事故的死亡人数都在稳步下降。对几起具有里程碑意义的火灾的详细检查表明，伤亡人数很多，但大多数受害者都有致命伤害，并在现场或24小时内死亡。第二大队列包括行走的伤员，他们只需要最少的门诊治疗。需要住院烧伤护理的患者只占总伤亡人数的一小部分，但在住院期间消耗了大量资源。烧伤造成大量人员伤亡的事件并不常见。每起事件的伤亡人数随着时间的推移而下降。在大多数火灾中，大多数受害者要么迅速死亡，要么受轻伤，可以接受治疗并出院。因此，大多数灾难产生的需要住院治疗的烧伤患者不到25到50人。这将是一个理性的点，开始烧伤中心准备大规模伤亡事件。强大的门诊能力也是可取的，可以管理行走的伤员。
The terrorist attacks of September 11 th have prompted interest in developing plans to manage thousands of burn casualties. There is little actual experience in the United States in managing disasters of this magnitude. As an alternative, lessons may be learned from the historical experiences of previous civilian burn or fire disasters occurring in this country. A review of relevant medical, fire service, and popular literature pertaining to civilian burn or fire disasters occurring in the United States between the years 1900 and 2000 was performed. In the 20th century, 73 major U.S. fire or burn disasters have occurred. With each disaster prompting a strengthening of fire regulations or building codes, the number of fatalities per incident has steadily decreased. Detailed examination of several landmark fires demonstrated that casualty counts were great but that most victims had fatal injuries and died on the scene or within 24 hours. A second large cohort comprised the walking wounded, who required minimal outpatient treatment. Patients requiring inpatient burn care comprise a small percentage of the total casualty figure but consume enormous resources during hospitalization. Burn mass casualty incidents are uncommon. The number of casualties per incident decreased over time. In most fire disasters, the majority of victims either rapidly die or have minimal injuries and can be treated and released. As a result, most disasters produce fewer than 25 to 50 patients requiring inpatient burn care. This would be a rational point to begin burn center preparations for mass casualty incidents. A robust outpatient capability to manage the walking wounded is also desirable.