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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 Planning
Planning 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 Planning
Planning 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 
        centers
Regional:     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 need
6‐120 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.edu

Bruce_cairns@med.unc.edu
Jholmes@wakehealth.edu


Kearns 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.

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