Burn Care in Mass Casualty Incidents

Burn injuries in mass casualty incidents present a unique constellation of clinical, logistical and ethical challenges. Rapid assessment and prioritisation must be balanced with finite resources, as burn depth and total body surface area involvement dictate fluid resuscitation, wound management and surgical timing. A tiered approach begins at the scene with basic first aid and triage, advances through stabilisation and debridement in field or district hospitals, and culminates in specialised burn centres equipped for critical care, reconstructive surgery and rehabilitation. Coordination across pre-hospital services, local health authorities and international relief networks underpins surge capacity, ensuring that staff, equipment and evacuation routes can be scaled according to patient influx. Recent advances in telemedicine and mobile burn teams have enhanced remote decision-making and on-site expertise, while modular shelters and portable wound-care kits offer pragmatic solutions where infrastructure is damaged or overwhelmed. Integration of mass casualty protocols with existing burn guidelines fosters consistency, yet disparities remain in low-resource settings. A global emphasis on preparedness training, stockpiling of dressings and grafting materials, and cross-border patient distribution aims to mitigate the impact of large-scale burn disasters and preserve long-term functional outcomes.

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Technical terms

Triage: Systematic sorting of patients by injury severity to prioritise treatment and resource allocation.

Surge capacity: Ability of a health system to expand services and personnel rapidly in response to a sudden increase in patient numbers.

Debridement: Surgical or mechanical removal of dead, damaged or infected tissue to promote wound healing.

Re-epithelialisation: Restoration of an intact epithelial layer over a wound surface, marking a key phase in healing.

Prolonged field care: Extended management of injuries in austere or resource-limited settings before evacuation to higher levels of care.

References

1. European Burns Association guidelines for the management of burn mass casualty incidents within a European response plan. Burns (2022).
2. Burn mass casualty incidents in Europe: A European response plan within the European Union Civil Protection Mechanism. Burns (2022).
3. Evaluation of Topical Off-The-Shelf Therapies to Improve Prolonged Field Care of Burn-Injured Service Members. Military Medicine (2022).