Burn mass casualty incidents in Europe: A European response plan within the European Union Civil Protection Mechanism

Stian Kreken Almeland; Evelyn Depoortere; Serge Jennes; Folke Sjöberg; J. Alfonso Lozano Basanta; Sofia Zanatta; Calin Alexandru; José Ramón Martinez-Mendez; Cornelis H. van der Vlies; Amy Hughes; Juan P. Barret; Naiem Moiemen; Thomas Leclerc

doi:10.1016/j.burns.2022.07.008

Burn mass casualty incidents in Europe: A European response plan within the European Union Civil Protection Mechanism

Stian Kreken Almeland^*, Evelyn Depoortere, Serge Jennes, Folke Sjöberg, J. Alfonso Lozano Basanta, Sofia Zanatta, Calin Alexandru, José Ramón Martinez-Mendez, Cornelis H. van der Vlies, Amy Hughes, Juan P. Barret, Naiem Moiemen, Thomas Leclerc

^*Corresponding author for this work

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Abstract

Background: Burn care is centralized in highly specialized burn centers in Europe. These centers are of limited capacity and may be overwhelmed by a sudden surge in case of a burn mass casualty incident. Prior incidents in Europe and abroad have sustained high standards of care through well-orchestrated responses to share the burden of care in several burn centers. A burn mass casualty incident in Romania in 2015 sparked an initiative to strengthen the existing EU mechanisms. This paper aims to provide insight into developing a response plan for burn mass casualties within the EU Civil Protection Mechanism. Methods: The European Burns Association drafted medical guidelines for burn mass casualty incidents based on a literature review and an in-depth analysis of the Romanian incident. An online questionnaire surveyed European burn centers and EU States for burn mass casualty preparedness. Results: The Romanian burn mass casualty in 2015 highlighted the lack of a burn-specific mechanism, leading to the late onset of international transfers. In Europe, 71% of respondents had existing mass casualty response plans, though only 35% reported having a burn-specific plan. A burns response plan for burn mass casualties was developed and adopted as a Commission staff working document in preparation for further implementation. The plan builds on the existing Union Civil Protection Mechanism framework and the standards of the WHO Emergency Medical Teams initiative to provide 1) burn assessment teams for specialized in-hospital triage of patients, 2) specialized burn care across European burn centers, and 3) medevac capacities from participating states. Conclusion: The European burn mass casualty response plan could enable the delivery of high-level burn care in the face of an overwhelming incident in an affected European country. Further steps for integration and implementation of the plan within the Union Civil Protection Mechanism framework are needed.

Original language	English
Pages (from-to)	1794-1804
Number of pages	11
Journal	Burns
Volume	48
Issue number	8
DOIs	https://doi.org/10.1016/j.burns.2022.07.008
Publication status	Published - Dec 2022

Bibliographical note

Funding Information:
This work was supported by funding from the European Commission, Directorate-General for European Civil Protection and Humanitarian Aid Operations ( ECHO ), Directorate B - Disaster Preparedness and Prevention, Unit B1 - Civil Protection Horizontal Issues by tender contract ECHO-B1-NP-2019-05 regarding a European response to mass burn casualty disasters.

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© 2022 The Authors

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Almeland, S. K., Depoortere, E., Jennes, S., Sjöberg, F., Lozano Basanta, J. A., Zanatta, S., Alexandru, C., Martinez-Mendez, J. R., van der Vlies, C. H., Hughes, A., Barret, J. P., Moiemen, N., & Leclerc, T. (2022). Burn mass casualty incidents in Europe: A European response plan within the European Union Civil Protection Mechanism. Burns, 48(8), 1794-1804. https://doi.org/10.1016/j.burns.2022.07.008

@article{ae3562311f6f4009b1a20d7e81a3742b,

title = "Burn mass casualty incidents in Europe: A European response plan within the European Union Civil Protection Mechanism",

abstract = "Background: Burn care is centralized in highly specialized burn centers in Europe. These centers are of limited capacity and may be overwhelmed by a sudden surge in case of a burn mass casualty incident. Prior incidents in Europe and abroad have sustained high standards of care through well-orchestrated responses to share the burden of care in several burn centers. A burn mass casualty incident in Romania in 2015 sparked an initiative to strengthen the existing EU mechanisms. This paper aims to provide insight into developing a response plan for burn mass casualties within the EU Civil Protection Mechanism. Methods: The European Burns Association drafted medical guidelines for burn mass casualty incidents based on a literature review and an in-depth analysis of the Romanian incident. An online questionnaire surveyed European burn centers and EU States for burn mass casualty preparedness. Results: The Romanian burn mass casualty in 2015 highlighted the lack of a burn-specific mechanism, leading to the late onset of international transfers. In Europe, 71% of respondents had existing mass casualty response plans, though only 35% reported having a burn-specific plan. A burns response plan for burn mass casualties was developed and adopted as a Commission staff working document in preparation for further implementation. The plan builds on the existing Union Civil Protection Mechanism framework and the standards of the WHO Emergency Medical Teams initiative to provide 1) burn assessment teams for specialized in-hospital triage of patients, 2) specialized burn care across European burn centers, and 3) medevac capacities from participating states. Conclusion: The European burn mass casualty response plan could enable the delivery of high-level burn care in the face of an overwhelming incident in an affected European country. Further steps for integration and implementation of the plan within the Union Civil Protection Mechanism framework are needed.",

author = "Almeland, {Stian Kreken} and Evelyn Depoortere and Serge Jennes and Folke Sj{\"o}berg and {Lozano Basanta}, {J. Alfonso} and Sofia Zanatta and Calin Alexandru and Martinez-Mendez, {Jos{\'e} Ram{\'o}n} and {van der Vlies}, {Cornelis H.} and Amy Hughes and Barret, {Juan P.} and Naiem Moiemen and Thomas Leclerc",

note = "Funding Information: This work was supported by funding from the European Commission, Directorate-General for European Civil Protection and Humanitarian Aid Operations ( ECHO ), Directorate B - Disaster Preparedness and Prevention, Unit B1 - Civil Protection Horizontal Issues by tender contract ECHO-B1-NP-2019-05 regarding a European response to mass burn casualty disasters. Publisher Copyright: {\textcopyright} 2022 The Authors",

year = "2022",

month = dec,

doi = "10.1016/j.burns.2022.07.008",

language = "English",

volume = "48",

pages = "1794--1804",

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Almeland, SK, Depoortere, E, Jennes, S, Sjöberg, F, Lozano Basanta, JA, Zanatta, S, Alexandru, C, Martinez-Mendez, JR, van der Vlies, CH, Hughes, A, Barret, JP, Moiemen, N & Leclerc, T 2022, 'Burn mass casualty incidents in Europe: A European response plan within the European Union Civil Protection Mechanism', Burns, vol. 48, no. 8, pp. 1794-1804. https://doi.org/10.1016/j.burns.2022.07.008

TY - JOUR

T1 - Burn mass casualty incidents in Europe

T2 - A European response plan within the European Union Civil Protection Mechanism

AU - Almeland, Stian Kreken

AU - Depoortere, Evelyn

AU - Jennes, Serge

AU - Sjöberg, Folke

AU - Lozano Basanta, J. Alfonso

AU - Zanatta, Sofia

AU - Alexandru, Calin

AU - Martinez-Mendez, José Ramón

AU - van der Vlies, Cornelis H.

AU - Hughes, Amy

AU - Barret, Juan P.

AU - Moiemen, Naiem

AU - Leclerc, Thomas

N1 - Funding Information: This work was supported by funding from the European Commission, Directorate-General for European Civil Protection and Humanitarian Aid Operations ( ECHO ), Directorate B - Disaster Preparedness and Prevention, Unit B1 - Civil Protection Horizontal Issues by tender contract ECHO-B1-NP-2019-05 regarding a European response to mass burn casualty disasters. Publisher Copyright: © 2022 The Authors

PY - 2022/12

Y1 - 2022/12

N2 - Background: Burn care is centralized in highly specialized burn centers in Europe. These centers are of limited capacity and may be overwhelmed by a sudden surge in case of a burn mass casualty incident. Prior incidents in Europe and abroad have sustained high standards of care through well-orchestrated responses to share the burden of care in several burn centers. A burn mass casualty incident in Romania in 2015 sparked an initiative to strengthen the existing EU mechanisms. This paper aims to provide insight into developing a response plan for burn mass casualties within the EU Civil Protection Mechanism. Methods: The European Burns Association drafted medical guidelines for burn mass casualty incidents based on a literature review and an in-depth analysis of the Romanian incident. An online questionnaire surveyed European burn centers and EU States for burn mass casualty preparedness. Results: The Romanian burn mass casualty in 2015 highlighted the lack of a burn-specific mechanism, leading to the late onset of international transfers. In Europe, 71% of respondents had existing mass casualty response plans, though only 35% reported having a burn-specific plan. A burns response plan for burn mass casualties was developed and adopted as a Commission staff working document in preparation for further implementation. The plan builds on the existing Union Civil Protection Mechanism framework and the standards of the WHO Emergency Medical Teams initiative to provide 1) burn assessment teams for specialized in-hospital triage of patients, 2) specialized burn care across European burn centers, and 3) medevac capacities from participating states. Conclusion: The European burn mass casualty response plan could enable the delivery of high-level burn care in the face of an overwhelming incident in an affected European country. Further steps for integration and implementation of the plan within the Union Civil Protection Mechanism framework are needed.

AB - Background: Burn care is centralized in highly specialized burn centers in Europe. These centers are of limited capacity and may be overwhelmed by a sudden surge in case of a burn mass casualty incident. Prior incidents in Europe and abroad have sustained high standards of care through well-orchestrated responses to share the burden of care in several burn centers. A burn mass casualty incident in Romania in 2015 sparked an initiative to strengthen the existing EU mechanisms. This paper aims to provide insight into developing a response plan for burn mass casualties within the EU Civil Protection Mechanism. Methods: The European Burns Association drafted medical guidelines for burn mass casualty incidents based on a literature review and an in-depth analysis of the Romanian incident. An online questionnaire surveyed European burn centers and EU States for burn mass casualty preparedness. Results: The Romanian burn mass casualty in 2015 highlighted the lack of a burn-specific mechanism, leading to the late onset of international transfers. In Europe, 71% of respondents had existing mass casualty response plans, though only 35% reported having a burn-specific plan. A burns response plan for burn mass casualties was developed and adopted as a Commission staff working document in preparation for further implementation. The plan builds on the existing Union Civil Protection Mechanism framework and the standards of the WHO Emergency Medical Teams initiative to provide 1) burn assessment teams for specialized in-hospital triage of patients, 2) specialized burn care across European burn centers, and 3) medevac capacities from participating states. Conclusion: The European burn mass casualty response plan could enable the delivery of high-level burn care in the face of an overwhelming incident in an affected European country. Further steps for integration and implementation of the plan within the Union Civil Protection Mechanism framework are needed.

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Burn mass casualty incidents in Europe: A European response plan within the European Union Civil Protection Mechanism

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