Introduction:
On the 9th of December 2019, Whakaari/White Island erupted with 47 people on the island at varying distances from the crater. The National Burn Centre eventually cared for 14 of the 31 patients who entered the National Burn Service network. Whilst the sheer number of patients created huge demands on theatre resource, there were additional logistical challenges encountered in planning the required sustained response. These challenges (and the solutions generated) have implications for future burn disaster management.
Methods:
The Middlemore hospital electronic system and database was used to evaluate surgical resource information, including theatre operating times, concurrent numbers of burn theatres running, operating time per patient, and resources consumed in the process. This data has also been compared to a predictive model previously published by the department.
Results:
Our predictive model had highlighted the magnitude and possible duration of the required response. Whilst the tool was said to be less accurate for larger burn sizes, the reverse proved to be true. The tool also did not predict some of the additional challenges that the White Island patients presented which greatly affected resource use, possibly explaining the discrepancy. The challenges of managing the initial ‘surge’ followed by the on-going challenges of the prolonged response required significant coordination and planning. Multiple factors needed to be taken into account including resource limitations (theatre time, personnel and equipment) not just the clinical state of the patient. Another unexpected complication included the presence of unique microorganisms, which placed additional constraints in planning care. In addition, existing major burn patients also required on-going care.
Conclusion:
Burn mass casualties consume a huge amount of resource, time and staff, in magnitude and duration. Better understanding these resource requirements and limitations is crucial for future planning of similar events.