TITLE

A Burn Mass Casualty Event Due to Boiler Room Explosion on a Cruise Ship: Preparedness and Outcomes

AUTHOR(S)
Tekin, Akin; Namias, Nicholas; O'Keeffe, Terence; Pizano, Louis; Lynn, Mauricio; Prater-Varas, Robin; Quintana, Olga Delia; Borges, Leda; Ishii, Mary; Seong Lee; Lopez, Peter; Lessner-Eisenberg, Sharon; Alvarez, Angel; Ellison, Tom; Sapnas, Katherine; Lefton, Jennifer; Ward, Charles Gillon
PUB. DATE
March 2005
SOURCE
American Surgeon;Mar2005, Vol. 71 Issue 3, p210
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The purpose of this study was to review our experience with a mass casualty incident resulting from a boiler room steam explosion aboard a cruise ship, Experience with major, moderate, and minor burns, steam inhalation, mass casualty response systems, and psychological sequelae will be discussed. Fifteen cruise ship employees wore brought to the burn center after a boiler room explosion on a cruise ship. Eleven were triaged to the trauma resuscitation area and four to the surgical emergency room. Seven patients were intubated for respiratory- distress or airway protection. Six patients had > 80 percent burns with steam inhalation, and all of these died. One of the 6 patients had 99 per cent burns with steam inhalation and died after withdrawal of support within the first several hours. All patients with major burns required escharotomy on arrival to trauma resuscitation. One patient died in the operating room, despite decompression by laparotomy for abdominal compartment syndrome and pericardiotomy via thoracotomy for cardiac tamponade. Four patients required crystalloid, 20,000 mls/m²-27, 000 ml/m² body surface area (BSA) in the first 48 hours to maintain blood pressure and urine output. Three of these four patients subsequently developed abdominal compartment syndrome and died in the first few days. The fourth patient of this group died after 26 days due to sepsis. Five patients had 13-20 percent burns and four patients had less than 10 per cent burns. Two of the patients with 20 per cent burns developed edema of the vocal cords with mild hoarseness. They improved and recovered without intubation. The facility was prepared for the mass casualty event, having just completed a mass casualty drill several days earlier. Twenty-six beds were made available in 50 minutes for anticipated casualties. Fifteen physicians reported immediately to the trauma resuscitation area to assist in initial stabilization. The event occurred at shift change; thus,...
ACCESSION #
16670855

 

Related Articles

  • Metabolic Implications of Severe Burn Injuries and Their Management: A Systematic Review of the Literature. Atiyeh, Bishara S.; Gunn, S. William A.; Dibo, Saad A. // World Journal of Surgery;Aug2008, Vol. 32 Issue 8, p1857 

    Severe burn patients are some of the most challenging critically ill patients, with an extreme state of physiologic stress and an overwhelming systemic metabolic response. A major component of severe burn injury is a hypermetabolic state associated with protein losses and a significant reduction...

  • Classifying burns.  // RN;Jan2006, Vol. 69 Issue 1, p56 

    This article classifies burns according to their depth and helps determine treatment. Superficial burns, often called first-degree burn, damage only the epidermis. They are pink to red in color. Superficial partial thickness is one of two types of second-degree burns. They extend into the upper...

  • Report of the Meeting of the Mediterranean Club for Burns and Fire Disasters (MBC and FD), Cyprus. Costagliola, M. // European Journal of Plastic Surgery;Jan2006, Vol. 28 Issue 6, p432 

    The article highlights the meeting of the Mediterranean Club for Burns and Fire Disasters held on the easternmost isle of the Mediterranean from October 20 to 23, 2004. There are two lectures were presented, one on infections in burnt patients by Maria Koliou, pediatrician at Nicosia Hospital...

  • Traumatic brain injury in children. Jamjoom, A. A. B.; Gupta, R. K.; Devkota, U. P. // British Journal of Hospital Medicine (17508460);Mar2010, Vol. 71 Issue 3, p138 

    This article provides a clinical overview of traumatic brain injury in children. It concentrates on the current management guidelines from initial assessment in the accident and emergency department through to specialist critical care.

  • Non-fatal burn is a major cause of illness: findings from the largest community-based national survey in Bangladesh. S R Mashreky // Injury Prevention (1353-8047);Dec2009, Vol. 15 Issue 6, p397 

    OBJECTIVE: To examine the incidence and characteristics of non-fatal burn injury in Bangladesh. METHODS: A population-based cross-sectional survey was conducted between January and December 2003 in Bangladesh. Nationally representative data were collected from 171 366 rural and urban households,...

  • Splinters & Fragments.  // Injury Prevention (1353-8047);Apr2004, Vol. 10 Issue 2, p128 

    This article reports on developments related to accidents and safety measures taken for injury prevention. A comparison of data from three national eye injury registries in Hungary revealed that champagne bottle corks were responsible for 71% of eye injuries caused by bottles containing...

  • Commonly missed injuries in the accident and emergency department. Lee, Caroline; Bleetman, Anthony // Trauma;Jan2004, Vol. 6 Issue 1, p41 

    Accident and emergency (A&E) medicine is a high-risk speciality in which the majority of patients are managed by junior doctors with limited clinical experience. A review of the literature identified that the rate of missed injury ranges from 0.4 to 65%. Missed injuries are by definition...

  • Telemedicine for acute burn treatment: the time has come. Saffle, Jeffrey R. // Journal of Telemedicine & Telecare;Jan2006, Vol. 12 Issue 1, p1 

    This brief paper sets out the arguments for the routine use of telemedicine in the evaluation of burns. Two cases are reported from the author's practice that show the need for it.

  • Mersey Burns App - Assessing major burns. Jones, Rowan Pritchard; McArthur, Paul; Seaton, Chris // International Journal of Integrated Care (IJIC);Nov2014 Supplement, Vol. 14, p114 

    Introduction: Accurate assessment and resuscitation of a major burn injury is a difficult task for inexperienced clinicians, yet essential for patient outcome. The commonly used Lund and Browder Chart (LB) offers an accurate tool but is the start of a series of 19 calculations required to begin...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics