title: Managing a combined burn trauma disaster in the post-9/11 world: lessons learned from the 2003 West Pharmaceutical plant explosion.
abstract: At 1:37 pm on January 29, 2003, an explosion occurred at the West Pharmaceutical chemical plant in Kinston, North Carolina. The explosion killed three people at the scene and resulted in more than 30 admissions to area hospitals. The disaster resulted in 10 critically ill burn patients, who were all intubated with inhalation injuries, many with combined burn and trauma injuries. All 10 critically injured patients were admitted to a tertiary care facility 100 miles away with both a Level I trauma center and a verified burn center. Ultimately, 7 of 10 patients survived (a mortality rate of 30%), and none were transferred to another trauma or burn center. This article analyzes the unique challenges that combined burn and trauma patients present during a disaster, critically examines the response to this disaster, describes lessons learned, and presents recommendations that may improve the response to such disasters in the future.
authors.affiliation: North Carolina Jaycee Burn Center and Department of Surgery, University of North Carolina, Chapel Hill, North Carolina 27514, USA.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Cairns
authors.forename: Arvilla
authors.initials: A
authors.lastname: Stiffler
authors.forename: Fred
authors.initials: F
authors.lastname: Price
authors.forename: Michael D
authors.initials: MD
authors.lastname: Peck
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Meyer
mesh_terms: D002053:Burn Units / Q000458:organization & administration* / Q000706:statistics & numerical data; D002056:Burns / Q000401:mortality / Q000628:therapy*; D004189:Disaster Planning / Q000458:organization & administration*; D004345:Drug Industry; D004631:Emergency Medical Service Communication Systems; D004632:Emergency Medical Services / Q000458:organization & administration*; D005107:Explosions; D006801:Humans; D009657:North Carolina / Q000453:epidemiology; D019982:Organizational Case Studies; D010360:Patient Transfer; D012041:Regional Medical Programs; D047851:September 11 Terrorist Attacks; D013997:Time Factors; D014193:Trauma Centers / Q000458:organization & administration* / Q000706:statistics & numerical data; D014218:Triage