title: Burn disaster response planning in New York City: updated recommendations for best practices.
abstract: Since its inception in 2006, the New York City (NYC) Task Force for Patients with Burns has continued to develop a city-wide and regional response plan that addressed the triage, treatment, transportation of 50/million (400) adult and pediatric victims for 3 to 5 days after a large-scale burn disaster within NYC until such time that a burn center bed and transportation could be secured. The following presents updated recommendations on these planning efforts. Previously published literature, project deliverables, and meeting documents for the period of 2009-2010 were reviewed. A numerical simulation was designed to evaluate the triage algorithm developed for this plan. A new, secondary triage scoring algorithm, based on co-morbidities and predicted outcomes, was created to prioritize multiple patients within a given acuity and predicted survivability cohort. Recommendations for a centralized patient and resource tracking database, plan operations, activation thresholds, mass triage, communications, data flow, staffing, resource utilization, provider indemnification, and stakeholder roles and responsibilities were specified. Educational modules for prehospital providers and nonburn center nurses and physicians who would provide interim care to burn injured disaster victims were created and pilot tested. These updated best practice recommendations provide a strong foundation for further planning efforts, and as of February 2011, serve as the frame work for the NYC Burn Surge Response Plan that has been incorporated into the New York State Burn Plan.
authors.affiliation: Department of Nursing, New York Presbyterian Hospital, New York, USA.
authors.forename: Nicole E
authors.initials: NE
authors.lastname: Leahy
authors.forename: Roger W
authors.initials: RW
authors.lastname: Yurt
authors.forename: Eliot J
authors.initials: EJ
authors.lastname: Lazar
authors.forename: Alfred A
authors.initials: AA
authors.lastname: Villacara
authors.forename: Angela C
authors.initials: AC
authors.lastname: Rabbitts
authors.forename: Laurence
authors.initials: L
authors.lastname: Berger
authors.forename: Carri
authors.initials: C
authors.lastname: Chan
authors.forename: Laurence
authors.initials: L
authors.lastname: Chertoff
authors.forename: Kathe M
authors.initials: KM
authors.lastname: Conlon
authors.forename: Arthur
authors.initials: A
authors.lastname: Cooper
authors.forename: Linda V
authors.initials: LV
authors.lastname: Green
authors.forename: Bruce
authors.initials: B
authors.lastname: Greenstein
authors.forename: Yina
authors.initials: Y
authors.lastname: Lu
authors.forename: Susan
authors.initials: S
authors.lastname: Miller
authors.forename: Frank P
authors.initials: FP
authors.lastname: Mineo
authors.forename: Darrin
authors.initials: D
authors.lastname: Pruitt
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Ribaudo
authors.forename: Chris
authors.initials: C
authors.lastname: Ruhren
authors.forename: Steven H
authors.initials: SH
authors.lastname: Silber
authors.forename: Lewis
authors.initials: L
authors.lastname: Soloff
mesh_terms: D000465:Algorithms; D019985:Benchmarking / Q000379:methods*; D002053:Burn Units; D002056:Burns / Q000453:epidemiology* / Q000517:prevention & control; D004189:Disaster Planning / Q000379:methods*; D006801:Humans; D009519:New York City / Q000453:epidemiology; D014218:Triage / Q000379:methods