Are burn centers in German-speaking countries prepared to respond to a burn disaster? Survey-based study.

Burn disasters present a challenge not only to burn centers but the entire healthcare system. Most burn centers worldwide are unprepared to deal with a burn disaster as it is an uncommon event. We investigated the status of burn center preparedness in German-speaking countries to respond to a burn disaster. Self-administered survey questionnaires were sent to the directors of burn centers; the questions of survey used before in a similar way in Belgium were translated into German language. Of the 46 questioned burn centers, 32 (78%) responded, including all of the German adult burn centers. A clear difference in the preparation status of the burn centers in the three countries was observed due to geopolitical factors such as decentralized healthcare systems. However, the healthcare system is generally well-prepared concerning command, transfer, and capacity to provide sustained supplies to handle a massive influx of patients. Nevertheless, there are some gaps in the areas of planning and preparation, funding for disaster activities, and regular training of staff for burn disasters. We call for a unified burn disaster plan and increased cooperation between burn centers and civil defense regarding communication and training. We strongly recommend the implementation of a special disaster fund and telemedicine in disaster management to circumvent shortages in burn staff.

Implication of Burn Disaster Planning and Management: Coverage and Accessibility of Burn Centers in Belgium.

INTRODUCTION: Burn disasters represent a real challenge to burn centers worldwide. Several burn disasters with a considerable number of casualties happened in Belgium in the past. The positioning of burn centers is a significant issue to account for in a burn disaster preparedness and response. The objectives of this study are to identify the geographic coverage and accessibility of the burn centers in Belgium in the realm of a burn disaster scenario. METHOD: Cross-sectional secondary analysis was performed using data from the Belgian Burn Association and Belgian Department of the Statistic. Data were analyzed using ArcGIS, a geographic information system tool to identify the coverage of burn centers within half an hour driving time, and access time of both populations in the districts and the disaster-prone areas to the individual burn centers. RESULTS: Around 7.3 million (65%) people are covered by a half an hour driving time window from the burn centers. However, the accessibility to the individual burn centers is varied across different regions and provinces. CONCLUSION: There is a slightly over-supply of burn centers in the mid part of the country, contrasted by an under-supply and poor accessibility for the population living near the borders, particularly in the south part of the country. This study would provide a benchmark for stakeholders in Belgium and other industrial countries to consider the coverage and accessibility of the burn centers as part of preparation and planning for burn disasters in the future.

Characteristics and outcomes of patients with grill-related Burn injuries admitted to the Cologne Burn Center, Germany.

BACKGROUND: Grilling has become increasingly common in Germany. Although grilling is considered a non-negligible household burn hazard, few reports have assessed this type of injury. This study aimed to determine the patterns and characteristics of grill-related burn injuries and to compare these with other types of burn injuries. METHODS: This retrospective observational study included all grill-related burn injuries admitted to Cologne Merheim Burn Center during 1989-2017. The collected data were analyzed descriptively and compared statistically with other fire injuries. RESULTS: Of 1706 cases admitted with fire injuries during the study period, 160 (∼10%) involved grill-related injuries. Most cases (85%) involved men, with an average age of 34 years. Moreover, 48% and 38% of cases occurred in summer and spring, respectively. The most common mechanism of injury was ignition via fluid accelerant. The upper limb was the most commonly affected body part, followed by the head. Statistical analyses revealed that grill-related injuries were associated with a lower mean age and total body surface area, shorter in-hospital stay, and fewer complications than the other fire injury group. CONCLUSION: Grill-related injuries are a relatively common cause of admission to the Cologne Burn Center. Although grill-related injuries underwent a less aggressive approach than the other investigated fire injuries, the former represent a public health concern because they mainly affect the upper body, with both psychologic and aesthetic consequences. We recommend a German nationwide multi-centric study of the patterns and characteristics of burn injury.

Assessment of the Capacity and Capability of Burn Centers to Respond to Burn Disasters in Belgium: A Mixed-Method Study.

Burn disaster is defined as a massive influx of patients that exceeds a burn center's capacity and capability. This study investigates the capacity and capability of burn centers to respond to burn disasters in the Belgian ground. Quantitative survey and qualitative semistructured interview questionnaires were administered directly to key informants of burn centers. The data collected from both methods were compared to get a more in-depth overview of the issue. Quantitative data were converted into a narrative to enrich the qualitative data and included in the thematic analysis. Finally, data from both methods were analyzed and organized into five themes. The Belgian Association of Burn Injury (BABI) has a specific prehospital plan for burn disaster management. Once the BABI Plan is activated, all burn centers respond as one entity. Burn Team (B-Team) is a professional team that is formed in case of urgent need and it is deployed to a scene or to nonburn specialized hospitals to help in disaster relief. The challenges for burn disasters response occur particularly in the area of triage, transfer, communication, funding, and training. We conclude that there is a variation in the capacity and capability of burn centers. Overall, the system of burn disaster management is advanced and it is comparable to other high-income countries. Nevertheless, further improvement in the areas of preparation, triage, communication, and finally training would make disaster response more resilient in the future. Therefore, there is still space for further improvement of the management of burn disasters in Belgium.

Disaster risk reduction in Iraq.

Iraq is at risk of multiple hazards including both natural and man-made calamities. Little effort had been made before 2003 to address the disaster risk; even though many legislations enacted to provide a relief in the event of the acute crisis, they were mainly focused on the reactive response to the calamities without taking into consideration the prevention, preparedness and mitigation approach. The recent years have witnessed some positive attitude from the government and international society to develop strategies for disaster risk reduction in Iraq. Iraq for the first time has drafted a law that is distinctive for the disasters. The purpose of this article is to review the possibilities and challenges of disaster risk reduction in Iraq.

Addressing the physicians' shortage in developing countries by accelerating and reforming the medical education: Is it possible?

INTRODUCTION: Doctors' shortage has remained a concern worldwide. The developed countries started aids to recruit international medical graduates (IMG) to cope with the defects that the health care system suffers from; however, this solution may not work in developing countries that have a limited resource and poor budget to spend on the health care system. This study aims to present an alternative way to approach the physicians' shortage by accelerating undergraduate medical education and reform some post-graduate courses in order to cope with this problem. METHODS: The literature in PubMed/Medline and Google scholar were searched using such keywords as undergraduate medical education, physician shortage, health care reform, physicians' performance, medical curriculum. RESULTS: The finding revealed that performance during undergraduate medical school does not have a relationship with the physician's performance post-graduation. Moreover, the overloaded curriculum and the years spent in undergraduate education have a negative impact on the students in terms of burn out, and lack of competency, and loss of motivation in medicine. The method of education was found to have a positive effect on preparing good students and ultimately good physicians. CONCLUSION: Since performance in undergraduate years does not have an impact on the practice post-graduation, the developing countries may consider the option of changing the context, and abbreviating undergraduate medical education as a solution for physicians' shortage dilemma. Moreover, modifying some post-graduate majors such as family physician, and general practitioner to allow the physicians enter the practice in areas of need is recommended.