Prioritizing Burn-Injured Patients During a Disaster

The U. S. government has mandated that, in a catastrophic event, metropolitan areas need to be capable of caring for 50 burn-injured patients per million population. In New York City, this corresponds to 400 patients. There are currently 140 burn beds in the region, which can be surged up to 210. To care for additional patients, hospitals without burn centers will be used to stabilize patients until burn beds become available. In this work, we develop a new system for prioritizing patients for transfer to burn beds as they become available and demonstrate its superiority over several other triage methods. Based on data from previous burn catastrophes, we study the feasibility of being able to admit 400 patients to burn beds within the critical three- to five-day time frame. We find that this is unlikely and that the ability to do so is highly dependent on the type of event and the demographics of the patient population. This work has implications for how disaster plans in other metropolitan areas should be developed.