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.

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.

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.

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.

Four experienced burn care providers participated as advisors in two mass casualty exercises in an area where access to a bum center is severely limited. The role of the advisors, lessons learned, and recommendations for future exercises will be presented.

Prior to the exercises, advisors provided a Justin-Time lecture orienting hospital workers to prehospital triage, emergent burn care, and burn center transfers. Exercise 1 consisted of a simulated train derailment with hazardous materials spill and involved 150 victims; many with burn injuries and associated trauma. An advisor was assigned to each car to provide guidance to victims and feedback to exercise evaluators on prehospital triage, victim management, and transfer decisions. Exercise two involved a terrorist attack at an oil refinery in a small community; 140 victims were moulaged, triaged, and transported to the hospital. A burn advisor was assigned to each of the following areas of the hospital: initial triage area, intensive care unit (ICU) for immediate/critical victims, rehabilitation area for patients triaged into delayed or minor injury categories, and the state Disaster Medical Assistance Team (DMAT) treatment area.

Overall, victims with injuries other than burns were more accurately triaged at the scene, assessed at the hospital, and managed. Although the state has provided burn courses to 150 nurses, physicians, and paramedics over the previous three years, there is a significant need for further burn training.

The presence of experienced burn advisors provided the opportunity for healthcare providers to receive training, ask questions during the exercise, and receive feedback following the exercise.