Can burn centers evacuate in response to disasters?

On August 29, 2005, the Gulf Coast was hit by Hurricane Katrina, a category 4 storm. The storm was responsible for more than 1000 deaths and the displacement of hundreds of thousands of people. Hospitals in the city of New Orleans evacuated because of the complete collapse of infrastructure. This event influenced the decisions and actions taken to protect patients, families, and staff of a 30-bed pediatric burn center in the projected path of a second catastrophic hurricane 3 weeks later. Approximately 80 hours before projected landfall, the local government announced that a mandatory evacuation of the community surrounding the burn center would occur. A coordinated decision was made by administration, nursing, and medical staff to cancel upcoming clinics and elective surgery and to evacuate all 14 inpatients, 52 outpatients, and 66 guardians to other facilities. The evacuation plan was successfully completed in 32 hours. The eye wall of the hurricane passed 65 miles east of the burn center. No significant damage to the physical plant was noted. Repopulation of the hospital by patients and acceptance of new acute burn referrals began approximately 40 hours after the local government permitted the population to return to the area. No morbidity or mortality was attributed to the evacuation. Emergent evacuation of threatened burn centers can be safely accomplished with adequate prior planning of evacuation sites, and modes of transportation. An established communication command center plays a key role in this process.