Infrastructure, resources and preparedness for mass burn injuries in a developing country.

Our aims were to evaluate resources and the preparedness of the health care facilities to respond to mass burn injuries in Vietnam. A survey was conducted in 19 provincial and central/regional hospitals using a questionnaire. The contents of the survey included infrastructure, human resources, medical equipment for burn care, and preparedness of hospitals for mass burn injuries. Results indicated that a variety of burn care facilities were set up, from separate burn departments (42.1%) to burn units (15.8%) or burn beds (42.1%) inside trauma or surgical departments. Medical staff/burn bed ratio was .7 and nurse/physician ratio was 1.7, with 52.7% of nurses having more than 5 years' experience. Infrastructure and medical equipment for burn facilities were limited, with just under half of the hospitals equipped with an air conditioner and heater. Bronchoscopy for diagnosis and management of inhalation injury was available in 6 (31.6%) hospitals. Few health facilities had a mechanical ventilator, fluid warmer, hemofiltration machine, burn theater, electro-dermatome or skin mesher. Only 26.3% hospitals had a plan for the management of mass burn injuries. A burn specialist was a member of the hospital's emergency medical team in 36.8% of the hospitals. Guidelines for burn emergency care were available in 63.2% hospitals. In the last 5 years, 21.1% of health facilities had conducted a drill for mass casualty incident management, but only 1 (5.3%) hospital had conducted a drill for MBI management. In conclusion, facilities, equipment, human resources for burn care and preparedness to manage mass burn injuries in Vietnam are still limited and need to be improved.