Responding to major burn disasters in resource-limited settings: Lessons learned from an oil tanker explosion in Nakuru, Kenya

Eline Van Kooij, Inge Schrever, Walter Kizito, Martine Hennaux, George Mugenya, Elvis Otieno, Miguel Trelles, Nathan P. Ford, Kathryn M. Chu

Research output: Contribution to journalArticle

Abstract

BACKGROUND:: On January 31, 2009, a fuel tanker exploded in rural Kenya, killing and injuring hundreds of people. This article describes the care of >80 burn victims at a rural hospital in Kenya, Nakuru Provincial General Hospital, and provides lessons for care of a large number of burned patients in a resource-limited setting. METHODS:: Data were obtained from retrospective review from hospital registers and patient files. RESULTS:: Treatment was provided for 89 victims. Eighty-six (97%) were men; median age was 25 years (interquartile range [IQR], 19-32). Half of the patients (45) died, the majority (31, 69%) within the first week. The median total body surface area burned for those who died was 80% (IQR, 60-90%) compared with 28% (IQR, 15-43%) for those who survived (p <0.001). Twenty patients were transfused a total of 73 units of blood including one patient who received 9 units. Eighty surgical interventions were performed on 31 patients and included 39 split-thickness skin grafts, 21 debridements, 7 escharotomies, 6 dressing changes, 4 contracture releases, and 3 finger amputations. Of the 44 survivors, 39 (89%) were discharged within 4 months of the event. CONCLUSIONS:: Mortality after mass burn disasters is high in Africa. In areas where referral to tertiary centers is not possible, district hospitals should have mass disaster plans that involve collaboration with other organizations to augment medical and psychologic services. Even for patients who do not survive, compassionate care with analgesics can be given.

Original languageEnglish (US)
Pages (from-to)573-576
Number of pages4
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume71
Issue number3
DOIs
StatePublished - Sep 2011

Fingerprint

Explosions
Kenya
Disasters
Oils
Rural Hospitals
District Hospitals
Body Surface Area
Contracture
Debridement
Bandages
Amputation
Tertiary Care Centers
General Hospitals
Fingers
Analgesics
Survivors
Organizations
Transplants
Skin
Mortality

Keywords

  • Africa
  • Mass burn disaster
  • Resource-limited setting

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Responding to major burn disasters in resource-limited settings : Lessons learned from an oil tanker explosion in Nakuru, Kenya. / Van Kooij, Eline; Schrever, Inge; Kizito, Walter; Hennaux, Martine; Mugenya, George; Otieno, Elvis; Trelles, Miguel; Ford, Nathan P.; Chu, Kathryn M.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 71, No. 3, 09.2011, p. 573-576.

Research output: Contribution to journalArticle

Van Kooij, Eline ; Schrever, Inge ; Kizito, Walter ; Hennaux, Martine ; Mugenya, George ; Otieno, Elvis ; Trelles, Miguel ; Ford, Nathan P. ; Chu, Kathryn M. / Responding to major burn disasters in resource-limited settings : Lessons learned from an oil tanker explosion in Nakuru, Kenya. In: Journal of Trauma - Injury, Infection and Critical Care. 2011 ; Vol. 71, No. 3. pp. 573-576.
@article{2e66cccf104240c6b8cf9398ffab54d5,
title = "Responding to major burn disasters in resource-limited settings: Lessons learned from an oil tanker explosion in Nakuru, Kenya",
abstract = "BACKGROUND:: On January 31, 2009, a fuel tanker exploded in rural Kenya, killing and injuring hundreds of people. This article describes the care of >80 burn victims at a rural hospital in Kenya, Nakuru Provincial General Hospital, and provides lessons for care of a large number of burned patients in a resource-limited setting. METHODS:: Data were obtained from retrospective review from hospital registers and patient files. RESULTS:: Treatment was provided for 89 victims. Eighty-six (97{\%}) were men; median age was 25 years (interquartile range [IQR], 19-32). Half of the patients (45) died, the majority (31, 69{\%}) within the first week. The median total body surface area burned for those who died was 80{\%} (IQR, 60-90{\%}) compared with 28{\%} (IQR, 15-43{\%}) for those who survived (p <0.001). Twenty patients were transfused a total of 73 units of blood including one patient who received 9 units. Eighty surgical interventions were performed on 31 patients and included 39 split-thickness skin grafts, 21 debridements, 7 escharotomies, 6 dressing changes, 4 contracture releases, and 3 finger amputations. Of the 44 survivors, 39 (89{\%}) were discharged within 4 months of the event. CONCLUSIONS:: Mortality after mass burn disasters is high in Africa. In areas where referral to tertiary centers is not possible, district hospitals should have mass disaster plans that involve collaboration with other organizations to augment medical and psychologic services. Even for patients who do not survive, compassionate care with analgesics can be given.",
keywords = "Africa, Mass burn disaster, Resource-limited setting",
author = "{Van Kooij}, Eline and Inge Schrever and Walter Kizito and Martine Hennaux and George Mugenya and Elvis Otieno and Miguel Trelles and Ford, {Nathan P.} and Chu, {Kathryn M.}",
year = "2011",
month = "9",
doi = "10.1097/TA.0b013e3181febc8f",
language = "English (US)",
volume = "71",
pages = "573--576",
journal = "Journal of Trauma and Acute Care Surgery",
issn = "2163-0755",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Responding to major burn disasters in resource-limited settings

T2 - Lessons learned from an oil tanker explosion in Nakuru, Kenya

AU - Van Kooij, Eline

AU - Schrever, Inge

AU - Kizito, Walter

AU - Hennaux, Martine

AU - Mugenya, George

AU - Otieno, Elvis

AU - Trelles, Miguel

AU - Ford, Nathan P.

AU - Chu, Kathryn M.

PY - 2011/9

Y1 - 2011/9

N2 - BACKGROUND:: On January 31, 2009, a fuel tanker exploded in rural Kenya, killing and injuring hundreds of people. This article describes the care of >80 burn victims at a rural hospital in Kenya, Nakuru Provincial General Hospital, and provides lessons for care of a large number of burned patients in a resource-limited setting. METHODS:: Data were obtained from retrospective review from hospital registers and patient files. RESULTS:: Treatment was provided for 89 victims. Eighty-six (97%) were men; median age was 25 years (interquartile range [IQR], 19-32). Half of the patients (45) died, the majority (31, 69%) within the first week. The median total body surface area burned for those who died was 80% (IQR, 60-90%) compared with 28% (IQR, 15-43%) for those who survived (p <0.001). Twenty patients were transfused a total of 73 units of blood including one patient who received 9 units. Eighty surgical interventions were performed on 31 patients and included 39 split-thickness skin grafts, 21 debridements, 7 escharotomies, 6 dressing changes, 4 contracture releases, and 3 finger amputations. Of the 44 survivors, 39 (89%) were discharged within 4 months of the event. CONCLUSIONS:: Mortality after mass burn disasters is high in Africa. In areas where referral to tertiary centers is not possible, district hospitals should have mass disaster plans that involve collaboration with other organizations to augment medical and psychologic services. Even for patients who do not survive, compassionate care with analgesics can be given.

AB - BACKGROUND:: On January 31, 2009, a fuel tanker exploded in rural Kenya, killing and injuring hundreds of people. This article describes the care of >80 burn victims at a rural hospital in Kenya, Nakuru Provincial General Hospital, and provides lessons for care of a large number of burned patients in a resource-limited setting. METHODS:: Data were obtained from retrospective review from hospital registers and patient files. RESULTS:: Treatment was provided for 89 victims. Eighty-six (97%) were men; median age was 25 years (interquartile range [IQR], 19-32). Half of the patients (45) died, the majority (31, 69%) within the first week. The median total body surface area burned for those who died was 80% (IQR, 60-90%) compared with 28% (IQR, 15-43%) for those who survived (p <0.001). Twenty patients were transfused a total of 73 units of blood including one patient who received 9 units. Eighty surgical interventions were performed on 31 patients and included 39 split-thickness skin grafts, 21 debridements, 7 escharotomies, 6 dressing changes, 4 contracture releases, and 3 finger amputations. Of the 44 survivors, 39 (89%) were discharged within 4 months of the event. CONCLUSIONS:: Mortality after mass burn disasters is high in Africa. In areas where referral to tertiary centers is not possible, district hospitals should have mass disaster plans that involve collaboration with other organizations to augment medical and psychologic services. Even for patients who do not survive, compassionate care with analgesics can be given.

KW - Africa

KW - Mass burn disaster

KW - Resource-limited setting

UR - http://www.scopus.com/inward/record.url?scp=80052704859&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052704859&partnerID=8YFLogxK

U2 - 10.1097/TA.0b013e3181febc8f

DO - 10.1097/TA.0b013e3181febc8f

M3 - Article

C2 - 21336193

AN - SCOPUS:80052704859

VL - 71

SP - 573

EP - 576

JO - Journal of Trauma and Acute Care Surgery

JF - Journal of Trauma and Acute Care Surgery

SN - 2163-0755

IS - 3

ER -