Health System Lessons From Black Saturday Bushfires

by VR Sreeraman on Jul 6 2009 12:58 PM

The Victorian hospital system coped well in the wake of the Black Saturday bushfires of February 2009 but new research, published in the Medical Journal of Australia, suggests the lessons learned over this time must be used to further strengthen the State’s prevention and medical response systems.

Prof Peter Cameron, an emergency physician at The Alfred hospital and Monash University and his co-authors examined how the Victorian State Trauma System responded to the bushfires over the first 72 hours.

The intensity and speed of the fires meant that most people injured in the bushfires either died or survived with minor injuries.

The statewide and national responses were triggered early and allowed the acute medical system to cope well with the relatively small number of surviving patients with serious burns.

Despite low numbers of patients with serious burns, substantial surgical resources were required during the first 72 hours - with adult burns patients at The Alfred collectively requiring close to 50 hours in theatre during that time.

Prehospital triage was essential in managing the large number of people with minor ailments to avoid overloading the major burns centres. Fortunately, a well-planned response, and strong prehospital triage system, ensured that patients with serious burn injuries received early treatment at Victoria’s major burns centres. Patients with minor conditions were managed well, either at scene or nearby hospitals. Non-burn trauma and other emergencies were managed at other Melbourne hospitals.

The Alfred managed 20 patients and the Royal Children’s Hospital four patients with serious burns. One patient admitted to the Royal Children’s Hospital and two at The Alfred died from their injuries.

The major burns centre continued to have substantial surge capacity during the bushfire emergency.

Although the number of surviving patients with severe burns was relatively low on this occasion, health authorities must be prepared to deal with disasters that result in even greater numbers of people suffering serious burns in the future.

“The Australian Bureau of Meteorology has predicted warmer conditions in the south-eastern states in the future, making it likely that the conditions which led up to the bushfires will be repeated,” Prof Cameron said.

“Should fires occur and advance into more built-up areas, there may be a much higher number of deaths and severe injuries.”

The Medical Journal of Australia is a publication of the Australian Medical Association.