Burn Surge Annex

The Burn Surge Annex outlines the state response and provides guidance in a large-scale incident that results in a surge of burn patients.   The annex contains a number of attachments that provide resources, tools, and guidelines to assist practitioners in managing burn patients during a surge or disaster event.  In addition, there is a post event data collection tool that can assist with compiling data to assist with quality improvement processes, identifying strengths and weaknesses, and lessons learned.

Several of the attachments are available in a Word fillable format (see below):

  • Burn Medical Incident Report Form
    • This form assists with ensuring consistent communication between stakeholders and provides a mechanism to request burn patient transfer, and identify availability of resources at a healthcare facility.
  • Patient Identification Tracking Form
    • This form assists in identifying, tracking and reunifying patients during a disaster.  Information on this form includes description of the patient, who accompanied the patient, minor information, medical history and treatment, and disposition/discharge. There is also a section on the form to attach a photo of the patient.
  • Burn Tracking Log
    • This form assists with the tracking of the burn patient during a disaster.
  • Burn Transfer Form
    • This form provides a method for communicating medical and treatment information during a disaster when burn patients are being transferred to another healthcare facility.
  • Job Action Sheet
    • This document provides guidance to Illinois hospitals with burn capabilities that may need to function in the role of the State Burn Coordinating Center (SBCC) during a burn surge event.
  • Burn Casualty Communication Log
    • This form provides a standardized method of tracking communications between healthcare facilities and the SBCC during a burn surge event.
  • Post Event Data Collection
    • This table assists with compiling data after a burn surge event that can then help outline lessons learned and needed improvements to response plans.

Patient Care Guidelines

T‌he Burn Surge Annex also contains patient care guidelines that can assist practitioners when providing medical care to burn patients during a burn mass casualty incident (MCI). The care guidelines within the Burn Surge Annex include: