Responding to major XXXX in resource-limited settings: lessons learned from an oil tanker explosion in Nakuru, Kenya.

@entity1 @entity4808
BACKGROUND: On January 31, 2009, a fuel tanker exploded in rural Kenya, killing and injuring hundreds of @entity1 . 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 @entity1 in a resource-limited setting. METHODS: Data were obtained from retrospective review from hospital registers and @entity1 files. RESULTS: Treatment was provided for 89 victims. Eighty-six (97%) were @entity1 ; median age was 25 years (interquartile range [IQR], 19-32). Half of the @entity1 (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 @entity1 were transfused a total of 73 units of blood including one @entity1 who received 9 units. Eighty surgical interventions were performed on 31 @entity1 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 @entity4808 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 @entity1 who do not survive, compassionate care with analgesics can be given.
