Aeromedical Transfer to Belgium of Severely Burned Patients during the Initial Days following the Volendam Fire

Abstract

Nineteen critical burn patients were transferred to burn centers in Belgium soon after an indoor fire in The Netherlands. This evacuation was done by helicopter and by ambulance. The first arterial blood gases and pH measurements of the patients on arrival in the burn centers were analyzed and compared. All patients were in metabolic acidosis, but the respiratory component to the pH and the resulting pH was variable. Although an efficient fluid resuscitation to maintain an adequate urine output and arterial pressure is essential, the arterial blood gases and pH should also be monitored during the early evacuation of severe burn patients. Because hyperkaliemia is associated with a low pH value, we suggest that during the evacuation of these patients the ventilation setting should maintain the pH between 7.35 and 7.45. The comparison of the measurements between the group of patients transferred by air and the group transferred by road showed here differences in favor of a road transfer.