Dr Alexander Murray-Douglass¹, Dr Elizabeth Vujcich

¹Royal Brisbane And Women’s Hospital, Brisbane, Australia

Abstract:

Background

In 2020, there was an explosion 300m underground at the Moranbah mine in central Queensland. Five miners were taken to Moranbah Hospital before transfer to the Royal Brisbane and Women’s Hospital (RBWH). Four patients were in critical conditions requiring intubation and ventilation and the fifth had milder burns. RBWH burns surgeons and intensive care physicians were contacted only 15 minutes after arrival at Moranbah Hospital to provide telehealth advice and all five patients arrived at the RBWH only 10.5 hours after the explosion. Advanced warning allowed for specialists to meet patients as they arrived in ED and ensured the CT scanners were available.

Resuscitation and management

Four patients required large volume resuscitation and had received eight litres of crystalloid upon arrival at the RBWH with a further two litres given in ED. Within the first 24 hours, they had received 92.5%, 110.5%, 131.6% and 121.2% of their estimated Parkland requirement, respectively. These four patients required multiple operations, with the initial debridement occurring the morning after arrival. They required a sum of 28 operations for debridement and grafting while admitted in the 45 days following the explosion. Patients had a further sum of 11 operations (mostly laser) after discharge. The fifth patient required only dressings.

Outcomes

Four patients continue to be reviewed for scar management and reconstruction; one has been discharged. Psychological distress was prominent for some patients with themes of mood lability, avoidance of interactions, body image distress post-traumatic stress disorder and survivor guilt.

Biography:

Alex is a Junior Doctor who is very interested in extra-curricular surgical research and is looking to pursue a career in surgery.