Management of multiple burn casualties from the Volendam disaster in the emergency departments of general hospitals

Objective To establish the level of medical care provided in the emergency department of general hospitals to the victims of the Volendam café fire on 1 January 2001. Methods A retrospective review was done based on a standardized chart, for all victims seen at the emergency departments of 19 hospitals. Diagnostic findings and logistic aspects were inventoried. Treatment described in the Emergency Management of Severe Burns protocol was used as a gold standard against which the care provided to the victims was assessed. Results Data from 233 patients were included in the analysis. The documentation rate was low. Suspected inhalation injury and burns were the most frequently documented diagnoses. Most patients with suspected inhalation injury, for whom treatment records were available, received oxygen therapy (81%). Intubation was performed in 43% of patients with suspected inhalation injury and 14% of the remaining patients required intubation after admission to the intensive care unit. Most patients with circulatory problems (83%) and/or more than 15% of total body surface area burned (97%), for whom treatment records were available, received intravenous lines. Pain treatment seemed to have had low priority. Two patients (3%) were re-admitted after having been released earlier from the emergency department. Conclusion Treatment and triage of the burn casualties after the Volendam café fire was adequate. The documentation rate was low. Not all steps in diagnosis and treatment may be of equal importance in disaster circumstances