title: The café fire on New Year's Eve in Volendam, the Netherlands: description of events.
abstract: OBJECTIVE
  The café fire at Volendam occurred shortly after midnight on the first of January 2001 and resulted in one of the worst mass burn incidents in recent Dutch history. The aim of this study was to provide insight into medical and organisational requirements of a major burns incident.
  
  
  METHODS
  Shortly after the fire, two university hospitals and a burn center in the region of the accident developed a plan for evaluation of medical care given during and after this major burn incident. A multidisciplinary research group investigated the management of victims at the scene, in the emergency departments (ED) and during admission in the hospitals. All 245 casualties were included in this study.
  
  
  RESULTS
  A brief severe fire occurred in a crowded cafe with around 350 young visitors on a small embankment of a relatively isolated town, resulting in a unusually high number of severely injured burn victims. Four died immediately. The ensuing rescue effort was hampered by poor access and chaotic circumstances. At the scene of the incident, mobile medical teams ensured orderly transport and treatment priority for the injured. There were 245 victims with a median total body surface area burned of 12%. Inhalation injury was present in 96 patients. A total of 182 victims were admitted, with 112 to intensive care. Ten patients died in the hospital. Seventy-eight patients were secondarily transported, many to specialised centers in the Netherlands and abroad. In total, 36 hospitals in three countries participated.
  
  
  CONCLUSIONS
  An incident with high numbers of burn victims poses a challenge to any health care system. The difficult circumstances at the site demonstrated the need for robust organisational structures. The primary and secondary distribution of patients required coordination, general hospitals were able to provide initial medical care to these major burn casualties.
authors.affiliation: Department of Surgery, Academic Medical Center, P.O. box 22660, 1100 DD, Amsterdam, the Netherlands. l.welling@amc.uva.nl
authors.forename: L
authors.initials: L
authors.lastname: Welling
authors.forename: S M
authors.initials: SM
authors.lastname: van Harten
authors.forename: P
authors.initials: P
authors.lastname: Patka
authors.forename: J J L M
authors.initials: JJ
authors.lastname: Bierens
authors.forename: M
authors.initials: M
authors.lastname: Boers
authors.forename: J S K
authors.initials: JS
authors.lastname: Luitse
authors.forename: D P
authors.initials: DP
authors.lastname: Mackie
authors.forename: A
authors.initials: A
authors.lastname: Trouwborst
authors.forename: D J
authors.initials: DJ
authors.lastname: Gouma
authors.forename: R W
authors.initials: RW
authors.lastname: Kreis
mesh_terms: D000293:Adolescent; D000328:Adult; D002053:Burn Units / Q000706:statistics & numerical data; D002056:Burns / Q000453:epidemiology / Q000628:therapy*; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D004638:Emergency Treatment; D005260:Female; D005390:Fires / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009426:Netherlands; D010343:Patient Admission / Q000706:statistics & numerical data; D015208:Smoke Inhalation Injury / Q000453:epidemiology / Q000628:therapy; D014187:Transportation of Patients / Q000706:statistics & numerical data; D014218:Triage / Q000458:organization & administration