A consensus process on management of major burns accidents: lessons learned from the café fire in Volendam, The Netherlands.
OBJECTIVE
The optimum response to the different stages of a major burns incident is still not established. The fire in a café in Volendam on New Year's Eve 2000 was the worst incident in recent Dutch history and resulted in mass burn casualties. The fire has been the subject of several investigations concerned with organisational and medical aspects. Based on the findings in these investigations, a multidisciplinary research group started a consensus study. The aim of this study was to further identify areas of improvement in the care after mass burns incidents.


METHODS
The consensus process comprised three postal rounds (Delphi Method) and a consensus conference (modified nominal group technique). The multidisciplinary panel consisted of 26 Dutch-speaking experts, working in influential positions within the sphere of disaster management and healthcare.


RESULTS
In response to the postal questionnaires, consensus was reached for 66 per cent of the statements. Six topics were subsequently discussed during the consensus conference; three topics were discussed within the plenary session and three during subgroup meetings. During the conference, consensus was reached for seven statements (one subject generated two statements). In total, the panel agreed on 21 statements. These covered the following topics: registration and evaluation of disaster care, capacity planning for disasters, pre hospital care of victims of burns disasters, treatment and transportation priorities, distribution of casualties (including interhospital transports), diagnosis and treatment and education and training.


CONCLUSIONS
In disaster medicine, the paper shows how a consensus process is a suitable tool to identify areas of improvement of care after mass burns incidents.
Welling
L
L
Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands. L.Welling@amc.uva.nl
Boers
M
M
Mackie
D P
DP
Patka
P
P
Bierens
J J L M
JJ
Luitse
J S K
JS
Kreis
R W
RW
D000328:Adult; D002056:Burns / Q000453:epidemiology / Q000628:therapy*; D003245:Consensus Statements as Topic; D003697:Delphi Technique; D004189:Disaster Planning / Q000458:organization & administration / Q000592:standards*; D004632:Emergency Medical Services / Q000458:organization & administration / Q000592:standards*; D005390:Fires; D006801:Humans; D009426:Netherlands / Q000453:epidemiology; D011785:Quality Assurance, Health Care; D012042:Registries; D012147:Restaurants; D014187:Transportation of Patients / Q000592:standards