title: Management of the Formosa Color Dust Explosion: Lessons Learned from the Treatment of 49 Mass Burn Casualty Patients at Chang Gung Memorial Hospital.
abstract: BACKGROUND
  This article reports the emergency management of a mass casualty disaster occurring on June 27, 2015, in New Taipei, Taiwan, as a fire erupted over a large crowd, injuring 499 people. Lessons learned in burn care treatment and disaster preparedness are analyzed through following the specific surgical response and patient outcomes of one hospital involved in the disaster response.
  
  
  METHODS
  Information regarding the fire and emergency management was obtained from the Ministry of Health and Welfare of Taiwan. Patient-specific data were obtained from Chang Gung Memorial Hospital's patient records.
  
  
  RESULTS
  A mass casualty management system was immediately initiated by the Ministry of Health and Welfare, which contacted local hospitals to prepare for the influx of patients with severe burn injuries. In response, Chang Gung Memorial Hospital called 336 medical personnel to the emergency room for the management of 49 burn patients and divided emergency management roles among chief physicians. The mean burn total body surface area of patients presenting to this hospital was 44.2 percent (range, 10 to 90 percent). No deaths occurred in the first 48 hours after the explosion. As of 3 months after the incident, only 12 deaths had resulted from this accident, all resulting from sepsis and organ failure.
  
  
  CONCLUSIONS
  Taiwan's effective mass casualty preparation plans, highly trained medical personnel, and large centers capable of treating burn patients allowed 499 injured patients to be successfully transferred and treated in hospitals across Taiwan. Lessons learned from this disaster response can be integrated into existing disaster management plans to aid in the response to mass casualty tragedies.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Linkou, Taiwan; and Ann Arbor, Mich.|From the Department of Plastic and Reconstructive Surgery, Center for Tissue Engineering, and the Emergency Department, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University; and the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School.
authors.forename: Ming-Huei
authors.initials: MH
authors.lastname: Cheng
authors.affiliation: Linkou, Taiwan; and Ann Arbor, Mich.|From the Department of Plastic and Reconstructive Surgery, Center for Tissue Engineering, and the Emergency Department, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University; and the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School.
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Mathews
authors.affiliation: Linkou, Taiwan; and Ann Arbor, Mich.|From the Department of Plastic and Reconstructive Surgery, Center for Tissue Engineering, and the Emergency Department, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University; and the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School.
authors.forename: Shiow-Shuh
authors.initials: SS
authors.lastname: Chuang
authors.affiliation: Linkou, Taiwan; and Ann Arbor, Mich.|From the Department of Plastic and Reconstructive Surgery, Center for Tissue Engineering, and the Emergency Department, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University; and the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School.
authors.forename: Meghan E
authors.initials: ME
authors.lastname: Lark
authors.affiliation: Linkou, Taiwan; and Ann Arbor, Mich.|From the Department of Plastic and Reconstructive Surgery, Center for Tissue Engineering, and the Emergency Department, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University; and the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School.
authors.forename: Yen-Chang
authors.initials: YC
authors.lastname: Hsiao
authors.affiliation: Linkou, Taiwan; and Ann Arbor, Mich.|From the Department of Plastic and Reconstructive Surgery, Center for Tissue Engineering, and the Emergency Department, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University; and the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School.
authors.forename: Chip-Jin
authors.initials: CJ
authors.lastname: Ng
authors.affiliation: Linkou, Taiwan; and Ann Arbor, Mich.|From the Department of Plastic and Reconstructive Surgery, Center for Tissue Engineering, and the Emergency Department, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University; and the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Chung
mesh_terms: D000293:Adolescent; D000328:Adult; D001753:Blast Injuries / Q000401:mortality / Q000601:surgery*; D002053:Burn Units; D002056:Burns / Q000401:mortality / Q000601:surgery*; D002423:Cause of Death; D003422:Critical Care; D004391:Dust; D004632:Emergency Medical Services / Q000379:methods*; D005107:Explosions; D005260:Female; D006801:Humans; D008297:Male; D054527:Mass Casualty Incidents; D010343:Patient Admission; D011208:Powders; D013213:Starch; D015996:Survival Rate; D013624:Taiwan; D014218:Triage; D055815:Young Adult
chemical_list: D004391:Dust; D011208:Powders; D013213:Starch