Title : Early management in a burn mass casualty incident – Our experience from march 2025 in Kochani, rn Macedonia
Abstract:
Introduction: Burn injuries are among the most complex emergencies, demanding rapid assessment and coordinated multidisciplinary management. Outcomes are strongly determined by the quality of early care, particularly in mass-casualty incidents when resources are challenged.
Objective: To present our experience and strategies for early burn management during the large-scale fire in Kochani, RN Macedonia in March 2025, with focus on interventions within the first 24 hours up to the fifth day.
Methods/Experience: Following the incident, over thirty patients with varying degrees of thermal injury were admitted to our center. Triage was performed according to American Burn Association (ABA) criteria. Based on severity and capacity, 18 patients were transferred within the first 12 hours to specialized facilities. Initial care emphasized airway protection, hemodynamic stabilization, and fluid resuscitation guided by established burn formulas. Pain control and infection prevention were prioritized. A broad multidisciplinary team—including surgeons, intensivists, ophthalmologists, otorhinolaryngologists, toxicologists, neurosurgeons, internists, nurses, and psychologists—coordinated treatment. Over the subsequent days, wound debridement, escharotomies when indicated, nutritional support, and close monitoring of renal and respiratory function were implemented. Telemedicine consultations supported decision-making during the patient surge.
Results: Early intervention significantly reduced complications. Patients stabilized in the first 24 hours demonstrated better recovery trajectories by day five, with fewer cases of renal dysfunction and respiratory compromise. Structured management allowed timely surgical interventions and minimized infection risks.
Conclusion: The Kochani fire underscored the importance of preparedness, rapid triage, and multidisciplinary collaboration. Above all, adherence to an initial Life Support Protocol and timely referral or transfer to burn centers or well-equipped clinical facilities were essential for survival and outcomes. Strengthening regional networks and continuous training remain crucial for future burn disaster response.
