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Background – The coordination of response to burn mass casualty incidents and disasters is complex and require coordination of medical resources and personnel. Casualties may have sustained thermal injury and/ or inhalation injury such as from a structural fire in an industrial complex or suffer combined thermal and poly-traumatic injury from an explosive device in an act of terrorism. These events require highly trained medical personnel for the initial response and for continued care in local medical facilities.

Summary – We re-visit the fire in Cocoanut Grove night club in 1942. This incident led to the development of an organized response to a burn mass casualty incident. This also led to the refinement of burn care. Next, we re-examine the response to the terrorist attacks of September 11, 2001. Many lessons learned from the response of an incident of this magnitude. The response to a mass casualty incident in which a significant proportion of patients have thermal injuries is reviewed and triage, transport to local medical facilities and transport to regional burn center phases are reviewed in detail. Finally, the role of the National Disaster Management System (NDMS), the Department of Defense (DOD), local/ state emergency response systems and the American Burn Association (ABA) are discussed.

Conclusion – The response to burn disasters and mass casualty incidents is thoroughly reviewed in the manuscript.