On the night of 06 December 2007, an explosion occurred at a steelworks plant in the city of Turin. The incident involved 10 people. The emergency medical services (EMS 118 Turin) declared a mass-casualty incident (MCI).

The aim of this case report is to analyze the response of the EMS 118 Turin to the MCI in order to identify problems or short-comings and improve the service for future responses.

Information from the dispatch center, medical report of the EMS, and hospitals that received the patients were analyzed.

The emergency call was placed at 01:04 hours, and the MCI was declared closed at 04:40 hours. The disaster, in according to Disaster Severity Scale (DSS), was classified 3. The METHANE message was sent to the dispatch center by the first ambulance 4 minutes after the call. There were 10 patients: seven T1; one T2; and two T3. The dispatch center deployed nine teams, which consisted of five advanced life support (ALS) teams and four basic life support (BLS) teams. All of the casualties were able to walk when they arrived to the medical care. The T1 casualties had burns to > 80% of their body surface area (BSA), the T2 and T1 casualties suffered inhalation of smoke gas. The first casualties were evacuated to the hospital 28 minutes after the call. Four casualties (three T1 and one T3) were transported to the nearest hospital. the other four T1 casualties were transported to four different hospitals of the city. All the T1 casualties died in the next 24 days.

The management of resources during this MCI was suboptimal. The number of ALS teams that responded to the MCI was high considering the number of casualties and the time taken to resolve the incident. The lessons learned from this incident and other cases have permitted the EMS Turin to improve their response plan concerning the use of resources and surge capacity.