Key lessons learnt: Singapore international medical mission following the burn mass casualty incident milestone school plane crash Dhaka, July 2025

Background Burn mass casualty poses substantial strain on tertiary care units due to need of highly complex surgical care, long-term intensive care, and rigorous infection control protocols. The plane crash at a school in Dhaka on 21 July 2025, resulting in serious burns cases with respiratory complications strained the local treatment capacity. Addressing the need, the Singapore Medical Team conducted a comprehensive operational analysis, including pre-triage guidelines, ICU support infrastructure, and the systematic implementation of essential burn management protocols, to support an evidence-based model for efficient mass casualty burn management. Methods This was a retrospective descriptive cohort study of verified data sources including operational logs, daily clinical summaries, intensive care unit reports, surgical reports, and infection control data between 21 and 31 July 2025. The dataset was analysed to define patient demographic, clinical intervention and the systemic operational responses of the incident. Results Fifty-five casualties aged 9–18 years arrived at hospitals within hours of the incident, with significant burns and inhalational injuries. The Singapore team conducted 28 surgical procedures, managed 8 intubated patients, treated 13 severe burn cases, established central venous and arterial access, and implemented prone ventilation for acute respiratory distress syndrome (ARDS). An Infection Control Task Force was created to prevent sepsis and ventilator-associated pneumonia. By the end of mission, no patients remained in intensive care. Conclusion Early needs assessment, structured triage, integrated command systems, and rapid international collaboration were critical in achieving favorable outcomes. The Dhaka experience underscores the importance of established burn disaster frameworks, ICU surge capacity, and robust infection prevention strategies, particularly in low- and middle-income settings.