How the Cocoanut Grove Fire Changed Burn Care at Mass General and Beyond - Bench Press (2023)

The Cocoanut Grove Fire—the deadliest fire in Boston’s history and seventh deadliest fire in the history of the United States—took place eighty years ago today on Saturday, Nov. 28, 1942.

The quick-moving fire in the overcrowded nightclub resulted in the loss of 492 lives. Many of those who survived the fire suffered severe injuries.

A small silver lining to the tragedy can be found in the advances in burn care that were made in treating survivors at Massachusetts General Hospital—advances that were made possible through research.

The hospital’s well-coordinated response to the event also highlights the importance of disaster training to prepare medical personnel for a sudden influx of critically injured patients.

A Quick and Deadly Fire

The Cocoanut Grove was located at 17 Piedmont Street in the theater district of Boston and was one of the most popular clubs in the city in the early 1940s.

More than 1,000 patrons—well over the club’s legal capacity —were at the club on Saturday, Nov. 28th when a small fire broke out the basement lounge and spread quickly across the tropical-themed décor covering the ceiling.

The fast-moving fire spread flames, smoke and panic through the overcrowded club within minutes.

The club’s main exit—a revolving door at the front, quickly became jammed with panicked patrons, and a second door that opened inward into the facility also became blocked.

Additional exits in the club had either been locked (to prevent patrons from leaving without paying), obstructed or hidden, compounding the tragedy and adding to the death toll.

The patrons who did not escape the club in the first few minutes of the fire were not likely to survive, overcome by smoke inhalation or by the fire itself.

(Video) Commemoration Of The Cocoanut Grove Fire

Mass General Mobilizes in Response

Massachusetts General Hospital and Boston City Hospital treated the vast majority of survivors that night—Mass General took in 114 victims while BCH took in 300.

Both hospitals were well-prepared for a mass casualty event, as medical facilities across the Eastern seaboard had drawn up emergency plans in preparation for potential attacks in the wake of the attack on Pearl Harbor in December of 1941.

BCH and Mass General had both received grants after the Pearl Harbor attack to study burn injuries and had stockpiles of supplies to treat patients.

The city of Boston had also run a disaster response drill the weekend before the fire.

Despite this, the majority of survivors taken to both hospitals either died on arrival or did not make it through the first night. At Mass General, only 39 of the 114 victims survived until Sunday morning. At BCH, only 114 of the 300 victims were still alive.

Nevertheless, the training and preparation of the Mass General staff allowed for the rapid triaging of patients and the quick isolation of survivors to prevent infection.

How the Cocoanut Grove Fire Changed Burn Care at Mass General and Beyond - Bench Press (1)

“The importance of anticipating a disaster cannot be overemphasized,” wrote Oliver Cope, MD, in a 1943 article in the New England Journal of Medicine recounting the hospital’s response to the fire.

Cope, who headed the burn research project at Mass General noted that at one point the hospital was receiving a new casualty once every 50 seconds that night, and staff members quickly had to remove the dead in order to treat the living.

When it was suspected that the number of casualties would overwhelm the emergency ward, the decision was made to clear out one floor in the surgical ward of the White building and use that as an isolation ward for the victims.

(Video) Wayland Library: The Cocoanut Grove Fire with Bob Begin

Centralizing and isolating the patients helped to reduce the risk of infection and made it easier to supervise survivors for symptoms of shock and anoxia (a lack of oxygen due to damaged lungs).

Within three hours of the fire, all 39 of the surviving patients were settled on the recently cleared surgical floor, with their surface burns covered with dressings and were receiving oxygen for anoxia and IV plasma for shock.

This rapid response was made possible by having adequate number of doctors and nurses on hand—the fire had occurred at the time of a shift change.

“But the number of personnel is of secondary importance to having a prearranged plan of action,” Cope noted in his NEJM article. “Without forethought…confusion will reign.”

How the Cocoanut Grove Fire Changed Burn Care at Mass General and Beyond - Bench Press (2)

Respiratory Complications

According to Cope, the majority of the Cocoanut Grove victims who arrived at Mass General were either maniacal or unconscious.

“At first, the mania was mistaken for hysteria aggravated by pain,” Cope writes. “Subsequently, it was realized that in many it was due to anoxia.”

The majority of the anoxia experienced by victims was due to damage to the lungs and respiratory tract caused by breathing in smoke and toxic fumes from the fire.

Patients with anoxia were treated with oxygen, which brought some initial relief, though the impact of pulmonary injuries increased by the hour in the immediate aftermath of the fire.

Seven patients died between in the three days following the fire due to a combination of respiratory obstruction and edema (the leaking of fluid into the lungs).

The peak of pulmonary complications occurred on the third or fourth day and eased after that. Strict isolation on the surgical ward helped to reduce the risk of pulmonary infection, Cope writes.

(Video) Boston on Fire


Shock—a life-threatening condition brought on by a drop in blood flow in the body—was another key concern for fire victims brought to Mass General.

The primary phase of burn shock was thought to be neurogenic—brought on by the nervous system due to the pain of the burns. This was treated with morphine.

The secondary phase of burn shock comes on more gradually and is caused by the seepage of blood plasma out through the capillaries into burned areas. This was treated with infusions of blood and saline, though care had to be taken that the fluids did not worsen symptoms of edema in the lungs.

How the Cocoanut Grove Fire Changed Burn Care at Mass General and Beyond - Bench Press (3)

Surface Burns

Perhaps the most significant clinical innovation to come from Mass General as a result of the Cocoanut Grove fire was the treatment of surface burns.

For the two years prior to the fire, Mass General had been conducting research into burn treatments and had pioneered a new approach that centered on the belief that the most effective way to prevent infection was to immediately cover up the wound

In the years prior to the fire, it had been common practice to debride all such wounds to remove any dead skin or blisters. The injured skin was then scrubbed with soap and water and rinsed to remove any infectious bacterial—an extremely painful process that frequently required anesthesia and could also cause shock.

Debridement was a carryover from the previous treatment strategy of treating burns with tannic acid.

For the surface burns of the victims, the protocol was as follows, Cope writes:

● Personnel were carefully masked to prevent the transmission of infection

● All exposed burn surfaces were covered with sterile towels

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● When patients were transferred from stretchers to beds, the burns were covered with sterile sheets

● No debridement or cleansing of any surface was done

● Once in isolation, the sterile sheets were removed so that the burned surfaces were covered with boric-ointment and gauze

● Pressure bandages were applied to the wounds

● As a final but integral part of the surface treatment, each patient received two grams of an antibiotic (sodium sulfadiazine).

“When it was first suggested a year ago that we should not debride a burn wound, this was objected to by all those concerned with infection,” Cope writes. “However, the results of this simplified treatment were gratifying—all second-degree or incomplete thickness burns of the skin healed without evidence of infection.”

Legacy of the Cocoanut Grove

“When the Cocoanut Grove went up in flames in November 1942, the 171 victims who made it alive to Boston City and Mass General hospitals became subjects in the most comprehensive clinical trial in the annals of burn treatment,” writes Barbara Ravage in her book Burn Unit: Saving Lives After the Flames.

“The patients exhibited every imaginable burn complication, making it possible to study this most complex of injuries in great detail,” Ravage writes. “New ideas were tried, old methods discarded, and the agenda for burn research was set for the next quarter century.”

Eighty years after the fire, Mass General investigators are continuing to explore new ways to improve treatment for burn patients.

In September of this year, for example, researchers from the Center for Engineering in Medicine and Surgery introduced a first-of-its kind hydrogel for second-degree burns that can be dissolved quickly and easily to reduce the pain of wound dressing changes in burn patients.

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The gel, which is now being developed for the consumer market, also reduces the risks of infections, sepsis and multi-organ failure.

About the Mass General Research Institute
Research at Massachusetts General Hospital is interwoven through more than 30 different departments, centers and institutes. Our research includes fundamental, lab-based science; clinical trials to test new drugs, devices and diagnostic tools; and community and population-based research to improve health outcomes across populations and eliminate disparities in care.
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What changed after the Cocoanut Grove fire? ›

As a result of this preventable tragedy, the fire and building codes in Massachusetts changed in 1943. Revolving doors were initially outlawed, but later allowed when flanked on both sides with outward swinging hinged doors with panic hardware and exit signs above each door.

What did we learn from Cocoanut Grove? ›

Safety lessons learned from Cocoanut Grove

Regulations for emergency exit doors were changed to ensure that all exit doors swing outward. Illuminated exit signage and emergency lighting was required. Requirements for widely separated means of egress for higher occupancy loads and minimum exit widths were established.

What was a contributing factor to the spread of the Coconut Grove fire? ›

The fire was initiated by an electrical short and fueled by methyl chloride in the air conditioning unit. Flames and smoke spread rapidly through all areas of the club, and people were unable to escape efficiently because of the locked exit doors.

When did the Coconut Grove burn down? ›

A minute-by-minute account of the most famous disaster in American History--the fire in Boston's Cocoanut Grove nightclub that, on November 28, 1942, claimed 491 lives.

What was the worst nightclub fires in the US? ›

List of nightclub fires
Study Club fireDetroit, Michigan22
Rhythm Club fireNatchez, Mississippi209
Cocoanut Grove fireBoston, Massachusetts492
Karlslust dance hall fireBerlin81
51 more rows

How many survived Cocoanut Grove fire? ›

2 known survivors are still alive

Joyce Spector and Bob Shumway are the last two remaining known survivors still living. They were both 18 at the time of fire, born months apart in 1924.

How would you describe Coconut Grove? ›

Lush, bayside Coconut Grove has a laid-back, tropical vibe and bohemian charm. Banyan trees, palms and live oaks line quiet residential streets. Parks and green spaces dot the Biscayne Bay shoreline, and peacocks are known to roam wild.

Who found Coconut Grove Miami? ›

In the late 1880s, Ralph Munroe discovered from a postal map at the Fowey Rocks Lighthouse of Porter's post office. When he informed his neighbors of this discovery, the post office was reopened and Coconut Grove acquired its enduring name although it continued to include an “a” in its spelling.

What was the reason that the fire spread so easily? ›

Convection is the most dangerous way in which fire can spread through a property. The heat generated by a fire naturally rises, but in an enclosed space such as an office, this heat becomes trapped when it hits the ceiling. The heat then travels horizontally, spreading the fire across the entire space.

What caused the Boston fire to spread so rapidly? ›

The fire spread quickly for a number of reasons, mainly that the wooden Mansard roofs popular in the district which provided fuel for the flame and the narrow streets enabled the fire to spread easily from building to building and street to street.

What are the factors that affect the growth of fire? ›

The three sides of the fire behavior triangle are weather, topography and fuels. Weather includes wind, temperature, cloudiness, moisture and air pressure. High temperatures and low humidity cause vegetation to dry and wildfires to burn rapidly.

What was the biggest fire in Boston history? ›

The Great Boston Fire of 1872 was Boston's largest fire, and still ranks as one of the most costly fire-related property losses in American history. The conflagration began at 7:20 p.m. on Saturday, November 9, 1872, in the basement of a commercial warehouse at 83–87 Summer Street.

What was the deadliest fire in history? ›

The largest community in the affected area was Peshtigo, Wisconsin which had a population of approximately 1,700 residents. The fire burned about 1.2 million acres and is the deadliest wildfire in recorded history, with the number of deaths estimated between 1,500 and 2,500.

How many firefighters died in the Cocoanut Grove fire? ›

The board identified that, as of the date of their findings, 39 servicemen (31 Navy, 5 Coast Guard, 3 Marine Corps) had died as a result of the Cocoanut Grove nightclub fire, while 27 (19 Navy, 8 Coast Guard) had sustained injuries.

What was the biggest city fire in US history? ›

The Great Chicago Fire was a conflagration that burned in the American city of Chicago during October 8–10, 1871. The fire killed approximately 300 people, destroyed roughly 3.3 square miles (9 km2) of the city including over 17,000 structures, and left more than 100,000 residents homeless.

What was the deadliest building fire in the United States? ›

The Iroquois Theatre fire occurred on December 30, 1903, at the Iroquois Theatre in Chicago. It is one of the deadliest single-building fires in U.S. history, resulting in 602 deaths.
Iroquois Theatre fire.
The Iroquois Theatre, shortly before the fire
DateDecember 30, 1903; 119 years ago
Non-fatal injuries250
4 more rows

What is the 2nd largest fire loss in US history? ›

Largest fire losses in the United States
Loss in Year Fire OccurredAdjusted Loss in 2018 Dollars
1. The World Trade Center New York City, New York September 11, 2001$33.4 billion$47.4 billion
2. Northern California Wildfire Urban Interface Fire October 8, 2017$10 billion$10.2 billion
23 more rows

How many people died at Coconut Grove? ›

In the blink of an eye the Cocoanut Grove, one of Boston's swankiest nightclubs, became an unimaginable inferno — trapping hundreds of panicked victims as they jammed the club's exits.In less than 15 minutes, 492 people were dead and another 166 injured, making the blaze the deadliest nightclub fire in U.S. history.

What well known actor was killed in the Cocoanut Grove fire? ›

Today, the old Cocoanut Grove site in Boston is occupied by a motion picture film delivery service. The event of 20 years ago is nearly forgotten except by those of us who survived the fire and by those who lost loved ones in it. About Buck Jones. The Life and Untimely Death of Buck Jones.

Who were the victims of the station fire? ›

Among those who died in the fire were Great White's lead guitarist, Ty Longley, and the show's emcee, WHJY DJ Mike "The Doctor" Gonsalves.

What is the story of Coconut Grove? ›

Coconut Grove is the oldest permanent settlement in Miami-Dade. Many were lured to its shores with the Homestead Act in the late 1800s, particularly from the Bahamas the Keys. By 1919 it became its own city, but in 1925 it was annexed by the City of Miami.

What is the black history of Coconut Grove? ›

Coconut Grove Neighborhood

Even before Julia Tuttle, known as the “Mother of Miami,” founded the city, Black fishermen from the Bahamas were known to frequent the Miami shoreline in the hunt for turtles. These Bahamians were some of the first foreign settlers to establish South Florida as their home.

What is the best part of Coconut Grove? ›

Coconut Grove is most dense and walkable around the central-east intersection of Grand Avenue and Main Highway, where you'll find most of the neighborhood's shops, restaurants, bars and parks perched along the waterfront and tucked beneath old-growth trees.

What is the oldest black community in Miami? ›

Overtown is one of the oldest neighborhoods located in the original boundaries of the City of Miami. Segregated by both custom and laws, it began as “Colored Town” at the turn of the 20th century, an accommodation to Miami's anticipated tourist industry.

Is Coconut Grove upscale? ›

Real Estate in Coconut Grove

Once a hidden gem, Coconut Grove is now a very sought-after community in not only Miami but the entire Southern Florida area. There are plenty of ultra-luxury gated communities, especially along the long waterfront that The Grove is known for.

What is the oldest home in Miami? ›

Built in 1891, The Barnacle is the oldest house in Miami-Dade County standing in its original location. Built in 1891, The Barnacle is the oldest house in Miami-Dade County standing in its original location.

What codes came from the Cocoanut Grove fire? ›

After the Cocoanut Grove fire, the NFPA Building Exits Code was adopted in many jurisdictions in reaction to the horrific fire and tragic loss of life.

Did the Cocoanut Grove fire have sprinklers? ›

The large fire was a result of the small fire, the lack of a sprinkler system and the highly combustible decorations throughout the club. Because the Cocoanut Grove was licensed as a restaurant, and therefore not considered a public place of assembly, it was not required to have a sprinkler system.

Which major place of assembly fire resulted in the deaths of 492 people? ›

The Cocoanut Grove fire of Nov. 28, 1942, took the lives of 492 people and sent another 166 to Boston-area hospitals. This is the deadliest known nightclub fire in the world. It is also the second deadliest fire in U.S. history — the 1903 Iroquois Theater in Chicago had a death toll of more than 600.


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