Introduction: We investigated the initial response and outcome of the Fukuchiyama Fireworks Festival stall explosion that occurred at 19:28 on August 15, 2013.
 Methods: A written request was submitted to the Fukuchiyama, Ayabe, Toyooka, Tamba, Nantan, and Kyoto fire departments, which were involved in the transport, as well as to the medical institutions that received the patients.
 Results: Responses were received from all fire departments and 12 medical institutions. All 60 injured and sick patients were transported to three nearby hospitals. Hospital A, the nearest emergency center, admitted 45 patients and transferred 15 patients to other institutions in Kyoto and other prefectures on the same day. Since the following day, a total of 27 related transfers have been carried out. Twenty-eight patients sustained serious injuries and three died.
 Conclusion: This was a rare case in which a large number of burn patients in a rural area were transported to the nearest emergency center and then dispersed over a wide area. It is essential for facilities receiving intensive transports to allocate adequate human and medical resources and establish wide-area collaborations.