The worst burn case I ever worked was a fuel explosion in a workshop. They were working on a snowmobile, they drained the gas tank - all of 1 gallon or so of gas was all that was in the tank - and they drained it into a milk jug. There was a tiny hole in the milk jug, which for milk is nothing to cry over, but for gasoline is a big deal. Well, as they worked, the gas slowly leaked out, slow enough that they didn't notice the increasing gasoline vapors in the shop. Then the kerosene heater - the ones the look like a jet engine - kicked on. The resulting explosion would have been a big POOF - scary and noisy, and a 2nd degree burn or so - if they hadn't had a gallon of gas in a thin-wall plastic container. The container basically instantly melted, dropped the gasoline, which flowed fire onto the two of them. Their synthetic clothing caught fire, and although they managed to get our of the workshop quickly enough, it was not before they had suffered 3rd degree burns on their face, hands, head and genitals. When we got there to put out the fire, the medics were already on scene doing what they could, but their skin was literally peeling off them and exposing charred muscle tissue. They were screaming like you can't imagine, and prepping for the airlift for them was - without a doubt - the worst call for an adult I ever did. I'd much prefer a call for a fatal wreck to a massive burn victim. The only thing worse is a pediatric major trauma. I've only had one of those, and never a pediatric fatality.