Mass gathering medicine: event factors predicting patient presentation rates

2016 ◽  
Vol 11 (5) ◽  
pp. 745-752 ◽  
Author(s):  
Samuel Locoh-Donou ◽  
Guofen Yan ◽  
Thomas Berry ◽  
Robert O’Connor ◽  
Mark Sochor ◽  
...  
Keyword(s):  
Mass Gathering ◽  
Mass Gathering Medicine ◽  
Patient Presentation

A Prospective Analysis of Patients Presenting for Medical Attention at a Large Electronic Dance Music Festival

2016 ◽  
Vol 32 (1) ◽  
pp. 78-82 ◽  
Author(s):  
Matt S. Friedman ◽  
Alex Plocki ◽  
Antonios Likourezos ◽  
Illya Pushkar ◽  
Andrew N. Bazos ◽  
...  
Keyword(s):  
New York ◽  
Vital Signs ◽  
Medical Attention ◽  
Prospective Analysis ◽  
Mass Gathering ◽  
Dance Music ◽  
Electronic Dance Music ◽  
Music Festival ◽  
Mass Gathering Medicine ◽  
Patient Presentation

AbstractMass-Gathering Medicine studies have identified variables that predict greater patient presentation rates (PPRs) and transport to hospital rates (TTHRs). This is a descriptive report of patients who presented for medical attention at an annual electronic dance music festival (EDMF). At this large, single EDMF in New York City (NYC; New York, USA), the frequency of patient presentation, the range of presentations, and interventions performed were identified.This descriptive report examined consecutive patients who presented to the medical tent of a summertime EDMF held at an outdoor venue with an active, mobile, bounded crowd. Alcohol was available for sale. Entry was restricted to persons 18 years and older. The festival occurred on three consecutive days with a total cumulative attendance of 58,000. Medical staffing included two Emergency Medicine physicians, four registered nurses, and 86 Emergency Medical Services (EMS) providers. Data collected included demographics, past medical history, vital signs, physical exam, drug and alcohol use, interventions performed, and transport decisions.Eighty-four patients were enrolled over 2.5 days. Six were transported and zero died. The ages of the subjects ranged from 17 to 61 years. Forty-three (51%) were male. Thirty-eight (45%) initially presented with abnormal vital signs; four (5%) were hyperthermic. Of these latter patients, 34 (90%) reported ingestions with 3,4-methylenedioxymethamphetamine (MDMA) or other drugs. Eleven (65%) patients were diaphoretic or mydriatic. The most common prehospital interventions were intravenous normal saline (8/84; 10%), ondansetron (6/84; 7%), and midazolam (3/84; 4%).Electronic dance music festivals are a growing trend and a new challenge for Mass-Gathering Medicine as new strategies must be employed to decrease TTHR and mortality. Addressing common and expected medical emergencies at mass-gathering events through awareness, preparation, and early, focused medical interventions may decrease PPR, TTHR, and overall mortality.FriedmanMS, PlockiA, LikourezosA, PushkarI, BazosAN, FrommC, FriedmanBW. A prospective analysis of patients presenting for medical attention at a large electronic dance music festival. Prehosp Disaster Med.2017; 32(1):78–82.

Use of Predictive Modeling to Plan for Special Event Medical Care During Mass Gathering Events

2019 ◽  
Vol 13 (5-6) ◽  
pp. 874-879
Author(s):  
Rachel L. Allgaier ◽  
Nina Shaafi-Kabiri ◽  
Carla A. Romney ◽  
Lee A. Wallis ◽  
John Joseph Burke ◽  
...  
Keyword(s):  
South Africa ◽  
Resource Allocation ◽  
Life Support ◽  
Advanced Life Support ◽  
Western Cape ◽  
Mass Gathering ◽  
World Cup ◽  
Mass Gathering Medicine ◽  
Number Of Patients ◽  
Patient Presentation

ABSTRACTObjectives:In 2010, South Africa (SA) hosted the Fédération Internationale de Football Association (FIFA) World Cup (soccer). Emergency Medical Services (EMS) used the SA mass gathering medicine (MGM) resource model to predict resource allocation. This study analyzed data from the World Cup and compared them with the resource allocation predicted by the SA mass gathering model.Methods:Prospectively, data were collected from patient contacts at 9 venues across the Western Cape province of South Africa. Required resources were based on the number of patients seeking basic life support (BLS), intermediate life support (ILS), and advanced life support (ALS). Overall patient presentation rates (PPRs) and transport to hospital rates (TTHRs) were also calculated.Results:BLS services were required for 78.4% (n = 1279) of patients and were consistently overestimated using the SA mass gathering model. ILS services were required for 14.0% (n = 228), and ALS services were required for 3.1% (n = 51) of patients. Both ILS and ALS services, and TTHR were underestimated at smaller venues.Conclusions:The MGM predictive model overestimated BLS requirements and inconsistently predicted ILS and ALS requirements. MGM resource models, which are heavily based on predicted attendance levels, have inherent limitations, which may be improved by using research-based outcomes.

A Systematic Review of Noncommunicable Health Issues in Mass Gatherings

2014 ◽  
Vol 29 (2) ◽  
pp. 167-175 ◽  
Author(s):  
Ahmed H. Alquthami ◽  
Jesse M. Pines
Keyword(s):  
Systematic Review ◽  
Presentation Rate ◽  
Healthcare Research ◽  
Mass Gathering ◽  
Health Issues ◽  
Publication Type ◽  
Mass Gatherings ◽  
Mass Gathering Medicine ◽  
Ambulance Transports ◽  
Patient Presentation

AbstractIntroductionThe review was conducted to evaluate if the field of mass-gathering medicine has evolved in addressing: (1) the lack of uniform standard measures; (2) the effectiveness of and needs for various interventions during a mass gathering; and (3) the various types of noncommunicable health issues (trauma and medical complaints) encountered and their severity during a gathering.MethodsA systematic review of papers published from 2003 through 2012 was conducted using databases of MEDLINE, Ovid, CINHAL, EBSCOHost, National Library of Medicine (NLM), Agency for Healthcare Research and Quality (AHRQ), Elsevier, Scopus, and Proquest databases. Of 37,762 articles, 17 articles were included in this review, covering 18 mass-gathering events; 14 were multiple-day events.ResultsAcross all events, the patient presentation rate (PPR) ranged from 0.13 to 20.8 patients per 1,000 attendees and the transfer to hospital rate (TTHR) ranged from 0.01 to 10.2 ambulance transports per 1,000 attendees. In four out of the seven studies, having on-site providers was associated with a lower rate of ambulance transports. The highest frequencies of noncommunicable presentations were headaches, abdominal complaints, and abrasions/lacerations. Most presentations were minor. Emergent cases requiring hospitalization (such as acute myocardial infarction) were rare.ConclusionsThe rate of noncommunicable health issues varies across events and very serious emergencies are rare.AlquthamiAH, PinesJM. A systematic review of noncommunicable health issues in mass gatherings. Prehosp Disaster Med. 2014;29(2):1-9.

scholarly journals Morbidity and mortality amongst Indian Hajj pilgrims: A 3-year experience of Indian Hajj medical mission in mass-gathering medicine

2018 ◽  
Vol 11 (2) ◽  
pp. 165-170 ◽  
Author(s):  
Inam D. Khan ◽  
Shahbaz A. Khan ◽  
Bushra Asima ◽  
Syed B. Hussaini ◽  
M. Zakiuddin ◽  
...  
Keyword(s):  
Morbidity And Mortality ◽  
Mass Gathering ◽  
Medical Mission ◽  
Mass Gathering Medicine

Mass Gathering Medicine: A Predictive Model for Patient Presentation and Transport Rates

2001 ◽  
Vol 16 (3) ◽  
pp. 150-158 ◽  
Author(s):  
Paul Arbon ◽  
Franklin H.G. Bridgewater ◽  
Colleen Smith
Keyword(s):  
Health Care ◽  
Environmental Factors ◽  
Predictive Model ◽  
Regression Models ◽  
Health Care Services ◽  
Mass Gathering ◽  
Mass Gatherings ◽  
Public Events ◽  
Care Services ◽  
Patient Presentation

AbstractIntroduction:This paper reports on research into the influence of environmental factors (including crowd size, temperature, humidity, and venue type) on the number of patients and the patient problems presenting to firstaid services at large, public events in Australia. Regression models were developed to predict rates of patient presentation and of transportation-to-a-hospital for future mass gatherings.Objective:To develop a data set and predictive model that can be applied across venues and types of mass gathering events that is not venue or event specific. Data collected will allow informed event planning for future mass gatherings for which health care services are required.Methods:Mass gatherings were defined as public events attended by in excess of 25,000 people. Over a period of 12 months, 201 mass gatherings attended by a combined audience in excess of 12 million people were surveyed through-out Australia. The survey was undertaken by St. John Ambulance Australia personnel. The researchers collected data on the incidence and type of patients presenting for treatment and on the environmental factors that may influence these presentations. A standard reporting format and definition of event geography was employed to overcome the event-specific nature of many previous surveys.Results:There are 11,956 patients in the sample. The patient presentation rate across all event types was 0.992/1,000 attendees, and the transportation-to-hospital rate was 0.027/1,000 persons in attendance. The rates of patient presentations declined slightly as crowd sizes increased. The weather (particularly the relative humidity) was related positively to an increase in the rates of presentations. Other factors that influenced the number and type of patients presenting were the mobility of the crowd, the availability of alcohol, the event being enclosed by a boundary, and the number of patient-care personnel on duty.Three regression models were developed to predict presentation rates at future events.Conclusions:Several features of the event environment influence patient presentation rates, and that the prediction of patient load at these events is complex and multifactorial. The use of regression modeling and close attention to existing historical data for an event can improve planning and the provision of health care services at mass gatherings.

The Gillette Stadium Experience: A Retrospective Review of Mass Gathering Events From 2010 to 2015

2018 ◽  
Vol 12 (6) ◽  
pp. 752-758 ◽  
Author(s):  
Scott A. Goldberg ◽  
Jeremy Maggin ◽  
Michael S. Molloy ◽  
Olesya Baker ◽  
Ritu Sarin ◽  
...  
Keyword(s):  
Public Health ◽  
Retrospective Review ◽  
National Football League ◽  
Cold Weather ◽  
Medical Attention ◽  
Mass Gathering ◽  
Event Type ◽  
Weather Events ◽  
And Gender ◽  
Patient Presentation

AbstractObjectiveMass gathering events can substantially impact public safety. Analyzing patient presentation and transport rates at various mass gathering events can help inform staffing models and improve preparedness.MethodsA retrospective review of all patients seeking medical attention across a variety of event types at a single venue with a capacity of 68,756 from January 2010 through September 2015.ResultsWe examined 232 events with a total of 8,260,349 attendees generating 8157 medical contacts. Rates were 10 presentations and 1.6 transports per 10,000 attendees with a non-significant trend towards increased rates in postseason National Football League games. Concerts had significantly higher rates of presentation and transport than all other event types. Presenting concern varied significantly by event type and gender, and transport rate increased predictably with age. For cold weather events, transport rates increased at colder temperatures. Overall, on-site physicians did not impact rates.ConclusionsAt a single venue hosting a variety of events across a 6-year period, we demonstrated significant variations in presentation and transport rates. Weather, gender, event type, and age all play important roles. Our analysis, while representative only of our specific venue, may be useful in developing response plans and staffing models for similar mass gathering venues. (Disaster Med Public Health Preparedness. 2018;12:752-758).

scholarly journals Mass-gathering Medicine: Risks and Patient Presentations at a 2-day Electronic Dance Music Event - Year Two

2016 ◽  
Vol 31 (6) ◽  
pp. 687-688 ◽  
Author(s):  
Sheila A. Turris ◽  
Michael Camporese ◽  
Samuel J. Gutman ◽  
Adam Lund
Keyword(s):  
Mass Gathering ◽  
Dance Music ◽  
Publication Type ◽  
Electronic Dance Music ◽  
Mass Gathering Medicine

TurrisSA, CamporeseM, GutmanSJ, LundA. Mass-gathering medicine: risks and patient presentations at a 2-day electronic dance music event - year two. Prehosp Disaster Med. 2016;31(6):687–688.

Patient Presentation Trends at 15 Mass-Gathering Events in South Australia

2018 ◽  
Vol 33 (4) ◽  
pp. 368-374 ◽  
Author(s):  
Olga Anikeeva ◽  
Paul Arbon ◽  
Kathryn Zeitz ◽  
Murk Bottema ◽  
Adam Lund ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
South Australia ◽  
Well Being ◽  
Mass Gathering ◽  
Care Providers ◽  
Mass Gatherings ◽  
Being There ◽  
The Impact ◽  
Patient Presentation

AbstractIntroductionMass gatherings are complex events that present a unique set of challenges to attendees’ health and well-being. There are numerous factors that influence the number and type of injuries and illnesses that occur at these events, including weather, event and venue type, and crowd demographics and behavior.ProblemWhile the impact of some factors, such as weather conditions and the availability of alcohol, on patient presentations at mass gatherings have been described previously, the influence of many other variables, including crowd demographics, crowd behavior, and event type, is poorly understood. Furthermore, a large number of studies reporting on the influence of these variables on patient presentations are based on anecdotal evidence at a single mass-gathering event.MethodsData were collected by trained fieldworkers at 15 mass gatherings in South Australia and included event characteristics, crowd demographics, and weather. De-identified patient records were obtained from on-site health care providers. Data analysis included the calculation of patient proportions in each variable category, as well as the total number of patient presentations per event and the patient presentation rate (PPR).ResultsThe total number of expected attendees at the 15 mass gatherings was 303,500, of which 146 presented to on-site health care services. The majority of patient presentations occurred at events with a mean temperature between 20°C and 25°C. The PPR was more than double at events with a predominantly male crowd compared to events with a more equal sex distribution. Almost 90.0% of patient presentations occurred at events where alcohol was available.Conclusion:The results of the study suggest that several weather, crowd, and event variables influence the type and number of patient presentations observed at mass-gathering events. Given that the study sample size did not allow for these interactions to be quantified, further research is warranted to investigate the relationships between alcohol availability, crowd demographics, crowd mobility, venue design, and injuries and illnesses.Anikeeva O, Arbon P, Zeitz K, Bottema M, Lund A, Turris S, Steenkamp M. Patient presentation trends at 15 mass-gathering events in South Australia. Prehosp Disaster Med. 2018;33(4):368–374.

scholarly journals OPERATIONS THROUGHPUT AS A DETERMINANT OF GOLDEN-HOUR IN MASS-GATHERING MEDICINE

2017 ◽  
Author(s):  
Inam Danish Khan ◽  
Buhra Asima ◽  
Shahbaz Ali Khan
Keyword(s):  
Systems Approach ◽  
Clinical Investigation ◽  
Healthcare Delivery ◽  
Turnaround Time ◽  
Population Based ◽  
Situational Analysis ◽  
Mass Gathering ◽  
Golden Hour ◽  
Mass Gathering Medicine ◽  
Patient Centric

BACKGROUNDGolden-hour, a time-tested concept for trauma-care, involves a systems approach encompassing healthcare, logistics, geographical, environmental and temporal variables. Golden-hour paradigm in mass-gathering-medicine such as the Hajj-pilgrimage entwines along healthcare availability, accessibility, efficiency and interoperability; expanding from the patient-centric to public-health centric approach. The realm of mass-gathering-medicine invokes an opportunity for incorporating operations-throughput as a determinant of golden-hour for overall capacity-building and interoperability.METHODSGolden-hour was evaluated during the Indian-Medical-Mission operations for Hajj-2016; which established, operated and coordinated a strategic network of round-the-clock medical operations. Throughput was evaluated as deliverables/time, against established Standard-Operating-Procedures for various clinical, investigation, drug-dispensing and patient-transfer algorithms. Patient encounter-time, waiting-time, turnaround-time were assessed throughout echeloned healthcare under a patient-centric healthcare-delivery model. Dynamic evaluation was carried out to cater for variation and heterogeneity.RESULTSMassive surge of 3,94,013 patients comprising 2,25,103 males (57.1%) and 1,68,910 females (42.9%) overwhelmed the throughput capacities of outpatient attendance, pharmacy, laboratory, imaging, ambulance, referrals and documentation. There was delay in attendance, suspicion, diagnosis and isolation of patients with communicable infections. The situational-analysis of operations-throughput highlights wasted turnaround-time due to mobilization of medical-team, diverting critical healthcare resources away from emergency situations.CONCLUSIONTime being a crucial factor in the complexity of medical-care, operations-throughput remains an important determinant towards interoperability of bottlenecks, thereby being a determinant of golden-hour in mass-gathering-medicine. Early transportation of patient to definitive-care reduces treatment initiation-time, notwithstanding logistics of communication, evacuation, terrain and weather being deterministic in outcome. Golden-hour needs to be emphasized under a population-based approach targeting the clientele towards administering first-aid and reaching out to hospital within the golden-hour.

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