Morbidity and mortality amongst Indian Hajj pilgrims: A 3-year experience of Indian Hajj medical mission in 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.

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

International Journal of Medicine and Medical Research ◽

10.11603/ijmmr.2413-6077.2017.1.7804 ◽

2017 ◽

Cited By ~ 2

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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From Hajj services to Mass Gathering Medicine: Saudi Arabia formalizes a novel discipline

Travel Medicine and Infectious Disease ◽

10.1016/j.tmaid.2018.07.007 ◽

2019 ◽

Vol 28 ◽

pp. 105-106 ◽

Cited By ~ 1

Author(s):

Qanta A. Ahmed ◽

Shahul Ebrahim ◽

Ziad A. Memish

Keyword(s):

Saudi Arabia ◽

Mass Gathering ◽

Mass Gathering Medicine

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Simulated-Scenario and Peer-Mentorship Curriculum to Train Prehospital Providers in the Practice of Mass Gathering Medicine

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2021.318 ◽

2021 ◽

pp. 1-5

Author(s):

Enzo G. Plaitano ◽

Bianca L. Pate ◽

Elana F. Everett ◽

Sarah K. Golden ◽

Raymond A. Levy ◽

...

Keyword(s):

Training Program ◽

Program Implementation ◽

Response Rate ◽

Emergency Medical Technicians ◽

Mass Gathering ◽

Program Schema ◽

Mass Gatherings ◽

Emergency Medical ◽

Mass Gathering Medicine ◽

Simulated Scenario

Abstract Objective: A mass gathering medicine training program was established for a 7,200-seat arena. The objectives of this study were to describe the program schema and determine its impact in preparing novice emergency medical technicians (EMTs) to manage the difficulties of large-venue emergency medical services (EMS). Methods: Optional, anonymous surveys were administered to EMTs. Novice EMTs were assessed pre-/post-program implementation, and both novice and experienced EMTs completed self-reported Likert scales. Data were analyzed with nonparametric methods. Results: A total of 43/56 responses (response rate = 76.8%) were received. Only 37.2% of providers felt prepared to work mass gatherings before the training, and 60.5% stated that their previous education did not prepare them for large-venue challenges. After the training program, novice EMTs were significantly associated with increased knowledge of large-venue EMS procedures (P = 0.0170), higher proficiency using extrication equipment (P = 0.0248), increased patient care skills (P = 0.0438), and both increased confidence working events (P = 0.0002) and better teamwork during patient encounters (P = 0.0001). The majority of EMTs reported the program as beneficial. Conclusion: Upon hire, EMS providers felt unprepared to work large-venue EMS. The analyses demonstrated that this training program improved select large-venue emergency skills for prehospital providers and may fill a gap in the education system regarding mass gathering medicine.

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Mass gathering medicine: a leisure or necessity?

International Journal of Clinical Practice ◽

10.1111/j.1742-1241.2012.02923.x ◽

2012 ◽

Vol 66 (6) ◽

pp. 530-532

Author(s):

J. A. Al-Tawfiq ◽

Z. A Memish

Keyword(s):

Mass Gathering ◽

Mass Gathering Medicine

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Mass-Gathering Medicine: A Review of the Evidence and Future Directions for Research

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00004507 ◽

2007 ◽

Vol 22 (2) ◽

pp. 131-135 ◽

Cited By ~ 99

Author(s):

Paul Arbon

Keyword(s):

Disaster Medicine ◽

Mass Gathering ◽

Future Directions ◽

Health Services Delivery ◽

Progressive Development ◽

Mass Gatherings ◽

Services Delivery ◽

Mass Gathering Medicine ◽

Apply Research ◽

Research Frameworks

AbstractA review of mass-gathering medicine literature published by the Journal Prehospital and Disaster Medicine, demonstrates the progressive development of our knowledge and understanding of the health effects of mass gatherings and the strategies that appear to contribute positively to effective health services delivery during these events. In addition, the growing need for research that can underpin a more evidence-based approach to planning for and managing these events is apparent. The call for less descriptive and more critical and conceptual analyses has been increasing in volume and, it is argued, the challenge now is to apply research frameworks that can contribute more effectively to science-based, medical practice.

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

Prehospital and Disaster Medicine ◽

10.1017/s1049023x16001187 ◽

2016 ◽

Vol 32 (1) ◽

pp. 78-82 ◽

Cited By ~ 11

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.

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