Mass Gathering Events: Retrospective Analysis of Patient Presentations over Seven Years

2002 ◽  
Vol 17 (3) ◽  
pp. 147-150 ◽  
Author(s):  
Kathryn M. Zeitz ◽  
David P.A. Schneider ◽  
Dannielle Jarrett ◽  
Christopher J. Zeitz
Keyword(s):  
Formal Analysis ◽  
Presentation Rate ◽  
Evidence Base ◽  
First Aid ◽  
Event Analysis ◽  
Mass Gathering ◽  
Medical Problems ◽  
Maximum Daily Temperature ◽  
Day Of The Week ◽  
Crowd Size

AbstractIntroduction:St John Ambulance Operations Branch Volunteers have been providing first-aid services at the Royal Adelaide Show for 90 years. The project arose from a need to more accurately predict the workload for first-aid providers at mass gathering events. A formal analysis of workload patterns and the determinants of workload had not been performed.Hypothesis:Casualty presentation workload would be predicted by factors including day of the week, weather, and crowd size.Method:Collated and analyzed casualty reports over a seven-year period representing >7,000 patients who presented for first-aid assistance for that period (63 show days) were reviewed retrospectively.Results:Casualty presentations correlated significantly with crowd size, maximum daily temperature, humidity, and day of the week. Patient presentation rate had heterogeneous determinants. The most frequent presentation was minor medical problems with Wednesdays attracting higher casualty presentations and more major medical categories.Conclusion:Individual event analysis is a useful mechanism to assist in determining resource allocation at mass gathering events providing an evidence base upon which to make decisions about future needs. Subsequent analysis of other events will assist in supporting accurate predictor models.

scholarly journals Epistaxis 2016: national audit of management

2017 ◽  
Vol 131 (12) ◽  
pp. 1131-1141 ◽  
Author(s):  
Keyword(s):  
Presentation Rate ◽  
Evidence Base ◽  
Current Evidence ◽  
Event Analysis ◽  
National Audit ◽  
Inclusion Criteria ◽  
Current Evidence Base ◽  
Consensus Guidance ◽  
The Uk ◽  
Audit Standards

AbstractBackground:Epistaxis is a common condition that can be associated with significant morbidity, and it places a considerable burden on our healthcare system. This national audit of management sought to assess current practice against newly created consensus recommendations and to expand our current evidence base.Methods:The management of epistaxis patients who met the inclusion criteria, at 113 registered sites across the UK, was compared with audit standards during a 30-day window. Data were further utilised for explorative analysis.Results:Data for 1826 cases were uploaded to the database, representing 94 per cent of all cases that met the inclusion criteria at participating sites. Sixty-two per cent of patients were successfully treated by ENT clinicians within 24 hours. The 30-day recurrent presentation rate across the dataset was 13.9 per cent. Significant event analysis revealed an all-cause 30-day mortality rate of 3.4 per cent.Conclusion:Audit findings demonstrate a varying alignment with consensus guidance, with explorative analysis countering some previously well-established tenets of management.

scholarly journals Forecasting Medical Work at Mass-Gathering Events: Predictive Model Versus Retrospective Review

2005 ◽  
Vol 20 (3) ◽  
pp. 164-168 ◽  
Author(s):  
Kathryn M. Zeitz ◽  
Chris J. Zeitz ◽  
Paul Arbon
Keyword(s):  
Predictive Model ◽  
Retrospective Review ◽  
Presentation Rate ◽  
First Aid ◽  
Individual Variability ◽  
Historical Event ◽  
Mass Gathering ◽  
Limited Information ◽  
Medical Work ◽  
Number Of Patients

AbstractIntroduction:Mass-gathering events are dynamic and challenge traditional medical management systems. To improve the system for the provision of first aid at mass-gathering events, an evaluation of two models that assist in forecasting the number of patients presenting for first-aid services was conducted.Method:A prospective evaluation of a recurrent, mass-gathering event was undertaken comparing predicted patient presentations and ambulance transfers generated by a predictive model developed by Arbon et al and a retrospective review of seven years of historical, event data as described by Zeitz et al.Results:Patient presentation rate (per 1,000 patrons) for this event was 1.6 and the transport to hospital rate (per 1,000 patrons) was 0.07. The retrospective review closely predicted the actual overall attendance.Both methods forecast the number of patients presenting on a daily basis. The prediction proved to be more accurate, on a day-by-day basis, using the Zeitz method.Conclusion:The Arbon method is particularly useful for events where there is no or limited information about previous medical work. Retrospective review of data generated from specific events (Zeitz method) considers the unique and individual variability that can occur from event to event and is more accurate at predicting patient presentations when the data are available. Both methods have the potential to be used more frequently to adequately and efficiently plan for the resources required for specific events.

Common feline problem behaviors: Urine spraying

2019 ◽  
Vol 21 (3) ◽  
pp. 209-219 ◽  
Author(s):  
Debra F Horwitz
Keyword(s):  
Problem Behaviors ◽  
Treatment Options ◽  
Scent Marking ◽  
Standing Position ◽  
Evidence Base ◽  
Correct Identification ◽  
Medical Problems ◽  
Urine Marking ◽  
Resultant Increase ◽  
Relationship Of

Practical relevance: Urine spraying (synonymous terms include urine marking or scent marking) is commonly described as urine deposited on vertical surfaces while the cat is in a standing position. With the increasing trend of keeping cats indoors in some countries and the potential resultant increase in frustration-related behaviors, urine spraying may occur in the home. Although also a normal feline behavior, it is usually not deemed acceptable when the cat targets household possessions. Urine spraying is a common behavioral complaint that practitioners receive from cat owners and has the potential to disrupt the human–cat bond. In fact, feline elimination issues are a frequent reason cited by owners when they relinquish their cats to shelters and rescue organizations. Clinical challenges: While the location of the deposited urine should be diagnostic, this is not always the case. Urine marking can occur on horizontal surfaces, thus complicating the diagnosis. Urine spraying by intact males and females is used to signal availability for mating but the behaviour can also be exhibited by neutered animals. Multiple factors including medical problems can trigger the onset and maintenance of urine spraying, and correct identification of these is necessary for treatment to be most successful. Evidence base: This review draws on information from multiple studies that have been published on the normal aspects of urine spraying in cats, the frequency as reported by owners, the relationship of urine spraying to intercat aggression and various treatment options including behavior modification, pheromone therapy and use of psychoactive medication.

Mass Gathering Emergency Medicine Organization for the Union of European Football Associations’ Under-21 Championship 2019 in Bologna, Italy

2020 ◽  
pp. 1-4
Author(s):  
Guglielmo Imbriaco ◽  
Alfonso Flauto ◽  
Tiziano Bussolari ◽  
Fiorella Cordenons ◽  
Giovanni Gordini
Keyword(s):  
Alcohol Consumption ◽  
Free Water ◽  
Presentation Rate ◽  
Heat Index ◽  
Mass Gathering ◽  
Medical Assistance ◽  
Emergency Nurses ◽  
Effective Care ◽  
European Football ◽  
Minor Injuries

Abstract Football events represent a type of Mass Gathering Events (MGE) where crowd behavior, temperature and Heat Index, absence of free water, and alcohol consumption can lead to an increased need for medical assistance in participants. This report describes the environmental issues, organization, and healthcare assistance provided during the four matches of the Union of European Football Associations’ (UEFA) Under-21 tournament held in Bologna in June, 2019. The four matches had a total of 72655 spectators; 31 patients required medical assistance with a mean Patient Presentation Rate (PPR) of 0.41; Mean Transport To Hospital Rate (TTHR) of 0.04; with PPR and TTHR comparable with literature findings. Majority of patients suffered from minor injuries and illnesses, and were treated directly in stadium medical sites. Medical assistance involved volunteer rescuers, emergency nurses, and physicians; resources were efficiently allocated and provided effective care to every patient. Climate factors, heat and humidity, the absence of free water, and increased alcohol consumption appear to be associated with increased requests for medical assistance. The retrospective analysis of a wider range of environmental factors, and the historical experience developed during similar MGEs suggest the need for a more comprehensive, improved approach for adequately assessing risk and planning the necessary healthcare resources.

scholarly journals Medical Care at Mass Gatherings: Emergency Medical Services at Large-Scale Rave Events

2012 ◽  
Vol 27 (1) ◽  
pp. 71-74 ◽  
Author(s):  
Jan Krul ◽  
Björn Sanou ◽  
Eleonara L Swart ◽  
Armand R J Girbes
Keyword(s):  
Medical Care ◽  
Large Scale ◽  
Life Support ◽  
Advanced Life Support ◽  
Field Research ◽  
Severity Index ◽  
First Aid ◽  
Disaster Medicine ◽  
Medical Problems ◽  
Mass Gatherings

AbstractObjective: The objective of this study was to develop comprehensive guidelines for medical care during mass gatherings based on the experience of providing medical support during rave parties.Methods: Study design was a prospective, observational study of self-referred patients who reported to First Aid Stations (FASs) during Dutch rave parties. All users of medical care were registered on an existing standard questionnaire. Health problems were categorized as medical, trauma, psychological, or miscellaneous. Severity was assessed based on the Emergency Severity Index. Qualified nurses, paramedics, and doctors conducted the study after training in the use of the study questionnaire. Total number of visitors was reported by type of event.Results: During the 2006–2010 study period, 7,089 persons presented to FASs for medical aid during rave parties. Most of the problems (91.1%) were categorized as medical or trauma, and classified as mild. The most common medical complaints were general unwell-being, nausea, dizziness, and vomiting. Contusions, strains and sprains, wounds, lacerations, and blisters were the most common traumas. A small portion (2.4%) of the emergency aid was classified as moderate (professional medical care required), including two cases (0.03%) that were considered life-threatening. Hospital admission occurred in 2.2% of the patients. Fewer than half of all patients presenting for aid were transported by ambulance. More than a quarter of all cases (27.4%) were related to recreational drugs.Conclusions: During a five-year field research period at rave dance parties, most presentations on-site for medical evaluation were for mild conditions. A medical team of six healthcare workers for every 10,000 rave party visitors is recommended. On-site medical staff should consist primarily of first aid providers, along with nurses who have event-specific training on advanced life support, event-specific injuries and incidents, health education related to self-care deficits, interventions for psychological distress, infection control, and disaster medicine. Protocols should be available for treating common injuries and other minor medical problems, and for registration, triage, environmental surveillance and catastrophe management and response.

Retrospective Analysis of Patient Presentations at the Sydney (Australia) Royal Easter Show from 2012 to 2014

2017 ◽  
Vol 32 (2) ◽  
pp. 187-194 ◽  
Author(s):  
Nathan Crabtree ◽  
Shirley Mo ◽  
Leon Ong ◽  
Thuvarahan Jegathees ◽  
Daniel Wei ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Health Care Providers ◽  
Patient Treatment ◽  
Study Patient ◽  
Mass Gathering ◽  
Care Providers ◽  
Data Set ◽  
Patient Demographics ◽  
Crowd Size ◽  
Sydney Australia

AbstractIntroductionComprehensive studies on the relationship between patient demographics and subsequent treatment and disposition at a single mass-gathering event are lacking. The Sydney Royal Easter Show (SRES; Sydney Olympic Park, New South Wales, Australia) is an annual, 14-day, agricultural mass-gathering event occurring around the Easter weekend, attracting more than 800,000 patrons per year. In this study, patient records from the SRES were analyzed to examine relationships between weather, crowd size, day of week, and demographics on treatment and disposition. This information would help to predict factors affecting patient treatment and disposition to guide ongoing training of first responders and to evaluate the appropriateness of staffing skills mix at future events.HypothesisPatient demographics, environmental factors, and attendance would influence the nature and severity of presentations at the SRES, which would influence staffing requirements.MethodsA retrospective analysis of 4,141 patient record forms was performed for patients who presented to St John Ambulance (Australian Capital Territory, Australia) at the SRES between 2012 and 2014 inclusive. Presentation type was classified using a previously published minimum data set. Data on weather and crowd size were obtained from the Australian Bureau of Meteorology (Melbourne, Victoria, Australia) and the SRES, respectively. Statistical analyses were performed using SPSS v22 (IBM; Armonk, New York USA).ResultsBetween 2012 to 2014, over 2.5 million people attended the SRES with 4,141 patients treated onsite. As expected, the majority of presentations were injuries (49%) and illnesses (46%). Although patient demographics and presentation types did not change over time, the duration of treatment increased. A higher proportion of patients were discharged to hospital or home compared to the proportion of patients discharged back to the event. Patients from rural/regional locations (accounting for 15% of all patients) were more likely to require advanced treatment, health professional review, and were more likely to be discharged to hospital or home rather than discharged back to the event. Extremes of temperature were associated with a lower crowd size and higher patient presentation rate (PPR), but had no impact on transfer or referral rates to hospital.ConclusionThis study demonstrated that analyses of patient presentations at an agricultural show provide unique insights on weather, attendance, and demographic features that correlated with treatment and disposition. These data can help guide organizers with information on how to better staff and train health care providers at future mass-gathering events of this type.CrabtreeN,MoS,OngL,JegatheesT,WeiD,FaheyD,LiuJ.Retrospective analysis of patient presentations at the Sydney (Australia) Royal Easter Show from 2012 to 2014.Prehosp Disaster Med.2017;32(2)187–194.

scholarly journals Use of a Novel Electronic Patient Care Record System at Mass Gathering Events by St. John Ambulance Victoria

2019 ◽  
Vol 34 (s1) ◽  
pp. s88-s88
Author(s):  
Crystal Gao ◽  
Zheng Jie Lim ◽  
Brendan Freestone ◽  
Kristy Austin ◽  
Rob McManus
Keyword(s):  
Patient Care ◽  
Real Time ◽  
First Aid ◽  
Gps Tracking ◽  
List Type ◽  
Mass Gathering ◽  
Time Data ◽  
Record System ◽  
Patient Demographics ◽  
Improving Patient Care

Introduction:The growing number of mass gathering events (MGEs) in Victoria has seen an increase in demand for event health services and the need for real-time reporting of medical incidents at these events.Aim:Since 2016, St. John Ambulance Victoria has introduced an electronic patient care record (ePCR) system with the aim of improving patient care and satisfaction. It appears that this ePCR system is the first of its kind to be trialed at MGEs by a volunteer organization.Methods:A qualitative study was conducted to determine strengths and limitations of the ePCR system by compiling results of surveys and interviews and through anonymous feedback from volunteers and patrons (event organizers, patients). This study is ongoing.Results:It was found that the use of ePCR: 1.Allowed for collection of relevant data to assist in future planning of MGEs2.Aids the overall coordination of first aid delivery at MGEs -faster relaying of patient information to event commanders-reduction of paperwork-improved ability to locate first aid crews using GPS tracking3.Received positive feedback from first aiders, event organizers, and patrons4.Was deemed easy-to-use (4/5), acceptable (4.3/5), and helpful (4.1/5) by our membersDiscussion:These experiences demonstrate that ePCR is well-received, easy to use, and leads to improved patient satisfaction and treatment outcomes at MGEs. Furthermore, the ability to collect and analyze real-time data such as GPS location tracking, incidence heat maps, and patient demographics facilitate future event planning and resource allocation at MGEs. It is acknowledged that this study is preliminary, and the trialed use of an ePCR system has been limited to metropolitan areas and MGEs with <1 million patrons. The intent is to continue this study and explore the use of ePCRs at larger MGEs and events in rural or regional areas.

An Analysis of Demand for First-Aid Care at a Major Public Event

1996 ◽  
Vol 11 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Arthas Flabouris ◽  
Franklin Bridgewater
Keyword(s):  
Medical Care ◽  
Presentation Rate ◽  
First Aid ◽  
Poor Correlation ◽  
Public Event ◽  
Initial Symptoms ◽  
Initial Care ◽  
Presentation Time ◽  
Daily Attendance ◽  
Delivery Of Medical Care

AbstractIntroduction:First aid is the initial care of the ill or injured. It aims to preserve and protect life, prevent further injury or deterioration of illness, and help promote recovery. At major public events, there is a large gathering of people, physical spectacles, and equipment within a concentrated area, where organized first-aid care is provided.Objective:To analyze the demand for primary medical care at a public event by identifying the patients and initial symptoms that may predict that demand, and to use such information to improve the efficiency and delivery of medical care.Methods:A questionnaire was completed by St. John Operations Branch personnel after each patient consultation and a retrospective analysis of the data was conducted.Results:A total of 1,276 questionnaires were returned. Mean patient presentation rate (PPR) was 1.9±0.47 per 1,000 show attendees. This correlated best with the maximum daily temperature (r = 0.715, p <0.02) and show day (r = 0.615, p <0.05). There was poor correlation with daily attendance (r = −0.235, p >0.54). Mean presentation time was 15:13 h. Of those whose gender was recorded, 58.4% were females, and 41.6% were males. The most frequent age group was 13 to 20 years. The nature and number of initial symptoms are listed. Basic first-aid skills were used for 96.7% of symptoms; 2.4% of patients were referred to the hospital.Conclusions:Temperature and show day significantly contributed to variability of PPR. These factors, together with an estimated PPR and predicted attendance, can be used to forecast demand. Most cases required only basic first-aid skills. Guidelines are suggested for management by nonmedical personnel. A medical officer's role is not reliably defined, but involvement in consultation is suggested.

Tools for managing feline problem behaviours: Environmental and behavioural modification

2018 ◽  
Vol 20 (11) ◽  
pp. 1005-1014
Author(s):  
Vicky Halls
Keyword(s):  
Evidence Base ◽  
First Aid ◽  
Evidence Based ◽  
Practical Relevance ◽  
The Past ◽  
Behavioural Modification ◽  
Specific Behaviour ◽  
Problem Behaviours ◽  
Work Up ◽  
Referral Practice

Practical relevance: Problem feline behaviour can be managed successfully by early diagnosis and intervention, good first-aid advice in veterinary practice and then, if necessary, a referral to a suitably qualified behaviourist for those cases that are complex. There are a number of tools available to assist in the resolution of problem feline behaviour and this article will cover environmental modification and behavioural modification. Clinical challenges: Problem feline behaviours are not uncommon and the veterinary team often have to rely on their own knowledge to assist clients if a specialist behaviourist is not available. Evidence base: There is a lack of evidence-based information regarding how best to work-up and treat cases of problem feline behaviour in practice; therefore, some recommendations within this article are based on the author’s experience of treating cases in a cat-specific behaviour referral practice over the past 20 years. However, there is evidence available regarding how best to enrich a cat’s environment and how to ensure a cat’s environmental needs are met. Audience: Any veterinarians, veterinary nurses or technicians who are involved in the diagnosis or treatment of problem feline behaviour in practice would benefit from understanding the principles of environmental and behavioural modification.

Mass-Gathering Medical Care: Retrospective Analysis of Patient Presentations over Five Years at a Multi-Day Mass Gathering

2010 ◽  
Vol 25 (2) ◽  
pp. 183-187 ◽  
Author(s):  
William D. Grant ◽  
Nicholas E. Nacca ◽  
Louise A. Prince ◽  
Jay M. Scott
Keyword(s):  
Medical Care ◽  
New York State ◽  
Analytical Data ◽  
Age Groups ◽  
Presentation Rate ◽  
Medical Attention ◽  
Mass Gathering ◽  
Emergency Physicians ◽  
The Past ◽  
Gender Discrepancies

Introduction:There is a scarcity of analytical data regarding mass-gathering medical care. The purpose of this study was to identify and evaluate the range and nature of illness and injury for patrons of an annual, multi-day, mass gathering.Methods:Encounter data from all patients seen by emergency physicians at the New York State Fair Infirmary during the past five years were analyzed. From these data, a category list was consolidated to 36 reasons for the visit based on chief complaint, nursing notes, and physician notes. The most common reasons for being seen by a physician were analyzed to determine age and gender discrepancies.Results:The average number of attendees at the Fair per year from 2004–2008 was 950,973. Emergency physicians evaluated a total of 2,075 patients from 2004–2008. The average patient presentation rate over the past four years (2005–2008) was 4.8 ±1.1/10,000 patrons. The average transport to hospital rate over the past four years was 2.7 ±1.1/100,000 patrons. The average age of all patients seen was 34.4 ±21.6 years, and 58.1% of the patients were female. The most common reasons to seek medical attention included: dehydration/heat-related illness (11.4%); abrasion/laceration (10.6%); and fall-related injury (10.2%). Two groups, dehydration/heat-related illness 74% (t (4) = 2.90, p <0.05), and fall-related injury (68%; t (4) = 5.17, p <0.05) were disproportionately female. There also was a direct relationship between age and female gender within the fall-related injury category (χ2 (1, n = 213) = 11.41, p <0.05).Conclusions:Patron data from fairs and expositions is a valuable resource for studying mass-gathering medical care. A majority (58%) of patients seen at the infirmary were female. The most common reason for being seen was dehydration/ heat-related illness, which heavily favored females, but favored no age groups. The abrasion/laceration category did not contribute to the gender discrepancy. Patients who fell tended to be females >40 years of age. Further analysis is required to determine the reason for the gender discrepancies. Planners of multi-day mass gatherings should develop public education programs and evaluate their impact on the at-risk populations identified by this analysis.

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