Medical Care at Mass Gatherings: Considerations for Physician Involvement

AbstractAlthough many authorities define a “mass gathering” as a group exceeding 1,000 persons, several times that number likely are to be present. The event for which the group will gather may be anything from a rock concert to an Olympic competition. Preparations for the event can be minor or major. This article reviews the issues that a physician should consider if he or she chooses to become involved in the delivery of medical care to such populations, as well as the evidence suggesting that a physician should be involved in most such gatherings.Emergency medical care at public gatherings is haphazard at best and dangerous at worst.There are surprisingly few data from which to plan the emergency medical needs for public events and no recognized standards or guidelines for providing emergency medical services at mass public gatherings.

Download Full-text

Mass Gathering Medicine: A Review

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00037250 ◽

1997 ◽

Vol 12 (1) ◽

pp. 68-72 ◽

Cited By ~ 82

Author(s):

Robert A. De Lorenzo

Keyword(s):

Medical Care ◽

Mass Casualty ◽

Mass Gathering ◽

Emergency Medical Care ◽

Mass Gatherings ◽

Area Of Interest ◽

Emergency Medical ◽

Mass Gathering Medicine ◽

Transportation Assets

AbstractThe provision for emergency medical care for spectators and participants at large events is a growing area of interest. This article describes the definition and characteristics of medical care at mass gatherings. The literature is reviewed with regard to the planning, organization, personnel, and staffing required at these events. The equipment and transportation assets needed are also discussed. Disaster and mass casualty planning implications also are described.

Download Full-text

Development of an Equipment and Supply List for Emergency Medical Services Delivery at an Annual Air Show

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00027369 ◽

1999 ◽

Vol 14 (2) ◽

pp. 68-71 ◽

Cited By ~ 2

Author(s):

Francis M. Sullivan ◽

Gary Kleinman ◽

Selim Suner ◽

Jack St.Jean

Keyword(s):

Medical Care ◽

Mass Casualty ◽

Patient Volume ◽

Emergency Medical Care ◽

Mass Gatherings ◽

Services Delivery ◽

Medical Supplies ◽

Emergency Medical ◽

Supply Costs ◽

Delivery Models

AbstractIntroduction:Reports of medical care at mass gatherings reflect variability in mission and delivery models. Equipment recommendations are similarly varied. Thoughtful pre-planning and experience-based analysis are the best mechanisms for defining general and specific equipment recommendations.Objective:This report presents a suggested supply and equipment list developed over a six-year period of medical coverage at an air show, with an emphasis on the usage and cost of expendable supplies.Methods:The authors were involved in the planning for and execution of emergency medical care for a large, local, military air show on an annual basis, including provision of expendable medical supplies. A list of such supplies was developed over the initial two to three years, formalized and refined over the subsequent two years, and analyzed in the final, highest patient volume year of coverage. Detailed usage and cost was tracked over the final year for expendable supplies.Results:The results of this analysis indicate that comprehensive emergency medical care from first aid to mass casualty care can be offered at reasonable equipment and supply costs, if existing equipment resources can be supplemented by expendable supplies from a pre-determined list. Given the need for large quantities of supplies for a mass casualty contingency and the low likelihood of occurrence, a loan arrangement with a supplier, with return of unused supplies, is particularly convenient and economical. The approach used in this study should be appreciable in other similar settings. In concurrent scheduled events, the iterative process described can lead to greater specificity of needs for expendable supplies.

Download Full-text

Half-a-Million Strong: The Emergency Medical Services Response to a Single-Day, Mass-Gathering Event

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00001916 ◽

2004 ◽

Vol 19 (04) ◽

pp. 287-296 ◽

Cited By ~ 32

Author(s):

Michael J. Feldman ◽

Jane L. Lukins ◽

P. Richard Verbeek ◽

Russell D. MacDonald ◽

Robert J. Burgess ◽

...

Keyword(s):

Medical Care ◽

Emergency Medical Services ◽

First Aid ◽

Medical Services ◽

Medical Attention ◽

Mass Gathering ◽

Field Hospital ◽

Mass Gatherings ◽

Emergency Medical ◽

Included Patient

AbstractIntroduction:Emergency medical services (EMS) responses to mass gatherings have been described frequently, but there are few reports describing the response to a single-day gathering of large magnitude.Objective:This report describes the EMS response to the largest single-day, ticketed concert held in North America: the 2003 “Toronto Rocks!” Rolling Stones Concert.Methods:Medical care was provided by paramedics, physicians, and nurses. Care sites included ambulances, medically equipped, all-terrain vehicles, bicycle paramedic units, first-aid tents, and a 124-bed medical facility that included a field hospital and a rehydration unit. Records from the first-aid tents, ambulances, paramedic teams, and rehydration unit were obtained. Data abstracted included patient demographics, chief complaint, time of incident, treatment, and disposition.Results:More than 450,000 people attended the concert and 1,870 sought medical care (42/10,000 attendees). No record was kept for the 665 attendees simply requesting water, sunscreen, or bandages. Of the remaining 1,205 patients, the average of the ages was 28 ±11 years, and 61% were female. Seven-hundred, ninety-five patients (66%) were cared for at one of the first-aid tents. Physicians at the tents assisted in patient management and disposition when crowds restricted ambulance movement. Common complaints included headache (321 patients; 27%), heat-related complaints (148; 12%), nausea or vomiting (91; 7.6%), musculoskeletal complaints (83; 6.9%), and breathing problems (79; 6.6%). Peak activity occurred between 14:00 and 19:00 hours, when 102 patients per hour sought medical attention. Twenty-four patients (0.5/10,000) were transferred to off-site hospitals.Conclusions:This report on the EMS response, outcomes, and role of the physicians at a large single-day mass gathering may assist EMS planners at future events.

Download Full-text

Emergency Medical Care in the Athletes' Village: World University Games 1993

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00041832 ◽

1995 ◽

Vol 10 (2) ◽

pp. 113-117 ◽

Cited By ~ 10

Author(s):

David M. Janicke ◽

Donald J. Jacob ◽

Richard B. LaFountain ◽

Mark R. Pundt ◽

Gregory E. Young

Keyword(s):

Medical Care ◽

Medical Center ◽

Demographic Data ◽

The United States ◽

Sporting Events ◽

Emergency Medical Care ◽

Medical Problems ◽

Language Differences ◽

Medical Needs ◽

Emergency Medical

AbstractObjective:Little information exists concerning special medical needs at the athletes' residence (as distinct from the sport venues) at major international sporting events. During the summer of 1993, Buffalo, New York became the first city in the United States to host the World University Games. Approximately 6,000 athletes and accompanying staff from 118 countries attended. This report seeks to characterize emergency medical care use and the degree of language difficulty encountered at the athletes' village medical center (AVMC) set up at the athletes' residence for this event.Methods:Demographic data were collected prospectively for each athlete or staff member housed in the athletes' village who presented to AVMC for medical evaluation rather than being cared for by a team physician or at one of the venues. Difficulty in medical treatment secondary to language differences was assessed, by the treating physician on a scale of 0–3.Results:Over the 14 days that the AVMC was in operation, for 24 hours a day, a total of 362 athletes (mean age: 22.9 ±2.9 years, 257 males, 105 females) and 149 accompanying staff (mean age: 39.8 ±11.6 years, 110 males, 39 females) were treated. More than 90 % of the patients were seen between the hours of 0800 and 2400. A broad spectrum of minor medical problems occurred, with musculoskeletal injuries accounting for most of the visits for both athletes (54 %) and staff (27%). Nonsteroidal anti-inflammatory agents and oral antibiotics were the most commonly prescribed medications. On-site radiographic facilities were used for 22% of the athletes and 11% of the staff treated. The majority of patients (92% of athletes, 91% of staff) were discharged from the AVMC. Four of the 12 patients that were transferred to a hospital-based emergency department were admitted to the hospital. Language problems, as assessed by the treating physician, were mostly minor; 25% of the patients had accompanying interpreters. One volunteer Physician, and two to three nurses adequately staffed each shift.Conclusion:The AVMC provided medical care for a large variety of medical problems that could, be treated on-site without transfer to a higher-level facility, thereby providing directed medical care for this special population in a secure environment. Language differences were perceived as a minor problem. This report should be valuable in the planning of medical care at the athletes' residences for similarly large sporting events.

Download Full-text

Understanding the drivers on medical workloads: an analysis of spectators at the Australian Football League

Australian Health Review ◽

10.1071/ah13032 ◽

2013 ◽

Vol 37 (3) ◽

pp. 402 ◽

Cited By ~ 3

Author(s):

Kathryn Zeitz ◽

Pari Delir Haghighi ◽

Frada Burstein ◽

Jeffrey Williams

Keyword(s):

Medical Care ◽

Pearson Correlation ◽

Demand Management ◽

The Body ◽

Emergency Medical Care ◽

Mass Gatherings ◽

Emergency Medical ◽

Australian Football League ◽

Australian Football ◽

Crowd Size

Objective. The present study was designed to further understand the psychosocial drivers of crowds impacting on the demand for healthcare. This involved analysing different spectator crowds for medical usage at mass gatherings; more specifically, did different football team spectators (of the Australian Football League) generate different medical usage rates. Methods. In total, 317 games were analysed from 10 venues over 2 years. Data were analysed by the ANOVA and Pearson correlation tests. Results. Spectators who supported different football teams generated statistically significant differences in patient presentation rates (PPR) (F15, 618 = 1.998, P = 0.014). The present study confirmed previous findings that there is a positive correlation between the crowd size and PPR at mass gatherings but found a negative correlation between density and PPR (r = –0.206, n = 317, P < 0.0005). Conclusions. The present study has attempted to scientifically explore psychosocial elements of crowd behaviour as a driver of demand for emergency medical care. In measuring demand for emergency medical services there is a need to develop a more sophisticated understanding of a variety of drivers in addition to traditional metrics such as temperature, crowd size and other physical elements. In this study we saw that spectators who supported different football teams generated statistically significant differences in PPR. What is known about this topic? Understanding the drivers of emergency medical care is most important in the mass gathering setting. There has been minimal analysis of psychological ‘crowd’ variables. What does this paper add? This study explores the psychosocial impact of supporting a different team on the PPR of spectators at Australian Football League matches. The value of collecting and analysing these types of data sets is to support more balanced planning, better decision support and knowledge management, and more effective emergency medical demand management. What are the implications for practitioners? This information further expands the body of evidence being created to understand the drivers of emergency medical demand and usage. In addition, it supports the planning and management of emergency medical and health-related requirements by increasing our understanding of the effect of elements of ‘crowd’ that impact on medical usage and emergency healthcare.

Download Full-text

Actual problems of emergency medical care

Problems of Uninterrupted Medical Training and Science ◽

10.31071/promedosvity2018.02.005 ◽

2018 ◽

Vol 2018 (2) ◽

pp. 5-11

Author(s):

I.Z. Yakovtsov ◽

Keyword(s):

Medical Care ◽

Emergency Medical Care ◽

Emergency Medical

Download Full-text

Infectious safety of patients in the provision of prehospital care for burns

Medsestra (Nurse) ◽

10.33920/med-05-2004-13 ◽

2020 ◽

pp. 71-75

Author(s):

Marina Dmitryeva

Keyword(s):

Medical Care ◽

Prehospital Care ◽

Medical Professionals ◽

Emergency Medical Care ◽

Emergency Medical

The article describes the measures taken by medical professionals of emergency medical care to observe infectious safety of patients in the provision of pre-medical care in case of burns.

Download Full-text