scholarly journals Injuries Reported by Selected Health Facilities During the Arbaeenia Mass Gathering at Babel Governorate, Iraq, 2014: Retrospective Records Analysis (Preprint)

2018 ◽  
Author(s):  
Abdulaal Chitheer ◽  
Faris Lami ◽  
Ahmed Radhi ◽  
Ali Arbaji
Keyword(s):  
Medical Care ◽  
Traffic Accidents ◽  
Public Hospitals ◽  
Mass Gathering ◽  
Injury Surveillance System ◽  
Mass Gatherings ◽  
Minor Injuries ◽  
Nonfatal Injuries ◽  
Injured Patients ◽  
Fatal Injuries

BACKGROUND Arbaeenia is the largest religious mass gathering in Iraq. The conditions associated with mass gatherings result in high rates of injury. There have been no prior studies on injuries during the Arbaeenia mass gathering. OBJECTIVE This study describes the injuries observed during the Arbaeenia mass gathering in Babel Governorate in Iraq between November 24 and December 14, 2014. METHODS The study was conducted in Babel Governorate at the emergency departments of six public hospitals and two major temporary medical units that were located along the three roads connecting the Middle and Southern Iraqi governorates. We used the Iraq Injury Surveillance System modified form to collect information on injured patients treated in the selected facilities. Data on fatal injuries was obtained from the coroner’s office. The following data were collected from the patients: demographics, outcome of injury, place and time of occurrence, mode of evacuation and medical care before arriving at the hospital, duration of travel from place of occurrence to hospital, disposition of non-fatal injury, cause and mode of injury, and whether the injury occurred in connection with the Arbaeenia mass gathering. RESULTS Information was collected on 1564 injury cases, of which 73 were fatal. About half of the reported nonfatal injuries, 687/1404 (48.9%), and a quarter of fatalities, 18/73 (25%) were related to the Arbaeenia mass gathering (<i>P</i>&lt;.001). Most of the reported injuries were unintentional, 1341/1404 (95.51%), occurred on the street, 864/1323 (65.6%), occurred during the daytime 1103/1174 (93.95 %). Most of those injured were evacuated by means other than ambulance 1107/1206 (91.79%) and did not receive pre-hospital medical care 788/1163 (67.7%). Minor injuries 400/1546 (25.9%) and traffic accidents 394/1546 (25.5%) were the most common types of injuries, followed by falls 270/1546 (17.5%). Among fatal injuries, traffic accidents 38/73 (52%) and violence 18/73 (25%) were the leading causes of death. Mass gathering injuries were more likely to occur among individuals aged 21-40 years (odds ratio [OR] 3.5; 95% CI 2.7-4.5) and &gt;41 years (OR 7.6; 95% CI 5.4-10.6) versus those &lt;21 years; more likely to be unintentional than assault (OR 5.3; 95% CI 1.8-15.5); more likely to happen on the street versus at home (OR 37.7; 95% CI 22.4-63.6); less likely to happen at night than during the day (OR 0.2; 95% CI 0.1-0.4); and less likely to result in hospital admission (OR 0.5; 95% CI 0.3-0.7). CONCLUSIONS The study shows that most injuries were minor, unintentional, and nonfatal, and most people with injuries had limited access to ambulance transportation and did not require hospitalization.

scholarly journals Injuries Reported by Selected Health Facilities During the Arbaeenia Mass Gathering at Babel Governorate, Iraq, 2014: Retrospective Records Analysis

10.2196/10877 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e10877
Author(s):  
Abdulaal Chitheer ◽  
Faris Lami ◽  
Ahmed Radhi ◽  
Ali Arbaji
Keyword(s):  
Medical Care ◽  
Traffic Accidents ◽  
Public Hospitals ◽  
Mass Gathering ◽  
Injury Surveillance System ◽  
Mass Gatherings ◽  
Minor Injuries ◽  
Nonfatal Injuries ◽  
Injured Patients ◽  
Fatal Injuries

Background Arbaeenia is the largest religious mass gathering in Iraq. The conditions associated with mass gatherings result in high rates of injury. There have been no prior studies on injuries during the Arbaeenia mass gathering. Objective This study describes the injuries observed during the Arbaeenia mass gathering in Babel Governorate in Iraq between November 24 and December 14, 2014. Methods The study was conducted in Babel Governorate at the emergency departments of six public hospitals and two major temporary medical units that were located along the three roads connecting the Middle and Southern Iraqi governorates. We used the Iraq Injury Surveillance System modified form to collect information on injured patients treated in the selected facilities. Data on fatal injuries was obtained from the coroner’s office. The following data were collected from the patients: demographics, outcome of injury, place and time of occurrence, mode of evacuation and medical care before arriving at the hospital, duration of travel from place of occurrence to hospital, disposition of non-fatal injury, cause and mode of injury, and whether the injury occurred in connection with the Arbaeenia mass gathering. Results Information was collected on 1564 injury cases, of which 73 were fatal. About half of the reported nonfatal injuries, 687/1404 (48.9%), and a quarter of fatalities, 18/73 (25%) were related to the Arbaeenia mass gathering (P<.001). Most of the reported injuries were unintentional, 1341/1404 (95.51%), occurred on the street, 864/1323 (65.6%), occurred during the daytime 1103/1174 (93.95 %). Most of those injured were evacuated by means other than ambulance 1107/1206 (91.79%) and did not receive pre-hospital medical care 788/1163 (67.7%). Minor injuries 400/1546 (25.9%) and traffic accidents 394/1546 (25.5%) were the most common types of injuries, followed by falls 270/1546 (17.5%). Among fatal injuries, traffic accidents 38/73 (52%) and violence 18/73 (25%) were the leading causes of death. Mass gathering injuries were more likely to occur among individuals aged 21-40 years (odds ratio [OR] 3.5; 95% CI 2.7-4.5) and >41 years (OR 7.6; 95% CI 5.4-10.6) versus those <21 years; more likely to be unintentional than assault (OR 5.3; 95% CI 1.8-15.5); more likely to happen on the street versus at home (OR 37.7; 95% CI 22.4-63.6); less likely to happen at night than during the day (OR 0.2; 95% CI 0.1-0.4); and less likely to result in hospital admission (OR 0.5; 95% CI 0.3-0.7). Conclusions The study shows that most injuries were minor, unintentional, and nonfatal, and most people with injuries had limited access to ambulance transportation and did not require hospitalization.

scholarly journals The burden of injury in Brazil, 2003

2006 ◽  
Vol 124 (4) ◽  
pp. 208-213 ◽  
Author(s):  
Vilma Pinheiro Gawryszewski ◽  
Eugênia Maria Silveira Rodrigues
Keyword(s):  
Population Based ◽  
Public Hospitals ◽  
National Data ◽  
Young Males ◽  
Intentional Injuries ◽  
Injury Mortality ◽  
Unintentional Falls ◽  
Nonfatal Injuries ◽  
Nonfatal Injury ◽  
Fatal Injuries

CONTEXT AND OBJECTIVE: Since 1980, injuries have been the second biggest cause of death among the Brazilian population. This study aimed to analyze national data on fatal injuries and nonfatal injury hospitalization in Brazil, for 2003. DESIGN AND SETTING: This was a population-based descriptive study, Brazil, 2003. METHODS: Data from 126,520 fatal injuries and 733,712 nonfatal injuries seen at public hospitals were analyzed. The data were stratified by sex, age, intent and injury mechanism. Raw and age- and sex-specific rates were calculated per 100,000 individuals. RESULTS: The raw injury mortality rate was 71.5/100,000 (122.6/100,000 for male and 22.0/100,000 for female). For fatal injuries, the proportions of unintentional and intentional injuries were equal (44.3% and 46.9%, respectively). Homicides were the leading cause, 40.3% overall (28.8/100,000), followed by transport-related deaths, 26.2% overall (17.0/100,000). For nonfatal injuries, the rate was 414.8/100,000 and unintentional injuries were predominant (88.9%). Overall, the leading cause was unintentional falls, accounting for 42.6% of victims treated in public hospitals (176.8/100,000). Transport-related injuries were second: 15.0% overall; 62.0/100,000. Fractures comprised 46.7% of principal diagnoses at hospitals. The injury types in the fatal and nonfatal datasets varied according to sex and age. The highest rates were found among young males and elderly people. CONCLUSIONS: Injury prevention activities need to be developed. To prevent deaths, homicide has to be addressed. Among hospitalized cases, falls are the most important problem. Traffic-related injuries play an important role in morbidity and mortality.

Physician Integration into Mass Gathering Medical Care: The United States Air Show

1993 ◽  
Vol 8 (2) ◽  
pp. 165-168 ◽  
Author(s):  
Michael F. Boyle ◽  
Robert A. De Lorenzo ◽  
Richard Garrison
Keyword(s):  
United States ◽  
Medical Care ◽  
The United States ◽  
Vital Role ◽  
Mass Gathering ◽  
Limited Information ◽  
Physician Staffing ◽  
Small Patient Population ◽  
Minor Injuries ◽  
Physician Integration

AbstractIntroduction:Limited information exists concerning physician staffing at mass gathering events.Methods:A retrospective review of the preparation, planning, and provision of medical care for the United States Air Show was performed. Patient encounters from the air show for the years 1981–1991 also were evaluated.Results:The frequency rate of overall encounters was 8.45 patients/10,000 spectators and hospital transport rate was 0.6/10,000 spectators. The majority of complaints were related to heat or minor injuries. During this period, emergency physicians played a vital role in both medical planning and on-site staffing. Emergency medicine residents also participated. A small patient population received direct benefit from on-site physician intervention.Conclusion:The on-site emergency physician is of benefit in event preplanning and reducing the burden on the EMS system during mass gathering events.

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

2004 ◽  
Vol 19 (04) ◽  
pp. 287-296 ◽  
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.

Use and Analysis of Field Triage Criteria for Mass Gatherings

2003 ◽  
Vol 18 (4) ◽  
pp. 347-352 ◽  
Author(s):  
Steven D. Salhanick ◽  
William Sheahan ◽  
Jeffrey J. Bazarian
Keyword(s):  
Emergency Department ◽  
Medical Care ◽  
Emergency Medical Services ◽  
Patient Contact ◽  
Mass Gathering ◽  
Hospital Services ◽  
Mass Gatherings ◽  
Field Triage ◽  
Medical Facilities ◽  
Acute Increase

AbstractIntroduction:Mass gatherings may result in an acute increase in the number of people seeking medical care potentially causing undue stress to local emergencymedical services (EMS) and hospitals. Often, temporary medical facilities are established within the mass gathering venue. Emergency Medical Services providers encountering patients in the field should be equipped with effective protocols to determine transport destination (venue facility vs. hospital).Hypothesis:Paramedics are capable of appropriately using triage criteria written specifically for a particular mass gathering. The use of triage criteria, when appliedcorrectly, decreases over-triage to the venue facility and under-triage to the hospital.Methods:Paramedics triaged patients at a mass gathering to a temporary venue facility or to a single emergency department using criteria specific for the event. Cases were reviewed to determine if the patients transported went to an appropriate facility and if the triage criteria were applied appropriately. Results: Transport destination was consistent with that dictated by the criteria for 78% of cases. Analysis of these cases shows that the criteria had a sensitivity of 100% (95% CI = 58–100%) and a specificity of 90% (95% CI = 73–98%) for predicting which patients needed hospital services and which could be cared for safely in the temporary clinic setting.Conclusions:Triage by paramedics at the point of patient contact may reduce transporting of patients to hospitals unnecessarily. Patients in need of hospital services were identified. Point-of-contact triage should be applied in mass gatherings.

Mass Gathering Medical Care: A Twenty-Five Year Review

1997 ◽  
Vol 12 (4) ◽  
pp. 72-79 ◽  
Author(s):  
John A. Michael ◽  
Joseph A. Barbera
Keyword(s):  
Medical Care ◽  
English Language ◽  
Case Reports ◽  
Rank Correlation ◽  
Climatic Conditions ◽  
Sporting Events ◽  
Mass Gathering ◽  
Primary Analysis ◽  
Mass Gatherings ◽  
Number Of Patients

AbstractIntroduction:The purpose of this study was to critically review the provision of medical care at mass gatherings as described in 25 years of case reports. Specifically measured was the relationship between the size of a mass gathering and the frequency of patients seeking medical aid and the effects of certain event characteristics on this relationship.Methods:Data were obtained through a retrospective literature review. Medline and CINHAL computerized databases were searched for English language articles using several keywords: “mass gathering”, “concert”, “festival”, “Olympics”, “crowd”, “riot”, “stadium”, “sports”, “games”, “papal”, and “football”. Only articles containing complete information on the number of spectators, number of patients, type, location, and duration of the mass gathering were included in the primary analysis. As available, additional information was added including the described weather patterns, number of patients transported to a hospital, and number of patients suffering a cardiac arrest. Thirty-five of the approximately 100 articles reviewed, met these criteria.Results:A Spearman Rank Correlation Coefficient was calculated for number of spectators and patients and a significant relationship was identified (p = 0.0001). Mann-Whitney U-tests indicated that papal masses (p = 0.04), rock concerts (p = 0.005), hot climatic conditions (p = 0.03) and events held in the British Commonwealth (p = 0.03) had a significantly higher frequency of patient visits. Significantly more cardiac arrests occurred at papal masses (p = 0.04) and sporting events (p = 0.0002).Conclusion:Type of event, country, weather, and the size of the mass gathering had a significant effect on the numbers of spectators seeking medical care. A uniform classification scheme is necessary for future prospective studies of mass gatherings.

Medical Care at Mass Gatherings: Considerations for Physician Involvement

1995 ◽  
Vol 10 (4) ◽  
pp. 273-275 ◽  
Author(s):  
Steven J. Parrillo
Keyword(s):  
Medical Care ◽  
Mass Gathering ◽  
Emergency Medical Care ◽  
Mass Gatherings ◽  
Public Events ◽  
Medical Needs ◽  
Mass Public ◽  
Emergency Medical ◽  
Delivery Of Medical Care ◽  
Few Data

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.

scholarly journals Anatomy of a “Mass” Mass Gathering

2019 ◽  
Vol 34 (s1) ◽  
pp. s38-s38
Author(s):  
Michael Molloy ◽  
Ciaran Browne ◽  
Tom Horwell ◽  
Jason VanDeVelde ◽  
Patrick Plunkett
Keyword(s):  
Medical Care ◽  
Access Point ◽  
Medical Attention ◽  
Point System ◽  
Mass Gathering ◽  
Mass Gatherings ◽  
Number Of Patients ◽  
Medical Reports ◽  
The Media ◽  
Medical Attendance

Introduction:Mass gatherings are growing in frequency. Religious, or in this case, “mass” mass gatherings are also growing in complexity, requiring considerable effort from nations hosting a Papal Mass. Ireland hosted a papal mass in 1979 when the prospect of terrorism at such events was significantly lower. Large high-profile events such as a Papal Mass offer a platform via the media and social media to gain widespread coverage of adverse events. In 2018, a predicted 500,000 guests were scheduled to attend a Papal Mass gathering in Phoenix Park, Dublin, a bounded 1,700-hectare park in the center of Dublin.Aim:To develop a medical plan estimating numbers of people requiring medical attention at a Papal Mass held in Ireland late August 2018, and compare same with actual numbers treated post-event. This study aims to reduce the medical impact of such an event on local receiving hospitals through plans that effectively manage medical- and trauma-related presentations on site.Methods:A literature review of medical reports regarding medical care at Papal Mass gatherings worldwide found a range of predicted medical attendance from 21-61 per 10,000 attendees. On that basis we had prepared on-site facilities, facilities on travel routes and access point system for medical care for a crowd of 500,000 were selected.Results:One of 6 receiving hospitals in Dublin had an increase in average presentations on the day. Attendance was reduced significantly due to weather. 261 patients were treated on site, falling in line with lower rate predicted of 31 patients treated in hospital on site and 17 transports off-site.Discussion:A predictable number of patients presented for medical care. On-site medical services reduced transports to hospital. Reduced attendance ensured facilities were sufficient, but could have been under the pressure of the predicted attendance of 500,000.

Mass Gathering Medicine: A Review

1997 ◽  
Vol 12 (1) ◽  
pp. 68-72 ◽  
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.

scholarly journals (P2-42) Mass-Gathering Risks in the Beijing Subway System

2011 ◽  
Vol 26 (S1) ◽  
pp. s149-s149
Author(s):  
W. Du ◽  
G. Fitzgerald
Keyword(s):  
Health And Safety ◽  
Significant Risk ◽  
Mass Gathering ◽  
Psychosocial Risks ◽  
Mass Gatherings ◽  
Biomedical Monitoring ◽  
Safety Aspects ◽  
Safety And Health ◽  
Subway System ◽  
Beijing Subway

IntroductionMass gatherings pose a significant risk on health and safety. The mass gathering in the subway systems in Beijing represents a daily risk. An average of 4.52 million passengers rode the subway each day between 15 November and 30 November 2010, with the highest daily passenger number totaling 5.14 million. The purpose of this study is to identify the health and safety aspects of mass gatherings in Beijing subways, and proposes strategies that may mitigate these risks.MethodsThe methods included a literature review, field visitation of the subway systems, and interviews of 20 passengers and 10 management personnel from the subway system.ResultsMany safety and health measures has been taken by the Beijing Subway System, including emergency exit signs and other safety signs, prohibition of smoking, firefighting equipment and explosion-proof tanks, safety inspection of bags, and safety education in the subways. However, additional key health and safety aspects were indentified, including: (1) lack of strict flow control of passengers in interchange subway stations; (2) lack of platform safety gates in Line 1, Line 2, Line 13; (3) lack of passenger control during peak hours; (4) lack of biomedical monitoring systems in the subways; and (5) lack of health facilities and rescue equipments in the subways.ConclusionsMass gatherings pose great risks on subway passengers in Beijing, including psychosocial risks, biomedical risks, and environmental risks. Additional safety measures need to be taken to ensure the safety and health of passengers in subways in Beijing.

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