MEDICAL SUPPORT FOR MASS GATHERINGS
Section snippets
THE SCOPE OF THE PROBLEM
Although the bulk of the medical care delivered to people at a "crowd scene" is of the "bandaid and aspirin" variety, the attending emergency physician must be ready to deal with major events such as acute myocardial infarction, respiratory failure, or precipitous childbirth.
Likewise, although the emergency physicians will expect to treat a "reasonable" number of people seeking medical care, the emergency planner must understand that any huge crowd of people is capable of presenting a true
Information Gathering
Before making any plans, the emergency planner must gather some initial information. Any event, large or small, is being organized by some group that has someone in charge of the overall operation. The emergency planner should formally meet with this person to ascertain what is expected of the emergency medical group and to learn of his or her understanding of the level of medical care expected. This is the time to discuss what is reasonable and what is not.
If other groups (Boy Scouts, Red
Duration
A very important question is how long the event will last: a day, a weekend, a week or longer, and during what hours it will be open to the public. This information will help to determine how many people will be needed to staff the medical aid stations. Keep in mind the necessity of having the aid stations staffed before the crowd arrives as well as a predetermined amount of time after closing.
Site Layout
The layout of the site must be known in detail before any plans are made. A small site, such as a
Anticipated Types of Medical Problems
An obviously important piece of information to have is the types of medical problems to anticipate. Some of the previously determined variables will give some idea of special problems with which the emergency planner may be faced (Table 1).
Of course, the emergency team should be ready to deal with the full range of cardiac problems as per advanced cardiac life support (ACLS) protocols, as well as with respiratory problems such as asthma, choking, or respiratory failure. Also a consideration is
OTHER CONSIDERATIONS
Summertime is the usual time for "big" outdoor events, which means there may be a big demand for water, something the organizer may not have considered. If possible, it would certainly reduce the number of patients with heat-related illnesses if drinking water was provided. Also, if large numbers of people are getting overheated, outdoor sprinklers could be provided to cool them off.
On a similar note, if band members are standing around in hot uniforms waiting to perform, emergency team members
FURTHER READING
Space constraints prohibit discussion of all papers in the literature. Accordingly, Table 5 lists types of events and cites an article or articles on this topic that will provide further information.
AFTER THE EVENT
At the conclusion of the event, a discussion should be held with the event organizers, security, and the medical teams to learn what went right and, even more important, what went wrong. Ideas on how to improve medical care should be solicited. A final report will help for future medical planning. Remember to compile the data from the patient encounter forms for future use.
Last, a final gesture should be a formal "thank you" letter to all volunteers and donators of supplies and equipment.
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Cited by (41)
Large-event medicine-event characteristics impacting medical need
2011, American Journal of Emergency MedicineCitation Excerpt :If an event planner does not have particular experience with that type of event, then he or she is likely to benefit from examining MUR at similar events in the past. Environmental concerns are among the most commonly cited factors that contribute to the need for medical resources at large events [1,7-15]. Inclement weather can directly contribute to the development of illness and injury, affect significant numbers of attendees simultaneously, and inhibit the response of medical personnel [5].
Mass gathering emergency medicine: A review of the taiwan experience of long-distance swimming across sun-moon lake
2010, International Journal of GerontologyHospital-based healthcare provider (nurse and physician) integration into an emergency medical services-managed mass-gathering event
2007, American Journal of Emergency MedicineCitation Excerpt :The majority of research on mass gathering medical care (MGMC) has focused on describing variables that influence the number and types of patients seen at mass gatherings in an effort to anticipate medical care needs at these events [4,5]. Several groups have expressed a need for uniformity or standardization of MGMC, and several guidelines have been written including recommendations for physician and nonphysician staffing levels based on crowd size and other variables such as nature of the event, local environmental conditions, and the presence of alcohol [6-10]. Yet, the need for physician involvement at mass gathering events continues to be debated; in fact, several studies have aimed to describe the arguments for and against physician staffing [11,12].
Wilderness event medicine: Planning for mass gatherings in remote areas
2005, Travel Medicine and Infectious DiseaseCritical illness at mass gatherings is uncommon
2003, Journal of Emergency Medicine
Address reprint requests to Ralph B. Leonard, PhD, MD, FACEP, Department of Emergency Medicine, Bowman Gray School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1089
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From the Department of Emergency Medicine, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina