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Larson EG, Hasley I, Post EG, Cali MG, Clark SC, McPherson AL, Noble-Taylor KE, Robinson DM, Anderson T, Finnoff J, Adams WM. Incidence of staff injury and illness at the Tokyo 2020 and Beijing 2022 Olympic and Paralympic Games. BMJ Open Sport Exerc Med 2024; 10:e001835. [PMID: 38645762 PMCID: PMC11029204 DOI: 10.1136/bmjsem-2023-001835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2024] [Indexed: 04/23/2024] Open
Abstract
Objective To report epidemiological data regarding injury and illness among the Team USA staff during the Tokyo 2020 Summer Olympic and Paralympic Games and Beijing 2022 Winter Olympic and Paralympic Games. Methods A retrospective review of all Team USA staff (total staff, N=1703 (62.5% female); total staff days (SD)=34 489) medical encounters during the Tokyo 2020 Games and Beijing 2022 Games was conducted. Details related to injury and illness were evaluated. Incidence with 95% CI per 1000 staff days were calculated. Results A total of 32 illnesses (incidence [95% CI] 0.9 [0.6, 1.2]) and 23 injuries (incidence 0.7 [0.4, 0.9]) were sustained by the Team USA delegation staff members during the Tokyo 2020 Games and Beijing 2022 Games. Female staff reported more illnesses (illnesses proportion (IP) 2.9%; incidence 1.4 [0.8, 2.0]), while male staff incurred more injuries (IP 1.8%; incidence 0.9 [0.5, 1.3]). When stratified by physiological system, dermatological and infectious were the most common systems involved with illness (IP 0.5%; incidence 0.2 [0.1, 0.4]). Injuries to the upper limb were most common (IP 0.3%; incidence 0.3 [0.1, 0.5]). Conclusion Injury and illness rates among the Team USA staff during the Tokyo 2020 Games and Beijing 2022 Games were low, but notable. Knowledge of injury and illness risks contributes to staffing decisions and prevention strategies for staff supporting athletes during competition.
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Affiliation(s)
- Emily G Larson
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA
| | - Ike Hasley
- Summit Orthopedics and Sports Medicine, Woodbury, Minnesota, USA
| | - Eric G Post
- Department of Sports Medicine, United States Olympic and Paralympic Committee, Colorado Springs, Colorado, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA
| | - Malia G Cali
- Department of Physical Medicine and Rehabilitation, Steadman Philippon Research Institute, Vail, Colorado, USA
| | - Stephanie C Clark
- Family Medicine, Rehabilitation and Performance Medicine Swedish Medical Group, Seattle, Washington, USA
| | - April L McPherson
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, Georgia, USA
- Department of Orthopedics, The Ohio State University, Columbus, Ohio, USA
| | | | - David M Robinson
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital Boston, Boston, Massachusetts, USA
| | - Travis Anderson
- Department of Sports Medicine, United States Olympic and Paralympic Committee, Colorado Springs, Colorado, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA
| | - Jonathan Finnoff
- Department of Sports Medicine, United States Olympic and Paralympic Committee, Colorado Springs, Colorado, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado, USA
| | - William M Adams
- Department of Sports Medicine, United States Olympic and Paralympic Committee, Colorado Springs, Colorado, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Asberry C, Copper D. The History of Vertical Flight and Air Medical Transport. Crit Care Nurs Q 2024; 47:95-101. [PMID: 38419172 DOI: 10.1097/cnq.0000000000000497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Vertical flight was sought-after by scientists for centuries, finding early beginnings in children's toys and slowly developing into the modern helicopter. For centuries, true success was elusive, and many machines failed to achieve safe, controlled flight. Despite slow progress, vertical flight enthusiasts were unrelenting and continued trialing new concepts until one finally rose above the rest. As technology advanced, the critical role of helicopters in medical evacuation became apparent. Throughout recent history, continuous progress in vertical flight technology has led to widespread and multifaceted use of helicopters in civilian and military medical operations.
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Affiliation(s)
- Cassandra Asberry
- AHN LifeFlight, Pittsburgh, Pennsylvania; and Allegheny General Hospital, Pittsburgh, Pennsylvania
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Han PD, Gao D, Liu J, Lou J, Tian SJ, Lian HX, Niu SM, Zhang LX, Wang Y, Zhang JJ. Medical services for sports injuries and illnesses in the Beijing 2022 Olympic Winter Games. World J Emerg Med 2022; 13:459-466. [PMID: 36636567 PMCID: PMC9807383 DOI: 10.5847/wjem.j.1920-8642.2022.106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/02/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Beijing 2022 Olympic Winter Games was the second Games held amid the COVID-19 pandemic. To a certain extent, it has altered the way sporting activities operate. There is a lack of knowledge on injury risk and illness occurrence in elite winter sport athletes amid the COVID-19 pandemic. This study aimed to describe the incidence of injuries and illnesses sustained during the XXIV Olympic Winter Games in Beijing from February 4 to 20, 2022. METHODS We recorded the daily number of injuries and illnesses among athletes reported by Beijing 2022 medical staff in the polyclinic, medical venues, and ambulance. We calculated injury and illness incidence as the number of injuries or illnesses occurring during competition or training, respectively, with incidence presented as injuries/illnesses per 100 athlete-days. RESULTS In total, 2,897 athletes from 91 nations experienced injury or illness. Beijing 2022 medical staff reported 326 injuries and 80 illnesses, equaling 11.3 injuries and 2.8 illnesses per 100 athletes over the 17-day period. Altogether, 11% of the athletes incurred at least one injury and nearly 3% incurred at least one illness. The number of injured athletes was highest in the skating sports (n=104), followed by alpine skiing (n=53), ice track (n=37), freestyle skiing (n=36), and ice hockey (n=35), and was the lowest in the Nordic skiing disciplines (n=20). Of the 326 injuries, 14 (4.3%) led to an estimated absence from training or competition of more than 1 week. A total of 52 injured athletes were transferred to hospitals for further care. The number of athletes with illness (n=80) was the highest for skating (n=33) and Nordic skiing (n=22). A total of 50 illnesses (62.5%) were admitted to the department of dentistry/ophthalmology/otolaryngology, and the most common cause of illness was other causes, including preexisting illness and medicine (n=52, 65%). CONCLUSION Overall, 11% of athletes incurred at least one injury during the Games, which is similar to the findings during the Olympic Winter Games in 2014 and 2018. Regarding illness, 2% of athletes were affected, which is approximately one-third of the number affected in the 2018 Olympic Winter Games.
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Affiliation(s)
- Peng-da Han
- Emergence Medical Service Group for Beijing 2022 Olympic Winter Games, Beijing Emergency Medical Center, Beijing 100031, China
| | - Ding Gao
- Emergence Medical Service Group for Beijing 2022 Olympic Winter Games, Beijing Emergency Medical Center, Beijing 100031, China
| | - Jie Liu
- Emergence Medical Service Group for Beijing 2022 Olympic Winter Games, Beijing Emergency Medical Center, Beijing 100031, China,Department of General Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Jing Lou
- Emergence Medical Service Group for Beijing 2022 Olympic Winter Games, Beijing Emergency Medical Center, Beijing 100031, China,Games Services Department, Beijing Organizing Committee for the 2022 Olympic and Paralympic Winter Games, Beijing 100041, China
| | - Si-jia Tian
- Emergence Medical Service Group for Beijing 2022 Olympic Winter Games, Beijing Emergency Medical Center, Beijing 100031, China
| | - Hui-xin Lian
- Emergence Medical Service Group for Beijing 2022 Olympic Winter Games, Beijing Emergency Medical Center, Beijing 100031, China
| | - Sheng-mei Niu
- Emergence Medical Service Group for Beijing 2022 Olympic Winter Games, Beijing Emergency Medical Center, Beijing 100031, China
| | - Lu-xi Zhang
- Emergence Medical Service Group for Beijing 2022 Olympic Winter Games, Beijing Emergency Medical Center, Beijing 100031, China
| | - Yong Wang
- Emergence Medical Service Group for Beijing 2022 Olympic Winter Games, Beijing Emergency Medical Center, Beijing 100031, China,
Yong Wang,
| | - Jin-jun Zhang
- Emergence Medical Service Group for Beijing 2022 Olympic Winter Games, Beijing Emergency Medical Center, Beijing 100031, China,Corresponding Authors: Jin-jun Zhang, ;
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Kim K, Jang JY, Moon G, Shim H, Jung PY, Kim S, Choi YU, Bae KS. Experiences of the Emergency Department at the Pyeongchang Polyclinic During the 2018 PyeongChang Winter Olympic Games. Yonsei Med J 2019; 60:474-480. [PMID: 31016910 PMCID: PMC6479134 DOI: 10.3349/ymj.2019.60.5.474] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 02/27/2019] [Accepted: 03/06/2019] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The 2018 PyeongChang Winter Olympic Games involved 2925 elite athletes, and providing proper health care services for these elite athletes was a critical priority. We established an emergency department (ED) in the Pyeongchang Mountain Polyclinic during the Olympics, which served staff and athletes from many countries. This experience, as well as a description of illnesses and injuries encountered during the games, may provide useful information for planning medical care at similar events in the future. MATERIALS AND METHODS The polyclinic ED operated from January 25 to February 27, 2018. All cases were enrolled in this study, and their data were analyzed by date and category. In addition, the number of injuries by body part, number of illnesses by organ system, and illness symptoms and causes were analyzed. RESULTS In total, 288 patients were encountered in the ED. These included 113 injuries and 175 illnesses. We consulted with 153 staff members and 75 athletes, and reported that the fingers were the most commonly injured body part, followed by the knee. The respiratory system was the most commonly involved organ system, and the most common cause of illness was infection. Thirty-eight influenza tests were performed, among which the results of seven were positive. We performed 17 norovirus tests, among which the results of four were positive. CONCLUSION Our analysis of our ED experience will aid arrangements for medical services in future Winter Games. Additionally, given our new experience, we will now be able to provide better medical services for future winter sports events.
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Affiliation(s)
- Kwangmin Kim
- Department of Surgery, Saidabad Clinic, Dhaka, Bangladesh
| | - Ji Young Jang
- Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
- Trauma Center, Wonju Severance Christian Hospital, Wonju, Korea
| | - Gilseong Moon
- Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hongjin Shim
- Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
- Trauma Center, Wonju Severance Christian Hospital, Wonju, Korea
| | - Pil Young Jung
- Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
- Trauma Center, Wonju Severance Christian Hospital, Wonju, Korea
| | - Sungyup Kim
- Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
- Trauma Center, Wonju Severance Christian Hospital, Wonju, Korea
| | - Young Un Choi
- Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
- Trauma Center, Wonju Severance Christian Hospital, Wonju, Korea
| | - Keum Seok Bae
- Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
- Trauma Center, Wonju Severance Christian Hospital, Wonju, Korea.
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Watanabe K, Akama T, Asakawa S, Fukuda K, Sakai H, Okuwaki T, Imai T, Sato H, Katayose M, Jegathesan M, Shamali NA. Medical services at the 2017 Sapporo Asian winter games: injury and illness epidemiology at a 34-nation multisport event. Br J Sports Med 2018; 53:32-36. [PMID: 30315117 DOI: 10.1136/bjsports-2018-099061] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We describe the medical services provided and report the injuries and illnesses that occurred at the eighth Asian Winter Games 2017. METHODS A total of 2010 athletes and team officials from 32 National Olympic Committees and 2 guest countries attended this event; medical services were provided for 16 days. Medical data (medical care and physiotherapy) were collected for the same period by the organising committee for athletes and non-athletes (team officials, workforce, media and spectators) and recorded on the electronic medical record system at the medical rooms in the venues and the team residences. RESULTS We recorded 745 medical encounters (medical care, 443; physiotherapy, 302), of which 549 (74%) were among athletes. There were 214 injuries as well as 144 illnesses and other medical conditions. Of the 1164 athletes, 549 (47%) utilised the services. Ice hockey, snowboarding and alpine skiing had high rate of medical encounters. More than half of the delegations were not accompanied by team doctor, and rate of medical encounters was high in these teams. The vast majority of patients transferred to hospital for further care were mostly athletes (n=36 out of 41), mostly alpine skiers and ice hockey players. CONCLUSION Injuries and illnesses varied depending on NOC medical staffing and sport events. These data will serve organisers of medical and physiotherapy services in the Asian Winter Games and similar large events.
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Affiliation(s)
- Kota Watanabe
- Medical Committee of the 8th Asian Winter Games Organising Committee, Sapporo, Japan.,Department of Physical Therapy, Sapporo Medical University, Sapporo, Japan
| | - Takao Akama
- Medical Committee of the 8th Asian Winter Games Organising Committee, Sapporo, Japan.,Faculty of Sports Sciences, Waseda University, Tokorozawa, Japan
| | - Shin Asakawa
- Medical Committee of the 8th Asian Winter Games Organising Committee, Sapporo, Japan.,The Japan Anti-Doping Agency, Tokyo, Japan
| | - Kimitaka Fukuda
- Medical Committee of the 8th Asian Winter Games Organising Committee, Sapporo, Japan.,Ito Seikeigeka Hospital, Sapporo, Japan
| | - Hiroya Sakai
- Medical Committee of the 8th Asian Winter Games Organising Committee, Sapporo, Japan.,Saitama Prefectural University, Koshigaya, Japan
| | - Toru Okuwaki
- Medical Committee of the 8th Asian Winter Games Organising Committee, Sapporo, Japan.,Japan Institute of Sports Sciences, Tokyo, Japan
| | - Tomohito Imai
- Medical Committee of the 8th Asian Winter Games Organising Committee, Sapporo, Japan.,Ito Seikeigeka Hospital, Sapporo, Japan
| | - Hiroko Sato
- Medical Committee of the 8th Asian Winter Games Organising Committee, Sapporo, Japan.,Iwate Prefectural Isawa Hospital, Oshu, Japan
| | - Masaki Katayose
- Medical Committee of the 8th Asian Winter Games Organising Committee, Sapporo, Japan.,Department of Physical Therapy, Sapporo Medical University, Sapporo, Japan
| | - Manikavasagam Jegathesan
- Medical Committee and Anti-Doping Commission of the Olympic Council of Asia, Kuwait City, Kuwait
| | - Nadia Al Shamali
- Medical Committee and Anti-Doping Commission of the Olympic Council of Asia, Kuwait City, Kuwait
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6
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Bibliometric indicators to identify emerging research fields: publications on mass gatherings. Scientometrics 2016. [DOI: 10.1007/s11192-016-2083-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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7
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ROSS COLLEEN, BAŞDERE MEHMET, CHAN JENNIFERL, MEHROTRA SANJAY, SMILOWITZ K, CHIAMPAS GEORGE. Data Value in Patient Tracking Systems at Racing Events. Med Sci Sports Exerc 2015; 47:2014-23. [DOI: 10.1249/mss.0000000000000637] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Soomaroo L, Murray V. Weather and environmental hazards at mass gatherings. PLOS CURRENTS 2012; 4:e4fca9ee30afc4. [PMID: 22953242 PMCID: PMC3426156 DOI: 10.1371/4fca9ee30afc4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction
Reviews of mass gathering events have traditionally concentrated on crowd variables that affect the level and type of medical care needed. Weather and environmental hazards at mass gathering events have not been fully researched. This review examines these events and aims to provide future suggestions for event organisers, medical resource planners, and emergency services, including local hospital emergency departments.
Methods
A review was conducted using computerised data bases: MEDLINE, The Cochrane Library, HMIC and EMBASE, with Google used to widen the search beyond peer-reviewed publications, to identify grey literature. All peer-review literature articles found containing information pertaining to lessons identified from mass gathering disasters due to weather or environmental hazards leading to participant death, injury or illness were analysed and reviewed. Disasters occurring due to crowd variables were not included. These articles were read, analysed, abstracted and summarised.
Results
20 articles from literature search were found detailing mass gathering disasters relating directly to weather or environmental hazards from 1988 – 2011, with only 17 cases found within peer-review literature. Two events grey literature from 2011 are due to undergo further inquiry while one article reviews an event originally occurring in 1922. Analysis of cases were categorised in to heat and cold-related events, lightning and storms and disease outbreak.
Conclusions
Mass gathering events have an enormous potential to place a severe strain on the local health care system, Prior health resource and environmental planning for heat & cold-related illness, lightning & storms, and disease outbreak can advance emergency preparedness and response to potential disasters.
Citation: Soomaroo L, Murray V. Weather and Environmental Hazards at Mass Gatherings. PLoS Currents Disasters. 2012 Jul 31
Keywords: Mass Gatherings, Disasters, Sporting Events, Festivals, Concerts, Storm, Lightning, Cyclone, Hot-weather illness, Cold-weather illness, Disease, Public Health, Syndromic Surveillance
Abbreviations: ALS – Advance Life support; BLS – Basic Life support; ED – Emergency Department;
EMS – Emergency Medical Services; PPR – Patient Presentation Rate
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10
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Experience of Health-Related Problems during House Parties in the Netherlands: Nine Years of Experience and Three Million Visitors. Prehosp Disaster Med 2012; 24:133-9. [DOI: 10.1017/s1049023x00006695] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:The objective of this study was to report on a nine years of experience of providing medical support during house parties (raves) in the Netherlands, where they can be organized legally.Design:This was a prospective, observational study of self-referred patients from 1997 to 2005. During raves, first aid stations are staffed with specifically trained medical and paramedical personnel. Self-referred patients were diagnosed, treated, and recorded using standardized methods.Results:During a nine-year period with 219 raves occurred, involving approximately three million participants, 23,581 patients visited the first aid stations. The medical usage rate (MUR) varied from 59–170 patients per 10,000 rave participants. The mean age increased from 1997 to 2005 from 18.7 ±2.7 to 23.3 ±5.7 years. The mean stay at the first aid station was 18 ±46 minutes. Most health problems were mild. Fifteen cases of severe incidents were observed with one death.Conclusions:Unique data from the Netherlands demonstrate a low number of serious, health-related, short-term problems during raves.
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Thierbach AR, Wolcke BB, Piepho T, Maybauer M, Huth R. Medical Support for Children's Mass Gatherings. Prehosp Disaster Med 2012; 18:14-9. [PMID: 14694895 DOI: 10.1017/s1049023x00000625] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractIntroduction:Medical care must be well-planned for mass gatherings. Events such as fairs, concerts, parades, and rallies cause many people to gather in one place, increasing the chance of injuries and for the development of a disaster. In this study, the level and quality of medical care were evaluated at a mass gathering of approximately 100,000 children. The event was a television-sponsored fun fair.Methods:Every patient contact was documented on printed forms, including data such as the number of patients treated, gender of the patients, presence or absence of a parental escort, time distribution of patient contacts, the diagnoses for the patient contacts, specific therapies applied, duration of the treatment, and patient discharge information. All data were coded after the event and transferred into a computer database. These data were analyzed using descriptive statistics.Results:Of the 100,000 spectators, 192 patients (81 male [42.2%] and 111 female [57.8%]) were treated during the nine-hour period, from 09:00 hours (h) until 18:00 h. Twenty percent of all the children up to the age of 10 years needing medical assistance were not accompanied by an adult. Seventy-five percent of all patient contacts were made during the afternoon. Of those treated, 164 patients (85.4%) suffered only minor injuries and were seen for <10 minutes. The most common type of complaint was minor trauma (103 patients, 53.6%); followed by minor medical problems such as headaches or light allergic reactions (21 patients, 10.9%); insect bites (20 patients, 10.4%); and serious medical problems or trauma such as severe arterial hypertension or long bone fractures (19 patients, 9.9%). Treatment included, but was not limited to, dressings (100 patients; 52.1%), local therapy (68 patient, 35.4%), and analgesic therapy (10 patients, 5.2%). Four patients (2%) were transferred to local hospitals.Conclusion:Most of the medical needs in the patients attending the children's fun fair were minor. Nevertheless, for similar events in the future, the medical team should be qualified for all serious medical emergencies, as well as major trauma; and should be prepared to meet the requirements of the specific group of spectators.The overall usage rate in the children's fun fair described was 19.2 patient encounters per 10,000 spectators. Half of all of the patients were children below the age of 14 years. Medical services should consider that this study shows that up to 33% of children seeking medical assistance may not be accompanied by adults.
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Affiliation(s)
- Andreas R Thierbach
- Clinic of Anesthesiology, Clinic of Pediatrics, Johannes Gutenberg University Mainz, Mainz, Germany.
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Olapade-Olaopa EO, Alonge TO, Amanor-Boadu SD, Sanusi AA, Alese OB, Omisanjo OO, Adeyinka AO, Sanya AO, Ogunbunmi PA, Adewole IF. On-Site Physicians at a Major Sporting Event in Nigeria. Prehosp Disaster Med 2012; 21:40-4. [PMID: 16602264 DOI: 10.1017/s1049023x00003307] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractIntroduction:Although the need for on-site physicians at mass gatherings has been investigated in developed countries, it has not been studied in a developing country, where resources are limited, paramedical services are unavailable, and transportation and other facilities are inadequate.Hypothesis:The presence of on-site physicians would result in the effective management and prehospital care of casualties at mass gatherings or major sporting events in a developing country.Methods:A retrospective review of the planning procedures and medical records of the 19th Nigerian University games was conducted. Data from demographic profiles of visitors presenting to the on-site, secondary, and tertiary medical centers and the treatments used were extracted from log-books and processed and interpreted.Results:The Games hosted 6,000 accredited athletes and officials, and an estimated 80,000 spectators. Medical coverage was provided by 54 doctors and other healthcare staff at on-site, secondary, and tertiary medical centers. No trained paramedics were available. A total of 494 visits were made to the medical centers (medical usage rate of 2.1/1,000, patient presentation rate of 0.08). Forty-six percent of the visitors were evaluated by a physician on-site. Ninety percent of the visits were managed on-site, while 5% and 3% were referred to secondary and tertiary medical centers, respectively.Conclusion:The presence of on-site physicians at a major sporting event resulted in the majority of injuries and complaints being effectively treated on-scene. This reduced the number of hospital referrals and saved time and money for treatment.
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Prehospital Emergency Care and Medical Preparedness for the 2005 World Championship Games in Athletics in Helsinki. Prehosp Disaster Med 2012; 22:304-11. [DOI: 10.1017/s1049023x0000491x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractIntroduction:International mass gatherings can cause great challenges to local healthcare system and emergency medical services (EMS). Traditionally, planning has been based on retrospective reports of previous events, but there still is a need for prospective studies in order to make the process more evidence-based. The aim of this study was to analyze the success of medical preparedness, ambulance patient characteristics, emergency care, and the use of pre-hospital resources during the 2005 World Championship Games in Athletics in Helsinki, Finland.Methods:The study was a prospective, observational study conducted within the Helsinki EMS. Data from all emergency calls at the sport venues and Games village between 05 and 14 August 2005 were collected. Data from the organizations responsible for the health care and first aid of spectators and accredited persons (e.g., athletes, coaches, the press, very important persons and personnel working in the Games area) also were collected. The Institutional Review Board of Helsinki University Central Hospital approved the study plan.Results:A total of 479,000 persons visited the Games. The ambulance call incidence at the Olympic Stadium was 0.50 per 10,000 people and 0.7 per 10,000 when the Games Village was included. The overall need for ambulance transportation to the emergency department was 0.52 per 10,000. No patients needed cardiopulmonary resuscitation or other immediate, life-saving procedures on-site. First aid was provided to 554 spectators (0.17per 10,000 people). The three medical organizations cared for 1,586 patients of which 25 (1.6%) were transported to a hospital by an ambulance. The number of patients needing transportation and the overall patient loadfor the healthcare system was well-anticipated. Accredited persons sought health care a total of 1,009 times.The number of patients treated was associated closely with the number of spectators (p = 0.05). The number of ambulance calls in the city increased 5.9 % as compared to the corresponding time period in the five previous years.Conclusions:The medical preparedness and resources for the Games proved to be sufficient. The EMS personnel were able to provide quality emergency care. This prospective study provided new, detailed data for the medical aspects of mass gatherings and confirmed many previous observations.
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Abstract
AbstractIntroduction:Rock and contemporary music concerts are popular, recurrent events requiring on-site medical staffing.Study objective:To describe a novel severity score used to stratify the level of acuity of patients presenting to first-aid stations at these events.Methods:Retrospective review of charts generated at the first-aid stations of five major rock concerts within a 60,000 spectator capacity, outdoor, professional sports stadium. Participants included all concert patrons presenting to the stadiums first-aid stations as patients. Data were collected on patient demographics, history of drug or ethanol usage while at the concert event, first-aid station time, treatment rendered, diagnosis, and disposition. All patients evaluated were retrospectively assigned a “DRUG-ROCK” Injury Severity Score (DRISS) to stratify their level of acuity. Individual concert events and patient dispositions were compared statistically using chi-square, Fisher's exact, and the ANOVA Mean tests.Results:Approximately 250,000 spectators attended the five concert events. First-aid stations evaluated 308 patients (utilization rate of 1.2 per 1,000 patrons). The most common diagnosis was minor trauma (130; 42%), followed in frequency by ethanol/illicit drug intoxication (98; 32%). The average time in the first-aid station was 23.5±22.5 minutes (± standard deviation; range: 5–150 minutes). Disposition of patients included 100 (32.5%) who were treated and released; 98 (32%) were transported by paramedics to emergency departments (EDs); and 110 (35.5%) signed-out against medical advise (AMA), refusing transport. The mean DRISS was 4.1 (±2.65). Two-thirds (67%) of the study population were ranked as mild by DRISS criteria (score = 1–4), with 27% rated as moderate (score = 5–9), and 6% severe (score >10). The average of severity scores was highest (6.5) for patients transported to hospitals, and statistically different from the scores of the average of the treated and released and AMA groups (p <0.005).Conclusion:The DRISS was useful in stratifying the acuity level of this patient population. This severity score may serve as a potential triage mechanism for future mass gatherings such as rock concerts.
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Abstract
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.
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Arbon P. Mass-Gathering Medicine: A Review of the Evidence and Future Directions for Research. Prehosp Disaster Med 2012; 22:131-5. [PMID: 17591185 DOI: 10.1017/s1049023x00004507] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
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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Affiliation(s)
- Paul Arbon
- Faculty of Health Sciences, Flinders University, Bedford Park 5042, South Australia, Australia.
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Milsten AM, Seaman KG, Liu P, Bissell RA, Maguire BJ. Variables Influencing Medical Usage Rates, Injury Patterns, and Levels of Care for Mass Gatherings. Prehosp Disaster Med 2012; 18:334-46. [PMID: 15310046 DOI: 10.1017/s1049023x00001291] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectives:Mass gatherings create difficult environments for which to plan emergency medical responses. The purpose of this study was to identify those variables that are associated with increased medical usage rates (MURs) and certain injury patterns that can be used to facilitate the planning process.Methods:Patient information collected at three types of mass gatherings (professional American football and baseball games and rock concerts) over a three-year period was reviewed retrospectively. Specific variables were abstracted: (1) event type; (2) gender; (3) age; (4) weather; and (5) attendance. All 216 events (total attendance9,708,567) studied were held in the same metropolitan region. All MURs are reported as patients per 10,000 (PPTT).Results:The 5,899 patient encounters yielded a MUR of 6.1 PPTT. Patient encounters totaled 3,659 for baseball games (4.85 PPTT), 1,204 for football games (6.75 PPTT), and 1,036 for rock concerts (30 PPTT). The MUR for Location A concerts (no mosh pits) was 7.49 PPTT, whereas the MUR for the one Location B concert (with mosh pits) was110 PPTT. The MUR for Location A concerts was higher than for baseball, but not football games (p= 0.005). Gender distribution was equal among patrons seeking medical care. The mean values for patient ages were 29 years at baseball games, 33 years at football games, and 20 years at concerts. The MUR at events held when the apparent temperature was £80°F significantly lower statistically than that at events conducted at temperatures <80°F were (18°C) (4.90 vs. 8.10 PPTT (p= 0.005)). The occurrence of precipitation and increased attendance did not predict an increased MUR. Medical care was sought mostly for minor/basic-level care (84%) and less so for advanced-level care (16%). Medical cases occurred more often atsporting events (69%), and were more common than were cases with traumatic injuries (31%). Concerts with precipitation and rock concerts had a positive association withthe incidence of trauma and the incidence of injuries; whereas age and gender were not associated with medical or traumatic diagnoses.Conclusions:Event type and apparent temperature were the variables that best predicted MUR as well as specific injury patterns and levels of care.
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Affiliation(s)
- Andrew M Milsten
- University of Maryland, Division of Emergency Medicine, Department of Surgery, Baltimore, Maryland, USA.
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A Redundant Resource: A Pre-Planned Casualty Clearing Station for a FIFA 2010 Stadium in Durban. Prehosp Disaster Med 2012; 27:409-15. [DOI: 10.1017/s1049023x12000453] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractThis report details the background, planning, and establishment of a mass-casualty management area for the Durban Moses Mabhida Stadium at the Natal Mounted Rifles base, by the Department of Health and the eThekwini Fire and Rescue Service, for the Fédération Internationale de Football Association (FIFA) 2010 Soccer World Cup. The report discusses the use of the site during the seven matches played at that stadium, and details the aspects of mass-gathering major incident site planning for football (soccer).The area also was used as a treatment area for other single patient incidents outside of the stadium, but within the exclusion perimeter, and the 22 patients treated by the Casualty Clearing Station (CCS) team are described and briefly discussed. A site-specific patient presentation rate of 0.48 per 10,000 and transport-to-hospital rate (TTHR) of 0.09/10,000 are reported. Lessons learned and implications for future event planning are discussed in the light of the existing literature.HardcastleTC, SamlalS, NaidooR, HendrikseS, GlosterA, RamlalM, NgemaS, RoweM. A redundant resource: a pre-planned casualty clearing station for a FIFA 2010 stadium in Durban. Prehosp Disaster Med. 2012;27(2):1-7.
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Steffen R, Bouchama A, Johansson A, Dvorak J, Isla N, Smallwood C, Memish ZA. Non-communicable health risks during mass gatherings. THE LANCET. INFECTIOUS DISEASES 2012; 12:142-9. [PMID: 22252147 DOI: 10.1016/s1473-3099(11)70293-6] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Mass gatherings (MGs) have been associated with high rates of morbidity and mortality from non-communicable diseases, accidents, and terrorist attacks, thus posing complex public health challenges. We assessed the health risks and public health responses to MGs to identify an evidence-based framework for public health interventions. Human stampedes and heat-related illnesses are the leading causes of mortality. Minor traumatic injuries and medical complaints are the main contributors to morbidity and, particularly, the need for on-site medical care. Infrastructure, crowd density and mood, weather, age, and sex determine the risks to health. Many predictive models for deployment of medical resources are proposed, but none have been validated. We identified the risks for mortality and morbidity during MGs, most efficient public health interventions, and need for robust research into health risks for non-communicable diseases during MGs.
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Affiliation(s)
- Robert Steffen
- Division of Epidemiology and Prevention of Communicable Diseases, Institute of Social and Preventive Medicine, University of Zurich, WHO Collaborating Centre for Travellers' Health, Hirschengraben 84/E29, Zurich, Switzerland.
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Hardcastle TC, Naidoo M, Samlal S, Naidoo M, Larsen T, Mabasu M, Ngema S. The Moses Mabhida Medical Plan: medical care planning and execution at a FIFA2010 stadium; the Durban experience. Open Access Emerg Med 2010; 2:91-7. [PMID: 27147844 PMCID: PMC4806833 DOI: 10.2147/oaem.s14899] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Aim This paper aims to outline the medical services provided at the Moses Mabhida Stadium, Durban, South Africa for the Fédération Internationale de Football Association (FIFA) 2010 Soccer World Cup and audit the clinical services delivered to persons seeking medical assistance. Methods Descriptive report of the medical facilities at the Moses Mabhida Stadium including the staff deployment. Retrospective data review of medical incident reports from the Stadium Medical Team. Results Medical staffing exceeded the local norms and was satisfactory to provide rapid intervention for all incoming patients. Senior medical presence decreased the transport to hospital rate (TTHR). A total of 316 spectators or support staff were treated during the seven matches played at the stadium. The majority of patients were male (60%), mostly of local origin, with mostly minor complaints that were treated and discharged (88.2% Green codes). The most common complaints were headache, abdominal disorders, and soft-tissue injuries. One fatality was recorded. The patient presentation rate (PPR) was 0.66/10,000 and the TTHR was overall 4.1% of all treated patients (0.027/10,000 spectators). Conclusion There was little evidence to guide medical planning for staffing from the FIFA governing body. Most patients are treated and released in accordance with international literature, leading to low TTHR rates, while PPR was in line with international experience. Headache was the most common medical complaint. The blowing of Vuvuzelas® may have influenced the high headache rate.
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Affiliation(s)
- Timothy C Hardcastle
- Inkosi Albert Luthuli Hospital, Mayville, South Africa; Department of Surgery, University of KwaZulu-Natal, Durban, South Africa
| | - Mergan Naidoo
- Wentworth Hospital, Durban, South Africa; Department of Family Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Sanjay Samlal
- Emergency Medical Rescue Service, KwaZulu-Natal, South Africa; Department of Health, KwaZulu-Natal, South Africa
| | - Morgambery Naidoo
- Emergency Medical Rescue Service, KwaZulu-Natal, South Africa; Department of Health, KwaZulu-Natal, South Africa
| | - Timothy Larsen
- Emergency Medical Rescue Service, KwaZulu-Natal, South Africa; Department of Health, KwaZulu-Natal, South Africa
| | - Muzi Mabasu
- Emergency Medical Rescue Service, KwaZulu-Natal, South Africa; Department of Health, KwaZulu-Natal, South Africa; EMRS 2010 Planning Committee, KwaZulu-Natal, South Africa
| | - Sibongiseni Ngema
- Department of Health, KwaZulu-Natal, South Africa; School of Public Administration and Development Management, University of KwaZulu-Natal, Durban, South Africa
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Piat SC, Minniti D, Traversi D, Gianino MM, Massazza G, Siliquini R. Torino 2006 Winter Olympic Games: Highlight on Health Services Organization. J Emerg Med 2010; 39:454-61. [DOI: 10.1016/j.jemermed.2009.08.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2009] [Revised: 07/17/2009] [Accepted: 08/29/2009] [Indexed: 11/27/2022]
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Chang WH, Chang KS, Huang CS, Huang MY, Chien DK, Tsai CH. Mass Gathering Emergency Medicine: A Review of the Taiwan Experience of Long-distance Swimming Across Sun-Moon Lake. INT J GERONTOL 2010. [DOI: 10.1016/s1873-9598(10)70025-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Betlehem J, Schaefer J. Emergency medical preparedness during the 2006 World Cup in Frankfurt, Germany. DISASTERS 2010; 34:155-163. [PMID: 19682004 DOI: 10.1111/j.1467-7717.2009.01119.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This paper describes emergency medical preparedness during FIFA (Fédération Internationale de Football Association) World Cup matches in Frankfurt, Germany, in 2006. The methods employed were document analysis and personal observation of games over five days in June-July 2006. The medical authorities in Frankfurt drew on a wide range of scientific literature and experiences to elaborate a National Concept. They paid attention to different models of handling mass catastrophes in shaping the final version of the document. The participation of designated authorities, associations, and volunteer organisations was coordinated sufficiently and the games in Frankfurt proceeded without great incident, even though more than 300,000 people in total attended. The adopted emergency medical procedure was appropriate for a mass gathering event. Official and volunteer organisations collaborated precisely in emergency preparedness. While one uniform concept for all mass gatherings events cannot be developed, case reports and experiences are useful tools.
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Affiliation(s)
- Jozsef Betlehem
- Department of Emergency Care, Faculty of Health Sciences, University of Pecs, Hungary.
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Perron AD, Brady WJ, Custalow CB, Johnson DM. ASSOCIATION OF HEAT INDEX andPATIENT VOLUME AT A MASS GATHERING EVENT. PREHOSP EMERG CARE 2009; 9:49-52. [PMID: 16036828 DOI: 10.1080/10903120590891976] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
UNLABELLED In 1999, a department of emergency medicine was asked to provide medical care at a football stadium with a capacity of 61,625. Over four seasons, the department's experience has been that the number of patients seen during a game correlates closely with game-time heat and humidity (heat index). OBJECTIVE To determine how closely the heat index is associated with the number of patients who will require care at a mass gathering event. METHODS This was a retrospective review of all patient care from 1999 to 2003 at a Division I college football stadium located in the southeastern United States. All patrons seen in two emergency care centers (ECCs) were included. To control for stadium attendance, the Pearson product-moment correlation (PPMC) was calculated for each game. This statistical tool determines whether there is a positive correlation between heat index and ratio of number of patients cared for per 10,000 patrons. RESULTS A total of 20 games occurred, and the heat index ranged from 33 to 92. Number of patients varied from 15 to 74, and stadium attendance ranged from 53,371 to 61,625. The PPMC was calculated as 0.607, which indicates a strong positive correlation between heat index and patient volume (p < 0.005). Linear modeling predicts that for every 10-degree increase in the heat index, three more patients per 10,000 patrons will require care. CONCLUSIONS In this retrospective study, the heat index was strongly associated with the volume of patients who would be seen at a mass gathering event.
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Affiliation(s)
- Andrew D Perron
- Department of Emergency Medicine, Maine Medical Center, Portland, Maine 04102, USA.
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Ishikawa H, Hori S, Aikawa N. The incidence of sickness/trauma in spectators of professional baseball at the Meiji Jingu Baseball Stadium. Keio J Med 2009; 56:85-91. [PMID: 17906419 DOI: 10.2302/kjm.56.85] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The Meiji Jingu Baseball Stadium attracts a large number of spectators in the Tokyo metropolitan area. To clarify the demand for medical care at a public ballpark, we analyzed following two types of medical records maintained at the stadium: (1) "Report of Aid": a record of patients visiting the first-aid station in 2003 season and (2) "Report of Accidents": a record of patients referred to clinics/hospitals between 1996 and 2003 season. (1) In 2003, approximately 1,582,000 spectators watched 67 professional baseball games (60 night games). Of the 247 spectators received medical care at the first-aid station (3.7 persons per game, 1/6,405 spectators), 128 (51.8%) had trauma and 109 (44.1%) had illness. The incidence of trauma was relatively higher before the start and near the end of the night games. The risk of becoming sick/wounded per spectator or the number of the sick/wounded per game differed depending on the participating sports teams. (2) Ninety-three spectators referred to clinics/hospitals during the 8-year period from 1996 to 2003, of which 57 were transferred by ambulance. Direct ball injury accounted for 65 (69.9%) cases of trauma, followed by stumbling/falls (18 cases, 19.4%). Twenty patients were diagnosed to have fractures at the clinics/hospitals. Intrinsic cardiopulmonary arrest occurred in one spectator. Trauma due to direct ball injury accounted for the largest number of wounded patients referred to clinics/hospitals. Treatment to patients at the first-aid station in the stadium may optimize the frequency of hospital visits. Records of medical care are effective to analyze the demand for medical preparedness.
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Affiliation(s)
- Hideki Ishikawa
- Department of Emergency & Critical Care Medicine, School of Medicine, Keio University, Shinju-ku, Tokyo, 160-8582 Japan.
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Planning of traumatological hospital resources for a major winter sporting event as illustrated by the 2005 Winter Universiad. Arch Orthop Trauma Surg 2009; 129:359-62. [PMID: 18560857 DOI: 10.1007/s00402-008-0658-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2007] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The 22nd Student World Winter Games took place in January 2005 in Innsbruck and Seefeld, Austria. Exactly 1,500 athletes of 50 nationalities competed in 69 events in ten winter sports. A total number of 750 functionaries, 800 volunteers and 85,000 spectators participated in the second largest winter sports event behind the Olympic winter games. AIM The aim of this study was to evaluate the needed resources to ensure traumatological care for an event of that size. MATERIAL At the medical "call-center" all consultations, as well as patient data, diagnosis, and medical treatment were recorded using a preset protocol. Further, all patients treated in the University Hospital Innsbruck were registered with an emphasis on trauma patients. RESULTS Forty-eight of 65 patients transported to the hospital as a result of the Universiade were trauma patients, 37 of whom were athletes. The gender distribution was 34:14 (m:f). Ice hockey players had the highest rate of injury (25% of all injured athletes), followed by alpine skiers (20.8% of injured athletes). The highest ISS was nine. Forty-three patients got ambulatory treatment, five were admitted to the hospital and surgical treatment was conducted in three cases. Mean patient number was 4.8 per day. No additional personnel, structural, or technical hospital resources were needed to accommodate a large winter sports event like the Universiad. Thus, a level-B trauma center with an emergency room and independent traumatological department with around the clock surgical capability seems to be sufficient to provide traumatological care for an event of this size if the possibility of patient transport to a larger facility exists in the case of catastrophic events.
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Dutch MJ, Senini LM, Taylor DJ. Mass gathering medicine: The Melbourne 2006 Commonwealth Games experience. Emerg Med Australas 2008; 20:228-33. [PMID: 18462409 DOI: 10.1111/j.1742-6723.2008.01085.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Martin-Gill C, Brady WJ, Barlotta K, Yoder A, Williamson A, Sojka B, Haugh D, Martin ML, Sidebottom M, Sandridge L. Hospital-based healthcare provider (nurse and physician) integration into an emergency medical services–managed mass-gathering event. Am J Emerg Med 2007; 25:15-22. [PMID: 17157677 DOI: 10.1016/j.ajem.2006.07.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2005] [Revised: 05/26/2006] [Accepted: 07/02/2006] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION This report describes not only the implementation of a coordinated emergency medical services-hospital-based healthcare team but also investigates the integration of nurse-physician teams at a mass gathering medical care event. METHODS A review of resource utilization, patient encounters, and local ED census was performed during this period at a college football stadium. RESULTS During this 4-year period, 1681 patients presented for medical care during 26 events with a total attendance of 1,544,244 (1.09 patients per thousand attendees [PT]). The majority of patient contacts were for minor complaints (1451, 87.6%), whereas 205 (12.4%) received full evaluations (focused history and physical examination most often with pulse oximetric and electrocardiographic monitoring). A total of 109 patients were transported (4.19 PT), representing 6.48% of all patients. Patient census for the event medical deployment increased from 0.44 PT in 2001 to 1.75 PT in 2004. The number and percent of patients transported also increased between 2001 (0.02 PT, 4.48%) and 2004 (0.12 PT, 6.67%). However, 118 (57.6%) patients who received full evaluations were able to be discharged by a physician, avoiding transport. Chief complaints and management of patients receiving full evaluations were consistent across this period, with altered mental status (52.7%) and chest pain (12.7%) as the most common complaints. Average ED census during this period was found to be significantly higher on event days (176.2) than nonevent days (161.2) (t = 8.04, P < .001), although this produced only a minor impact on the emergent care system. CONCLUSION This study describes one potential deployment plan for a mass gathering medical event and suggests that the incorporation of physicians into a mass gathering setting may be associated with an absolute increase in patient census and transports, while decreasing the percent of patients transported. The impact on local emergency medical services and ED resources, although not specifically investigated in this study, was likely minimal.
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Affiliation(s)
- Christian Martin-Gill
- Affiliated Residency in Emergency Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA
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Grissom CK, Finnoff JT, Murdock DC, Culberson JT. Nordic venue medical services during the 2002 Winter Olympics. J Emerg Med 2006; 30:203-10. [PMID: 16567259 DOI: 10.1016/j.jemermed.2005.08.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2004] [Revised: 04/22/2005] [Accepted: 08/04/2005] [Indexed: 11/28/2022]
Abstract
This article represents a retrospective analysis of medical care provided to spectators, athletes, officials, and workforce at the cross country skiing and biathlon venue, Soldier Hollow, during the 2002 Winter Olympic Games. A retrospective chart review was performed of the primary diagnosis category assigned to each patient on medical encounter forms completed at the time medical care was provided in the athlete or spectator medical clinics. Descriptive statistics were used to characterize data from the primary diagnosis categories for groups of patients. There were 590 total medical encounters among athlete and spectator medical services over 19 operational days with 227,847 total visitors (includes spectators, athletes, and workforce). The incidence of medical encounters was 26 per 10,000 visitors. There were 215 medical encounters that were evaluated and treated by a physician in the athlete (69 cases) or spectator (146 cases) medical clinics. The most common diagnoses were related to respiratory infection or respiratory disease. There were 177 patients discharged without follow-up and 26 referred to a medical facility off venue. Six patients were transported to a hospital by ground ambulance. In conclusion, the injuries and illnesses evaluated and treated were consistent with prior studies on medical care at Olympic Games. Although some patients required ground ambulance transport off venue due to injury or illness, there were no critical injuries or illnesses that resulted in death. The level of services available to both athletes and spectators was more than adequate for the injuries and illnesses encountered.
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Affiliation(s)
- Colin K Grissom
- Soldier Hollow venue, 2002 Olympics, Soldier Hollow, Utah 84143, USA
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Abstract
OBJECTIVE To develop and assess a community-based model for medical coverage for a large multisport event. DESIGN The model included pre-event risk stratification, a concise training program for all medical volunteers, and detailed medical control guidelines. Prospective data collection was performed using standardized injury reporting forms. SETTING The 2005 World Masters Games in Edmonton, Alberta, Canada. PATIENTS Approximately 21,600 athletes between the ages of 25 and 97 who were participants in the World Masters Games. INTERVENTIONS A 4-category risk scale was developed and applied to each sport. Medical volunteers were provided intensive training and guided by concise medical control guidelines. Medical encounters were recorded using a standardized injury report form. MAIN OUTCOME MEASURES Incidence of injury by sport. Rate of ambulance transportation. Rate of medication use. Relevance of medical control guidelines. RESULTS Medical coverage for over 80 venues was provided by 243 volunteers. A total of 1767 medical encounters were documented, with an overall injury rate of 8.2% (95% CI, 7.9 to 8.5). The majority of injuries were of a minor nature. Only 35 (0.16%) athletes had injuries that required medication or ambulance transportation. Cardiopulmonary resuscitation and defibrillation was required in only 1 patient. CONCLUSIONS The risk of injury during the World Masters Games appears to be low, and the risk of severe injury is extremely low. The described community-based model for medical coverage for multi-sport events appears to be safe and practical.
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Allen TL, Jolley SJ, Cooley VJ, Winn RT, Harrison JD, Price RR, Rich JC. The epidemiology of illness and injury at the alpine venues during the Salt Lake City 2002 Winter Olympic Games. J Emerg Med 2006; 30:197-202. [PMID: 16567258 DOI: 10.1016/j.jemermed.2005.07.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2003] [Revised: 04/08/2005] [Accepted: 07/28/2005] [Indexed: 11/28/2022]
Abstract
The Emergency Medicine literature has described levels of medical care for mass gatherings in the United States, including for the Los Angeles 1984 Summer and Calgary 1988 Winter Olympic Games. However, there are limited data to describe the type and number of illness or injury that may occur during mass gatherings in an alpine winter environment. To describe the epidemiology of illness and injury seen among spectators at the alpine and snowboarding venues during the Salt Lake City 2002 Winter Olympic Games, we conducted a retrospective review of the Salt Lake City 2002 Olympic Medical Care database for all patient encounters during the operational period of the Games at the alpine and snowboarding venues. The three venues included were: Deer Valley Resort (DVR), Park City Mountain Resort (PCM), and Snowbasin Resort (SBA). Each venue had a medical clinic located on site for spectators and another for athletes. Physicians, nurses, emergency medical technicians, and therapists staffed the clinics. The database was created by Inter-mountain Health Care (IHC) in conjunction with Salt Lake City 2002 Winter Olympic staff and consisted of descriptive reports of all patient encounters from all venues including demographic, epidemiology, and outcome information. IHC maintains the database, and was the sole medical provider for the Games. Each venue had at least 6 days of competition events. Over the 19 days of the Olympiad, a total of 410,160 spectators and 3,961 competitive athletes attended the three venues. There were 841 spectators evaluated and treated at the venue clinics, and mobile medical staff treated 262 spectators. The top five spectator clinic diagnostic categories were: sprain/strain (n=108), miscellaneous trauma (n=103), respiratory (n=88), miscellaneous medical (n=69), and digestive (n=52). Fifty spectators required transport to a hospital for additional care: 27 required transfer by ground ambulance and the remainder were transported by private vehicle. The overall spectator medical utilization rate was 26.9. In conclusion, the rate and acuity of patients seen at the alpine venues during the 2002 Winter Olympic Games was low. Nevertheless, we recommend full on-site physician and nurse staffing with advanced trauma and cardiac life support available during similar events.
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Affiliation(s)
- Todd L Allen
- Department of Emergency Medicine, LDS Hospital, Salt Lake City, Utah 84143, USA
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Affiliation(s)
- Paul Arbon
- Research Center for Nursing Practice, University of Canberra and the Canberra Hospital, Woden, Australia.
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What Types of Patients Were Seen after the Tsunami in Banda Aceh in an International Committee Red Cross (ICRC) Field Hospital Outpatient/Emergency Department? Prehosp Disaster Med 2005. [DOI: 10.1017/s1049023x00014503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Food Security and Anthropometry following One Year of Food Assistance in Palestinian Territories. Prehosp Disaster Med 2005. [DOI: 10.1017/s1049023x00014734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Impact of Rural Identity on Access to Emergency Health Care for Asthma: Impact of Community Perceptions. Prehosp Disaster Med 2005. [DOI: 10.1017/s1049023x00015132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Sloan B, Somerville G, Olinger M, Billows G, Brokaw D. Injury incidence during the 2001 world police and fire games. Am J Emerg Med 2004; 22:129-31. [PMID: 15011236 DOI: 10.1016/j.ajem.2003.12.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Burton JH, Baumann MR, Maoz T, Bradshaw JR, Lebrun JE. Endotracheal intubation in a rural EMS state: procedure utilization and impact of skills maintenance guidelines. PREHOSP EMERG CARE 2003; 7:352-6. [PMID: 12879385 DOI: 10.1080/10903120390936554] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Recent American Heart Association (AHA) guidelines have suggested that advanced life support (ALS) providers should have "regular field experience," defined as six to 12 intubations/year, as a prerequisite to patient endotracheal intubation (EI). The authors sought to assess the impact of this guideline on rural emergency medical services (EMS) practice. METHODS Statewide EMS records were reviewed for the calendar years 1997-2001. Data reviewed included the number of providers eligible to perform ALS skills (including EI), number of procedures performed per year by EMS provider, patient age, gender, and prehospital diagnosis. The institutional review board approved the study. RESULTS During the study period, a total of 957,836 patient encounters occurred with an average of 1,352 ALS providers annually eligible to perform EI. In the five-year period, there were 5,615 total EI attempts with a range of 37%-42% of eligible providers annually performing EI. A mean of 18 providers per year with a range of 1.8%-0.8% of EI-eligible providers annually attempted EI in more than five patients. One hundred thirty-seven pediatric EI encounters occurred during the five-year period with an annual range of 1.4%-2.7% of eligible providers attempting pediatric EI. During the five-year investigation, EI success rate was reported as 84% by providers with fewer than five annual intubation encounters and 86% by providers with more than five encounters. CONCLUSION Rural EMS providers rarely use EI skills, particularly in pediatric patients. If recent AHA intubation guidelines are to be followed in rural EMS settings, a small number of EMS providers will meet minimum EI utilization requirements.
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Affiliation(s)
- John H Burton
- Department of Emergency Medicine, Maine Medical Center, Portland, Maine 04102, USA.
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Grange JT, Baumann GW, Vaezazizi R. On-site physicians reduce ambulance transports at mass gatherings. PREHOSP EMERG CARE 2003; 7:322-6. [PMID: 12879381 DOI: 10.1080/10903120390936518] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To prospectively determine if on-site physicians at a mass gathering reduced the number of ambulance transports to local medical facilities. The authors also wished to determine the level of care provider (emergency medical technician, EMT-P, registered nurse, or medical doctor) required to treat and disposition each patient. METHODS This study determined whether each patient presenting to on-site first aid stations at California Speedway during a large motorsports event would require ambulance transport to the hospital per the local emergency medical services (EMS) protocols. Whether the on-site physician prevented certain ambulance transports also was determined. Additionally, the minimum level of provider that could treat and disposition each patient was determined. RESULTS On-site physicians significantly reduced (p < 0.001) the number of ambulance transports at this mass gathering. Ambulance transports to local hospitals were reduced by 89% (from 116 to 13). Fifty-two percent of the patients were able to be treated and dispositioned (cardiac arrests, minor first aid, etc.) by a paramedic. Registered nurses were able to treat and disposition another 39% of the patients with pre-established protocols written by the track medical director. These patients had abrasions requiring tetanus shots, mild to moderate heat exhaustion that resolved with intravenous hydration, and other minor complaints. Finally, about 9% of the patients required physician-level care (suturing, prescriptions, etc.) to treat and disposition them. CONCLUSION On-site physician-level medical care at large mass gatherings significantly reduces the number of patients requiring transport to hospitals, thus reducing the impact on the local EMS system and surrounding medical facilities.
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Affiliation(s)
- Jeff T Grange
- Department of Emergency Medicine, Loma Linda University Medical Center, Loma Linda, California 92354, USA.
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PDM volume 18 issue 1 Cover and Back matter. Prehosp Disaster Med 2003. [DOI: 10.1017/s1049023x00000571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Milsten AM, Maguire BJ, Bissell RA, Seaman KG. Mass-gathering medical care: a review of the literature. Prehosp Disaster Med 2002; 17:151-62. [PMID: 12627919 DOI: 10.1017/s1049023x00000388] [Citation(s) in RCA: 181] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
UNLABELLED Mass-gatherings events provide a difficult setting for which to plan an appropriate emergency medical response. Many of the variables that affect the level and types of medical needs, have not been fully researched. This review examines these variables. METHODS An extensive review was conducted using the computerized databases Medline and Healthstar from 1977 through May 2002. Articles selected contained information pertaining to mass-gathering variables. These articles were read, abstracted, analyzed, and compiled. RESULTS Multiple variables are present during a mass gathering, and they interact in complex and dynamic ways. The interaction of these variables contributes to the number of patients treated at an event (medical usage rate) as well as the observed injury patterns. Important variables include weather, event type, event duration, age, crowd mood and density, attendance, and alcohol and drug use. CONCLUSIONS Developing an understanding of the variables associated with mass gatherings should be the first step for event planners. After these variables are considered, a thorough needs analysis can be performed and resource allocation can be based on objective data.
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Affiliation(s)
- Andrew M Milsten
- University of Maryland, Division of Emergency Medicine, Department of Surgery, Baltimore, Maryland 21201-1734, USA.
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Chang EC, Koval E, Freer L, Kraus S. Planning for an annual episodic mass gathering: emergency department and clinic utilization in Yellowstone. Wilderness Environ Med 2001; 11:257-61. [PMID: 11199530 DOI: 10.1580/1080-6032(2000)011[0257:pfaaem]2.3.co;2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Planning and providing emergency and primary care for a large transient population of visitors and employees in a national park can be problematic. Furthermore, planning for emergency and primary health care needs of visitors and itinerant workers in a wilderness area national park has not been well documented. A study was performed to analyze emergency and primary health care utilization in a national park. METHODS Data was gathered from all patients presenting to Lake Hospital Emergency Department in Yellowstone in 1995, and a retrospective chart review was performed. RESULTS Two distinct populations with different health care needs were identified. CONCLUSION Utilization analysis revealed differences between conventional mass gatherings and the mass gatherings in Yellowstone. Because of the unique conditions and populations found in a wilderness area, conventional mass gathering emergency medical service models may not be an appropriate model for planning health care in a national park. Analysis of utilization data can help plan resources for emergency and primary health care for a park population.
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Affiliation(s)
- E C Chang
- University of Rochester School of Medicine, NY, USA.
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Thackway SV, Delpech VC, Jorm LR, McAnulty JM, Visotina M. Monitoring acute diseases during the Sydney 2000 Olympic and Paralympic Games. Med J Aust 2000; 173:318-21. [PMID: 11061404 DOI: 10.5694/j.1326-5377.2000.tb125666.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Sydney 2000 Olympic Games (the XXVII Olympiad) will be the biggest peacetime event ever held in Australia. During the Games, all public health decisions will be centralised, with daily briefing sessions held to review emerging public health issues and facilitate responses. Infectious diseases will be monitored and reported through the Olympic Surveillance System, with particular attention to foodborne diseases and conditions spread via the respiratory route. This system relies heavily on the cooperation of key notifiers such as emergency departments, laboratories and general practitioners. The lessons learned during the Games, and the new and enhanced systems and linkages that have been developed to support it, will strengthen future disease surveillance in NSW.
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Pitts SR, Kolla IS. The "Sherman effect": decreased ambulatory care volumes in Atlanta during the 1996 Summer Olympic Games. Med J Aust 2000; 173:309-11. [PMID: 11061401 DOI: 10.5694/j.1326-5377.2000.tb125663.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To estimate the effect of the 1996 Atlanta Summer Olympic Games on visits to local ambulatory healthcare facilities. DESIGN Comparison of median visit rates by time period, obtained from retrospective review of administrative data. SETTING The emergency department of the designated athletes' hospital, the public hospital's adult emergency department and adult walk-in clinics, and the adult and paediatric outpatient facilities of a large health maintenance organisation. PATIENTS All 132,826 visitors to the designated facilities during the study interval. MAIN OUTCOME MEASURE Daily visit frequencies at each facility. Our informal observations had suggested that volumes were not as high as expected. RESULTS In all but the athletes' designated hospital, there was a decrease in average volumes the week before the opening ceremonies, ranging from zero to 8.4% of baseline. Average daily volumes in these non-venue facilities varied from 3.2% above to 16.1% below baseline during the two weeks of the Games, but all experienced an increase in volumes the week after the closing ceremonies, ranging from 3.0% to 13.7% of baseline. CONCLUSION Unlike the venue-related facility, community ambulatory care sites did not encounter a significant rise in volumes until after the closing ceremonies. Although confirmation from other events is needed, our data suggest that, in addition to increased preparedness for sudden volume surges, overtime staffing of local facilities during planned mass gatherings should occur not during, but immediately after, the event.
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Affiliation(s)
- S R Pitts
- Emory University, Department of Emergency Medicine, Atlanta, Georgia, USA.
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Janchar T, Samaddar C, Milzman D. The mosh pit experience: emergency medical care for concert injuries. Am J Emerg Med 2000; 18:62-3. [PMID: 10674535 DOI: 10.1016/s0735-6757(00)90051-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Effective planning is essential for medical personnel preparing to provide emergency care at mass gatherings. At large concerts where audience members participate in "moshing," crowd surfing, and stage diving, there may be a potential for a dramatic increase in injuries requiring medical attention. Injuries seen at emergency medical stations at 3 concerts, all with large mosh pits, over 4 event days were recorded and evaluated. Each event day had over 60,000 attendees. A total of 1,542 medical incidents (82.9 per 10,000) were reported over the 4 event days. There were 37% (466 patients, 25.1 per 10,000) of incidents related to moshing activity. Hospital transport was required for 2.5% (39 patients, 2.1 per 10,000) of medical visits with 74% (29 patients, 1.5 per 10,000) of those transported being for mosh pit-related injuries. When planning emergency medical care for such concerts with mosh pits, the potential for an increase in the number of medical incidents and injuries requiring medical attention and hospital transport should be taken into account for efficient medical coverage.
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Affiliation(s)
- T Janchar
- Department of Emergency Medicine, Providence Hospital, Washington, DC 20017, USA
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O'Grady KA, Krause V. Public hospital utilisation during the 1997 Arafura Games. Aust N Z J Public Health 1999; 23:218-9. [PMID: 10330745 DOI: 10.1111/j.1467-842x.1999.tb01242.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Affiliation(s)
- M E Keim
- Division of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
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Brennan RJ, Keim ME, Sharp TW, Wetterhall SF, Williams RJ, Baker EL, Cantwell JD, Lillibridge SR. Medical and public health services at the 1996 Atlanta Olympic Games: an overview. Med J Aust 1997; 167:595-8. [PMID: 9418799 DOI: 10.5694/j.1326-5377.1997.tb138908.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Planning for the 2000 Sydney Olympic Games may benefit from the experience of the 1996 Atlanta Olympics. Excellent health promotion and prevention activities before and during the Games resulted in fewer medical and public health problems than anticipated. Despite this, there was room for improvement in the level of communication and cooperation between the many service providers to ensure the most appropriate and efficient responses.
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Affiliation(s)
- R J Brennan
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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Abstract
The 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.
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Affiliation(s)
- R A De Lorenzo
- Uniformed Services, University for the Health Sciences, Bethesda, Maryland, USA
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