Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-21T21:15:09.589Z Has data issue: false hasContentIssue false
  • English
  • Français

Mass Gathering Medicine: A Review

Published online by Cambridge University Press:  28 June 2012

Robert A. De Lorenzo
Robert A. De Lorenzo*
Affiliation:
Assistant Clinical Professor of Military and Emergency Medicine, Uniformed Services University for the Health Sciences, Bethesda, Maryland USA and the Department of Emergency Medicine, Darnall Army Community Hospital, Fort Hood, Texas, USA
*
Department of Emergency Medicine, Darnall Army Community Hospital, Ft. Hood, TX 76544-5063USA Telephone (817) 288-8302 Facsimile (817) 288-8336
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

confined spacescostscrowdsemergency medical servicesequipmentmass gatheringmass gathering medicinemedical controlmedical coverage of mass gatheringsnon-conveyancespectatorsorganizationphysician involvement at mass gatheringsplanningstaffingtrainingtransportationweather
Type
Comprehensive Review
Information
Prehospital and Disaster Medicine , Volume 12 , Issue 1 , March 1997 , pp. 68 - 72
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Sanders, AB, Criss, E, Steckl, P et al. : An analysis of medical care at mass gatherings. Ann Emerg Med 1956;15:515–519.CrossRefGoogle Scholar
2. Rose, WD, Larid, SL, Prescott, JE et al. : Emergency medical services for collegiate football games: A six and one—half year review. Prehospital and Disaster Medicine 1992;7:157–159.CrossRefGoogle Scholar
3. Chused, TM, Cohn, CK, Schneider, E et al. : Medical care during the 1969 antiwar demonstrations in Washington, DC. Arch Int Med 1971;127:67–70.CrossRefGoogle ScholarPubMed
4. Farrow, RJ: Pop music festivals. Practitioner 1972;208:380–386.Google ScholarPubMed
5. Franaszek, J: Medical care at mass gatherings. Ann Emerg Med 1986;15:600–601. Editorial.CrossRefGoogle ScholarPubMed
6. Whipkey, RR, Paris, PM, Steward, RD: Emergency care for mass gatherings. Postgrad Med 1984;76:44–47,50-51,54.Google Scholar
7. Spaite, DW, Criss, EA, Valenzuela, TD et al. : A new model for prehospital medical care in large stadiums. Ann Emerg Med 1988;17:825–828.CrossRefGoogle ScholarPubMed
8. Weaver, WD, Sutherland, K, Wirkus, MJ et al. : Emergency medical care requirements for large public assemblies and a new strategy for managing cardiac arrest in this setting. Ann Emerg Med 1989;18:155–160.CrossRefGoogle Scholar
9. Hnatow, DA, Gordon, DJ: Medical planning for mass gatherings: A retrospective review of the San Antonio Papal Mass. Prehospital and Disaster Medicine 1991;6:443–450.CrossRefGoogle Scholar
10. De Lorenzo, RA, Gray, BC, Bennett, PC et al. : Effect of crowd size on patient volume at a large, multipurpose, indoor stadium. J Emerg Med 1989;7:379–384.CrossRefGoogle Scholar
11. Pons, PT, Holland, B, Alfrey, E et al. : An advanced emergency medical care system at National Football League games. Ann Emerg Med 1980;4:203–206.CrossRefGoogle Scholar
12. Auerbach, P, Gelb, A, Turns, JE: Emergency medical services at the 1984 Democratic National Convention. Ann Emerg Med 1985;7:709–710. Letter.CrossRefGoogle Scholar
13. Boyle, MF, De Lorenzo, RA, Garrison, R: Physician integration into mass gathering medical care. Prehospital and Disaster Medicine 1993;8:165–168.CrossRefGoogle ScholarPubMed
14. Baker, WM, Simone, BM Niemann, JT et al. : Special event medical care: The 1984 Los Angeles Summer Olympics experience. Ann Emerg Med 1986;15:185–190.CrossRefGoogle ScholarPubMed
15. McSwain, NE Jr, Rodriguez, C: Disaster medical care: Mardi Gras. J Trauma 1982;22:235–237.CrossRefGoogle ScholarPubMed
16. Bock, HC, Cordell, WH, Hawk, AC et al. : Demographics of emergency medical care at the Indianapolis 500 Mile Race (1983–1990). Ann Emerg Med 1992;21:1204–1207.CrossRefGoogle ScholarPubMed
17. De Lorenzo, RA, Johnston, R: On the ground with the U.S. Air Show. Journal of Emergency Medical Services 1994;12:69–74.Google Scholar
18. Goldstein, SN: Presidential party. Emergency Medical Services 1993;11:65–69.Google Scholar
19. Eadie, JL: 1980 Winter Olympics Lake Placid, New York. J Environ Health 1981;43:178–187.Google ScholarPubMed
20. Loyd, C: Emergency medical services for large crowds. In: Lewis, G, Appenzeller, H (Eds). Successful Sports Management. Charlottesville, VA: The Michie Co., 1985, pp 89–99.Google Scholar
21. Carlson, L: Spectator medical care. Physician Sports Med 1992;20:141–144.CrossRefGoogle ScholarPubMed
22. Weiss, BP, Mascola, L, Fannin, SL: Public health at the 1984 Summer Olympics: The Los Angeles County Experience. Am J Public Health 1988;78:686–688.CrossRefGoogle ScholarPubMed
23. Leonard, RB, Petrilli, R, Noji, EK et al. : Provision for emergency medical care for crowds. American College of Emergency Physicians, Dallas, TX 1990, pp 1–25.Google Scholar
24. Sanders, AB, Criss, E: Planning medical care for large-scale events. Emergency Medical Services 1987;16:33,48.Google Scholar
25. Cohen, DL, Montalvo, MA, Turnbull, GP: Medical support for a major military air show: The RAF Mildenhall medical emergency support plan. J Trauma 1994;36:237–244.CrossRefGoogle Scholar
26. Ouanian, LL, Salinas, C, Shear, CL et al. : Medical care at the 1982 U.S. Festival. Ann Emerg Med 1986;15:520–527.CrossRefGoogle Scholar
27. McDonald, CD, Koenigsberg, MD, Ward, S: Medical control of mass gatherings: Can paramedics perform without physicians on site? Prehospital and Disaster Medicine 1992;8:327–331.CrossRefGoogle Scholar
28. Erickson, TB, Aks, SE, Koenigsberg, M et al. : Drug use patterns at major rock concert events. Ann Emerg Med 1996;28:22–26.CrossRefGoogle ScholarPubMed
29. Streat, S, McCallum, JA, Boswell, R et al. : Medical services at a music festival. NZ J Med 1975;82:76–80.Google Scholar
30. Thompson, JM, Savoia, G, Powell, G et al. : Level of medical care required for mass gatherings: The XV Winter Olympic Games in Calgary, Canada. Ann Emerg Med 1991;20:385–390.CrossRefGoogle ScholarPubMed
31. Flabouris, A: An analysis of demand for first-aid care at a major public event. Prehospital and Disaster Medicine 1996;11:48–51.CrossRefGoogle Scholar
32. Hewitt, S, Jarrett, L, Winter, B: Emergency medicine at a large rock festival. J Accid Emerg Med 1996;13:26–27.CrossRefGoogle Scholar
33. Vacalis, TD, Blewett, J: Advanced emergency medical care system at the University of Texas football stadium. J Am Coll Health Assoc 1981;30:145–147.CrossRefGoogle ScholarPubMed
34. Ma, OJ, Pirrallo, RG, Rubin, JM: Survey of medical services a major league baseball stadiums. Prehospital and Disaster Medicine 1995;10:268–272.CrossRefGoogle ScholarPubMed
35. De Lorenzo, RA: Can casualty rates be predicted? Sidebar accompanying De Lorenzo RA, Johnston R: On the ground with the U.S. Air Show. Journal of Emergency Medical Services 1994;12:69–74.Google Scholar
36. Editorial Staff: Mass casualty: Pope's visit to Denver causes mega MCI. Journal of Emergency Medical Services 1993;11:64–69,72–75.Google Scholar
37. Nordberg, M: EMS and mass gatherings. Emergency Medical Services 1990;19:46–61,91.Google Scholar
38. Bowdish, GE, Cordell, WH, Bock, HC et al. : Using regression analysis to predict emergency patient volume at the Indianapolis 500 Mile Race. Ann Emerg Med 1992;21:1200–1203.CrossRefGoogle ScholarPubMed
39. Chapman, KR, Carmichael, FJ, Goode, JE: Medical services for outdoor rock music festivals. Can Med Assoc J 1982;126:935–938.Google ScholarPubMed
40. Blandford, AG, Dunlop, HA: Glastonbury Fair. Practitioner 1972;209:205–211.Google ScholarPubMed
41. Burns, RS, Lerner, SE, Sexton, PA: Emergency medicine at Diamond Head Crater Festival. Hawaii Med J 1974;33:331–335.Google ScholarPubMed
42. Fulde, GWO, Forster, SL, Preisz, : Open air rock concert: Organised disaster. Med J Australia 1992;157:820–822.CrossRefGoogle ScholarPubMed
43. Richards, R, Richards, D, Whittaker, R: Method of predicting the number of casualties in the Sidney City-to-Surf Fun Runs. Med J Australia 1984;141:805–808.CrossRefGoogle Scholar
44. Ellis, DG, Verdile, VP, Paris, PM et al. : Medical coverage of a marathon: Establishing guidelines for deployment of health care resources. Prehospital and Disaster Medicine 1991;6:435–441.CrossRefGoogle Scholar
45. Gannon, DM, Derse, AR, Bronkema, PJ: The emergency care network of a ski marathon. Am J Sports Med 1985;13:316–320.CrossRefGoogle ScholarPubMed
46. Reddy, IS, Cusack, S: Emergency medicine at a large rock festival. J Accid Emerg Med 1996;13:303.CrossRefGoogle Scholar
47. James, SH, Calendrillo, B, Schnoll, SH; Medical and toxicological aspects of the Watkins Glen Rock Concert. J Forensic Sci 1974;1:71–82.Google Scholar
48. Sexton, PA, Burns, SR, Lerner, SE: Drug abuse may be declining. Sunshine '75: Rock medicine inside Diamond Head. Hawaii Med J 1975;34:271–275.Google Scholar
49. Steele, AG: Emergency medical care for open wheel racing events at Indianapolis Raceway Park. Ann Emerg Med 1994;24:264–268.CrossRefGoogle ScholarPubMed
50. Laskowski, ER, Najarian, MM, Smith, AM et al. : Medical coverage for multievent sports competition: A comprehensive analysis of injuries in the 1994 Star of the North summer games. Mayo Clin Proc 1995;70:549–555.CrossRefGoogle ScholarPubMed
51. Janicke, DM, Jacob, DJ, La Fountain, RB et al. : Emergency medical care in athlete's village: World University Games 1993. Prehospital and Disaster Medicine 1995;10:113–117.CrossRefGoogle ScholarPubMed
52. Dyche, WJ, Felsen, D, Gay, JH: Organizing medical services for large groups in field situations. EMT Journal 1980;4:43–49.Google ScholarPubMed
53. Kulp, RC: Preparing prehospital medical coverage for a Papal visit. Emerg Health Svces Q 1980;1:111–127.CrossRefGoogle ScholarPubMed
54. Parrillo, SJ: Medical care at mass gatherings: Considerations for physician involvement. Prehospital and Disaster Medicine 1995;10:273–275.CrossRefGoogle ScholarPubMed
55. Vukmir, RB, Paris, PM: The Three Rivers Regatta accident: An EMS perspective. Am J Emerg Med 1991;9:64–71.CrossRefGoogle ScholarPubMed
56. Milne, D: EMS at the Indy 500. Emergency 1983;15:28–31.Google Scholar
57. Orr, SM, Robinson, WA: The Hyatt Regency Skywalk: An EMS-based disaster response. Ann Emerg Med 1983;12:601–605.CrossRefGoogle ScholarPubMed
58. Waeckerle, JF: Disaster planning and response. N Engl J Med 1991;324:815–821.Google ScholarPubMed
59. Champion, MR, Sacco, WJ, Gainer, PS et al. : The effect of medical direction on trauma triage. J Trauma 1988;28:235–239.CrossRefGoogle ScholarPubMed
60. Brunko, M: Emergency physicians and special events. J Emerg Med 1989;7:405–406. Editorial.CrossRefGoogle ScholarPubMed
61. Goldman, B: Spectator events: Medical preparations a must. CMA, 1988;138:164–165.Google Scholar
62. Brown, WE: EMS at the Indianapolis 500. Emergency Medical Services 1978;7:12–23.Google ScholarPubMed
63. Krentz, MJ, Wainscott, MP: Medical accountability. Emerg Med Clin N Amer 1990;8:17–32.CrossRefGoogle ScholarPubMed
64. Frew, SA: Emergency medical services legal issues for the emergency physician. Emerg Med Clin N Amer 1990;8:41–55.CrossRefGoogle ScholarPubMed
65. Goldberg, RJ, Zautcke, JL, Koenigsberg, MD et al. : A review of prehospital care litigation in a large metropolitan EMS system. Ann Emerg Med 1990;19:557–561.CrossRefGoogle Scholar
66. Soler, JJ, Montes, MF, Egol, AB et al. : The ten-year malpractice experience of a large urban EMS system. Ann Emerg Med 1985;14:982–985.CrossRefGoogle ScholarPubMed
67. Editorial staff: Nontransport lawsuits. Journal of Emergency Medical Services 1983;8:107–109.Google Scholar
68. Zehner, WJ Jr, Davidson, SJ, Kelly, JJ et al. : Nontransport of prehospital patients: Is stronger medical control needed? Ann Emerg Med 1991;20:446. Abstract.Google Scholar
69. Bryon, ED, Zachariah, BS, Griffin, MP: Outcome of patients not transported by ambulance. Prehospital and Disaster Medicine 1991;6:381. Abstract.Google Scholar
70. Thomas, DR, Amos, WL: Medical services provided at the 1982 Southern Open Golf Tournament. Am J Sports Med 1984;12:155–158.CrossRefGoogle ScholarPubMed
71. American College of Emergency Physicians. Core content for emergency medicine. Ann Emerg Med 1991;20:920–934.CrossRefGoogle Scholar
72. De Lorenzo, RA, Boyle, MF, Garrison, F: A proposed model for a residency experience in mass gathering medicine: The United States Air Show. Ann Emerg Med 1993;22:1711–1714.CrossRefGoogle ScholarPubMed
73. Seletz, JM: Flugtag–88 (Ramstein Air Show Disaster): An Army response to a MASCAL. Milit Med 1990;155:152–155.Google ScholarPubMed
74. Anonymous: Stampede kills 93, injures 200 at stadium in Great Britain. Emerg Preparedness News 1989;13:61.Google Scholar
75. Klem, TJ: How could this fire cause 56 deaths in 5 minutes? Fire Command 1986;53:21–25.Google Scholar
76. Isner, MS; Stadium fires demonstrate unique protection problems. NFPA J 1994;88:49–54.Google Scholar
77. Newburn, T: Some lessons from Hillsborough. Civil Protection 1993;27(Summer):6–8.Google Scholar
78. Drabek, TE: Disaster in aisle 13: A case study of the coliseum explosion; at the Indiana State Fairgrounds, 31 October 1963. College of Administrative Science monograph No. D1, Ohio State University, Columbus, OH, 1968, p 197.Google Scholar