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  • Cited by 2
  • Print publication year: 2009
  • Online publication date: August 2011

17 - Management of Mass Gatherings

from PART II - OPERATIONAL ISSUES

Summary

The management of mass gatherings encompasses a wide range of activities because of varying types of events and baseline medical and health infrastructures. A classification system for mass gatherings can aid in the planning process internationally and also achieve a commonality of language for describing future events. This cycle of event, analysis, training, planning, and new event should be the goal for those involved in organizing mass gathering medical care. The event plan specifies the various training requirements, certifications, and indemnity/malpractice or insurance required of the medical director and deputy. Management of a mass gathering from the medical perspective requires human resources, medical equipment, pharmaceuticals, and medical facilities with sufficient examination rooms on site. As mass gatherings become more frequent, more experts need to be trained and more research performed to ensure continued reductions in morbidity and mortality among those attending or managing such events.
REFERENCES
Levett, J. A new opportunity for public health development: Athens 2004. Prehosp Disaster Med. 2004;19(2):130–132.
The role of the emergency physician in mass casualty/disaster management. ACEP position paper. JACEP. 1976;5(11):901–902.
,Manifesto for Emergency Medicine in Europe. Council of the European Society for Emergency Medicine. Eur J Emerg Med. 1998;5(4):389–390.
Hsu, EB, Jenckes, MW, Catlett, CL, Robinson, KA, Feuerstein, C, Cosgrove, SE, et al. Effectiveness of hospital staff mass-casualty incident training methods: a systematic literature review. Prehosp Disaster Med. 2004;19(3):191–199.
McDonald, R. Career Focus – Event medicine. BMJ Classified. 2001 15th December;323(7324).
Kerr, GW, Wilkie, SC, McGuffie, CA. Medical cover at Scottish football matches: have the recommendations of the Gibson Report been met? Br J Sports Med. 1999;33(4):274–275.
Avery, JG, Chitnis, JG, Daly, PJ, Pollock, GT. Medical planning for a major event: the Pope's visit to Coventry Airport, 30 May 1982. Br Med J (Clin Res Ed). 1982;285(6334):51–53.
Federman, JH, Giordano, LM. How to cope with a visit from the Pope. Prehosp Disaster Med. 1997;12(2):86–91.
El Bashir, H, Rashid, H, Memish, ZA, Shafi, S. Meningococcal vaccine coverage in Hajj pilgrims. Lancet. 2007;369(9570):1343.
Morrison, DJ. Heatstroke on the Hajj. Lancet. 1980;1(8174):935.
Ahmed, QA, Arabi, YM, Memish, ZA. Health risks at the Hajj. Lancet. 2006;367(9515):1008–1015.
Schulte, D, Meade, DM. The papal chase. The Pope's visit: a “mass” gathering. Emerg Med Serv. 1993;22(11):46–9, 65–75, 9.
Madani, TA, Ghabrah, TM, Al-Hedaithy, MA, et al. Causes of hospitalization of pilgrims in the Hajj season of the Islamic year 1423 (2003). Ann Saudi Med. 2006;26(5):346–351.
Al-Ghamdi, SM, Akbar, HO, Qari, YA, Fathaldin, OA, Al-Rashed, RS. Pattern of admission to hospitals during Muslim pilgrimage (Hajj). Saudi Med J. 2003;24(10):1073–1076.
,County Board of Commissioners, Union County, North Carolina. Ordinance Pertaining to Mass Gatherings. 1974:224–7 Docket 12.
An Ordinance for the Regulation of Mass Gatherings in Alleghany County. Alleghany County, North Carolina, 1975.
,Arkansas State Board of Health. Mass Gathering regulations. 1973.
Arnold, JL, Levine, BN, Manmatha, R, et al. Information-sharing in out-of-hospital disaster response: the future role of information technology. Prehosp Disaster Med. 2004;19(3):201–207.
Arbon, P, Bridgewater, FH, Smith, C. Mass gathering medicine: a predictive model for patient presentation and transport rates. Prehosp Disaster Med. 2001;16(3):150–158.
Jaslow, D, Drake, M, Lewis, J. Characteristics of state legislation governing medical care at mass gatherings. Prehosp Emerg Care. 1999;3(4):316–320.
Best, JP, McIntosh, AS, Savage, TN. Rugby World Cup 2003 injury surveillance project. Br J Sports Med. 2005;39(11):812–817.
Cheng, D, Yakobi-shvili, R, Fernandez, J. Major sport championship influence on ED sex census. Am J Emerg Med. 2005;23(3):408–409.
Roberts, DM, Blackwell, TH, Marx, JA. Emergency medical care for spectators attending National Football League games. Prehosp Emerg Care. 1997;1(3):149–155.
Moreno, Millan E, Bonilla, F, Alonso, JM, Casado, F. Medical care at the VIIth International Amateur Athletics Federation World Championships in Athletics ‘Sevilla '99’. Eur J Emerg Med. 2004;11(1):39–43.
Bock, HC, Cordell, WH, Hawk, AC, Bowdish, GE. Demographics of emergency medical care at the Indianapolis 500 mile race (1983–1990). Ann Emerg Med. 1992;21(10):1204–1207.
Ma, OJ, Millward, L, Schwab, RA. EMS medical coverage at PGA tour events. Prehosp Emerg Care. 2002;6(1):11–14.
Morimura, N, Katsumi, A, Koido, Y, et al. Analysis of patient load data from the 2002 FIFA World Cup Korea/Japan. Prehosp Disaster Med. 2004;19(3):278–284.
The price of pop. Lancet. 1971;2(7726):696–697.
Carveth, SW. Eight-year experience with a stadium-based mobile coronary-care unit. Heart Lung. 1974;3(5):770–774.
Fisher, JM. The British Association for Immediate Care (BASICS). Its experience in major disasters, with special reference to the role of the medical incident officer. Injury. 1990;21(1):45–48; discussion 55–57.
Slater, D. Hillsborough television drama. Br Med J. 1997;314(7084):901–902.
Wardrope, J, Hockey, MS, Crosby, AC. The hospital response to the Hillsborough tragedy. Injury. 1990;21(1):53–4; discussion 5–7.
Heller, T. Personal and medical memories from Hillsborough. Br Med J. 1989;299(6715):1596–1598.
Walker, E. Not all those who died after Hillsborough did so by 3:15 pm. Br Med J. 1997;314(7089):1283.
DeAngeles, D, Schurr, M, Birnbaum, M, Harms, B. Traumatic asphyxia following stadium crowd surge: stadium factors affecting outcome. WMJ. 1998;97(9):42–45.
Khoosal, DI, Broad, JA, Smith, RJ, Settle, JA. A one-year psychological follow-up of the most severely burned victims of the Bradford fire. Burns Incl Therm Inj. 1987;13(5):411–415.
Sivaloganathan, S, Green, MA. The Bradford fire disaster. Part 2. accident reconstruction: who died, when and why. Med Sci Law. 1989;29(4):284–286.
Sivaloganathan, S, Green, MA. The Bradford fire disaster. Part 1. The initial investigations: who died, where and how? Med Sci Law. 1989;29(4):279–283.
Ayton, FD, Hill, CM, Parfitt, HN. The dental role in the identification of the victims of the Bradford City football ground fire. Br Dent J. 1985;159(8):262–264.
Sharpe, DT, Roberts, AH, Barclay, TL, et al. Treatment of burns casualties after fire at Bradford City football ground. Br Med J (Clin Res Ed). 1985;291(6500):945–948.
Sharpe, DT, Foo, IT. Management of burns in major disasters. Injury. 1990;21(1):41–4; discussion 55–57.
Leonard, RB. Medical support for mass gatherings. Emerg Med Clin North Am. 1996;14(2):383–397.
Brock, SH, Schlicht, J. Medical aspects of large outdoor festivals. Lancet. 1972;1(7761):1178.
Schlicht, J, Mitcheson, M, Henry, M. Medical aspects of large outdoor festivals. Lancet. 1972;1(7757):948–952.
Erickson, TB, Aks, SE, Koenigsberg, M, Bunney, EB, Schurgin, B, Levy, P. Drug use patterns at major rock concert events. Ann Emerg Med. 1996;28(1):22–26.
Ounanian, LL, Salinas, C, Shear, CL, Rodney, WM. Medical care at the 1982 US Festival. Ann Emerg Med. 1986;15(5):520–527.
Nix, CM, Khan, IJ, Hoban, M, Little, G, Keye, G, O'Connor, HJ. Oxegen 2004: the impact of a major music festival on the workload of a local hospital. Ir Med J. 2006;99(6):167–169.
Chapman, KR, Carmichael, FJ, Goode, JE. Medical services for outdoor rock music festivals. Can Med Assoc J. 1982;126(8):935–938.
Tait, I. General practitioner and his music festival. Br Med J (Clin Res Ed). 1981;283(6292):647–648.
Grange, JT, Green, SM, Downs, W. Concert medicine: spectrum of medical problems encountered at 405 major concerts. Acad Emerg Med. 1999;6(3):202–207.
O'Keefe, JS, Kheir, JN, Martin, ML, Leslie, LF, Neal, JG, Edlich, RF. Balcony collapse at the University of Virginia graduation: what hath Jefferson wrought? J Emerg Med. 1999 17(2):293–297.
Martinez, JM. Medical coverage of cycling events. Curr Sports Med Rep. 2006;5(3):125–130.
Yan, CB, Rubin, AL. Equipment and supplies for sports and event medicine. Curr Sports Med Rep. 2005;4(3):131–136.
Grange, JT. Planning for large events. Curr Sports Med Rep. 2002;1(3):156–161.
Mortelmans, LJ, Rossom, P, Du Bois, M, Jutten, G. Carbon monoxide load in indoor carting. Eur J Emerg Med. 2003;10(2):105–107.
DeLorenzo, RA, Gray, BC, Bennett, PC, Lamparella, VJ. Effect of crowd size on patient volume at a large, multipurpose, indoor stadium. J Emerg Med. 1989;7(4):379–384.
Larkin, M. Medical teams geared up for winter Olympics. Lancet. 2002;359(9304):412.
Baker, WM, Simone, BM, Niemann, JT, Daly, A. Special event medical care: the 1984 Los Angeles Summer Olympics experience. Ann Emerg Med. 1986;15(2):185–190.
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(6):318–321.
Wetterhall, SF, Coulombier, DM, Herndon, JM, Zaza, S, Cantwell, JD. Medical care delivery at the 1996 Olympic Games. Centers for Disease Control and Prevention Olympics Surveillance Unit. JAMA. 1998;279(18):1463–1468.
Morimura, N, Takahashi, K, Katsumi, A, et al. Mass gathering medicine for the First East Asian Football Championship and the 24th European/South American Cup in Japan. Eur J Emerg Med. 2007;14(2):115–117.
Madzimbamuto, FD. A hospital response to a soccer stadium stampede in Zimbabwe. Emerg Med J. 2003;20(6):556–559.
Tang, N, Kraus, CK, Brill, JD, Shahan, JB, Ness, C, Scheulen, JJ. Hospital-based event medical support for the Baltimore marathon, 2002–2005. Prehosp Emerg Care. 2008;12(3):320–326.
Bowdish, GE, Cordell, WH, Bock, HC, Vukov, LF. Using regression analysis to predict emergency patient volume at the Indianapolis 500 mile race. Ann Emerg Med. 1992;21(10):1200–1203.
Auerbach, PS, Gelb, AM, Turns, JE. Emergency medical services at the 1984 Democratic National Convention. Ann Emerg Med. 1985;14(7):709–711.
Avsarogullari, L, Ikizceli, I, Sozuer, E, Yurumez, Y, Kilic, S. Hand injuries during a Muslim Sacrifice Festival. Am J Emerg Med. 2004;22(6):508–509.
The Football Association of Ireland – Club Licensing Manual. Dublin, Ireland: FAI 2004:118.
Murphy, D, Jabbar, N, Eldin, M, Gillen, P. Audit of the impact of a major pop concert on the workload of two regional hospitals. Ir Med J. 2001;94(1):15.
Zeitz, KM, Schneider, DP, Jarrett, D, Zeitz, CJ. Mass gathering events: retrospective analysis of patient presentations over seven years. Prehosp Disaster Med. 2002;17(3):147–150.
Chambers, J, Guly, H. The impact of a music festival on local health services. Health Trends. 1991;23(3):122–123.
Grange, JT, Baumann, GW, Vaezazizi, R. On-site physicians reduce ambulance transports at mass gatherings. Prehosp Emerg Care. 2003;7(3):322–326.
Sanders, AB, Criss, E, Steckl, P, Meislin, HW, Raife, J, Allen, D. An analysis of medical care at mass gatherings. Ann Emerg Med. 1986;15(5):515–519.
Zeitz, KM, Zeitz, CJ, Arbon, P. Forecasting medical work at mass-gathering events: predictive model versus retrospective review. Prehosp Disaster Med. 2005;20(3):164–168.
Bacon, J. The Event Safety Guide. 2nd ed. Sudbury, Suffolk, UK: HSE Books; 1999.
Calabro, J, Krohmer, J, Rivera-Rivera, E, Balcombe, D, Reich, J. Provision of Emergency Medical Care for Crowds. American College of Emergency Physicians; 1996.
Jaslow, D, Yancy, A, Milsten, A. Mass gathering medical care. National Association of EMS Physicians Standards and Clinical Practice Committee. Prehosp Emerg Care. 2000;4(4):359–360.
Jaslow, D, Yancy, A, Milsten, A. Mass Gathering Medical Care: The Medical Director's Checklist. National Association of EMS Physicians (NAEMSP); 2000.
Barbeschi, M, Healing, T. Communicable disease alert and response for mass gatherings – Key considerations. World Health Organization; June, 2008.
Ryan, JM, Noone, E, Plunkett, PK. Review of a mobile accident and emergency unit at a rock concert. Ir Med J. 1994;87(5):148–149.
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. 2003;18(4):334–346.
Milsten, AM, Maguire, BJ, Bissell, RA, Seaman, KG. Mass-gathering medical care: a review of the literature. Prehosp Disaster Med. 2002;17(3):151–162.
Black, JJ. Emergency use of the Airtraq laryngoscope in traumatic asphyxia: case report. Emerg Med J. 2007;24(7):509–510.
Maharaj, CH, Ni Chonghaile, M, Higgins, BD, Harte, BH, Laffey, JG. Tracheal intubation by inexperienced medical residents using the Airtraq and Macintosh laryngoscopes – a manikin study. Am J Emerg Med. 2006;24(7):769–774.
Timmermann, A, Russo, SG, Rosenblatt, WH, et al. Intubating laryngeal mask airway for difficult out-of-hospital airway management: a prospective evaluation. Br J Anaesth. 2007;99(2):286–291.
Code of Practice for Safety at Outdoor Pop Concerts and other Musical Events. Department of Education, The Stationery Office, Government of Ireland Publications, 1996.
Code of Practice for Safety at Sports Grounds. Department of Education, The Stationery Office, Government of Ireland Publications, 1996.
Code of Practice for Safety at Indoor Concerts. Department of Environment and Local Government, The Stationery Office, Government of Ireland Publications, 1998.
Mcdonnell, JG. Need for adequate sunscreen and after sun products at summer events. Personal communication ed. Dublin: email 2002.
Stubbe, M, Swinnen, R, Crusiaux, A, Mascart, F, Lheureux, PE. Seroprotection against tetanus in patients attending an emergency department in Belgium and evaluation of a bedside immunotest. Eur J Emerg Med. 2007;14(1):14–24.
Stubbe, M, Mortelmans, LJ, Desruelles, D, et al. Improving tetanus prophylaxis in the emergency department: a prospective, double-blind cost-effectiveness study. Emerg Med J. 2007;24(9):648–653.
Crocco, TJ, Sayre, MR, Liu, T, Davis, SM, Cannon, C, Potluri, J. Mathematical determination of external defibrillators needed at mass gatherings. Prehosp Emerg Care. 2004;8(3):292–297.
Motyka, TM, Winslow, JE, Newton, K, Brice, JH. Method for determining automatic external defibrillator need at mass gatherings. Resuscitation. 2005;65(3):309–314.
Britten, S, Whiteley, MS, Fox, PF, Goodwin, MI, Horrocks, M. Medical treatment at Glastonbury Festival. Br Med J. 1993;307(6910):1009–1010.
Delaney, JS, Drummond, R. Mass casualties and triage at a sporting event. Br J Sports Med. 2002;36(2):85–88; discussion 8.
Friedman, LJ, Rodi, SW, Krueger, MA, Votey, SR Medical care at the California AIDS Ride 3: experiences in event medicine. Ann Emerg Med. 1998;31(2):219–223.
Smith, FW. Where is the crowd doctor? Br J Sports Med. 1998;32(3):198.
Trites, P, Stephenson, D. Preparing a field hospital for a “mass” gathering. Can Nurse. 1984;80(11):48–50.
Banner, G. The Rhode Island Medical Emergency Distribution System (MEDS). Disaster Manage Response. 2004;2(2):53–57.
Lorenzo, RA, Boyle, MF, Garrison, R. A proposed model for a residency experience in mass gathering medicine: the United States Air Show. Ann Emerg Med. 1993;22(11):1711–1714.
Galante, JM, Jacoby, RC, Anderson, JT. Are surgical residents prepared for mass casualty incidents? J Surg Res. 2006;132(1):85–91.
Goldman, B. Spectator events: medical preparation a must. Can Med Assoc J. 1988;138(2):164–165.
Madge, SN, Kersey, JP, Murray, G, Murray, JR Are we training junior doctors to respond to major incidents? A survey of doctors in the Wessex region. Emerg Med J. 2004;21(5):577–579.
Mann, NC, MacKenzie, E, Anderson, C. Public health preparedness for mass-casualty events: a 2002 state-by-state assessment. Prehosp Disaster Med. 2004;19(3):245–255.
Rubin, AL. Safety, , security, and preparing for disaster at sporting events. Curr Sports Med Rep. 2004;3(3):141–145.
Rutherford, WH. The place of exercises in disaster management. Injury. 1990;21(1):58–60; discussion 3–4.
Michael, JA, Barbera, JA. Mass gathering medical care: a twenty-five year review. Prehosp Disaster Med. 1997;12(4):305–312.
Arbon, P. Mass-gathering medicine: a review of the evidence and future directions for research. Prehosp Disaster Med. 2007;22(2):131–135.