Skip to main content Accessibility help

Mass-Gathering Medical Care Provided by a Collegiate-Based First Response Service at an Annual College Music Festival and Campus-Wide Celebration

  • Nicholas M.G. Friedman (a1), Emily K. O’Connor (a1), Timothy Munro (a2) and David Goroff (a1) (a3)



There is insufficient research on medical care at mass-gathering events (MGEs) on college and university campuses. Fun Day is an annual celebratory day held at Skidmore College (Saratoga Springs, New York USA), a small liberal arts college in the Northeastern United States. Fun Day is focused around an outdoor music festival; students also congregate and celebrate throughout the surrounding campus. To improve care and alleviate strain on local resources, a model was developed for the provision of emergency care by a collegiate-based, volunteer first-response service – Skidmore College Emergency Medical Services (EMS) – in coordination with a contracted, private ambulance service.


The aims of this study were to: (1) analyze medical usage rates and case mixes at Fun Day over a four-year period, and to (2) describe the collegiate-based first response model for MGEs.


Data were collected retrospectively from event staff, college administrators, and Skidmore College EMS on event-related variables, patient encounters, and medical operations at Fun Day over a four-year period (2014-2017).


Annual attendance at the music festival was estimated at 2,000 individuals. Over four years, 54 patients received emergency medical care on campus on Fun Day, and 18 (33.3%) were transported to the emergency department. On-site contracted ambulances transported 77.8% of patients who were transported to the emergency department; mutual aid was requested for the other 22.2% of transports. The mean (SD) patient presentation rate (PPR) was 7.0 (SD = 1.0) per 1,000 attendees. The mean (SD) transport-to-hospital rate (TTHR) was 2.0 (SD = 1.0) per 1,000 attendees. Thirty (55.6%) patients presented with intoxication, seven (13.0%) with laceration(s), and five (9.3%) with head trauma as the primary concern. Medical command was established by volunteer undergraduate students. Up to 16 volunteer student first responders (including emergency medical technicians [EMTs]) were stationed on campus, in addition to two contracted ambulances at the Basic Life Support (BLS) and Advanced Life Support (ALS) levels. Operational strategies included: mobile first response crews, redundant communication systems, preventative education, and harm reduction.


High medical usage rates were observed, primarily due to alcohol/illicit substance use and traumatic injuries. The provision of emergency care by a collegiate-based first response service in coordination with a contracted, private ambulance agency serves as an innovative model for mass-gathering medical care on college and university campuses.

FriedmanNMG, O’ConnorEK, MunroT, GoroffD.Mass-Gathering Medical Care Provided by a Collegiate-Based First Response Service at an Annual College Music Festival and Campus-Wide Celebration. Prehosp Disaster Med. 2019;34(1):98–103.


Corresponding author

Correspondence: Nicholas MG Friedman, BA, EMT 117 N 15th Street Philadelphia, Pennsylvania 19102 USA E-mail:


Hide All

Conflicts of interest: none



Hide All
1. Arbon, P. Mass gathering medicine: a review of the evidence and future directions for research. Prehosp Disaster Med. 2007;22(2):131-135.
2. Milsten, AM, Maguire, BJ, Bissell, RA, et al. Mass gathering medical care: a review of the literature. Prehosp Disaster Med. 2002;17(3):151-162.
3. Wolbrom, DH, Rahman, A, Hilton, MT. A survey of 200 National Collegiate Emergency Medical Service organizations. Prehosp Disaster Med. 2017;32(suppl 1):S169-S170.
4. Friedman, NMG, Dingler, BJ, Nable, JV, Koenig, GJ. Research and scholarship in Collegiate Emergency Medical Services: current state and opportunities for progress. J Coll Emerg Med Serv. 2018;1(1):5-12.
5. National Oceanic and Atmospheric Administration. Climate Data Online (CDO). National Oceanic and Atmospheric Administration web site. Accessed March 26, 2018.
6. Ross, D, Schullek, J, Homan, M. EMS triage and transport of intoxicated individuals to a detoxification facility instead of an emergency department. Ann Emerg Med. 2013;61(2):175-184.
7. FitzGibbon, KM, Nable, JV, Ayd, B, et al. Mass-gathering medical care in electronic dance music festivals. Prehosp Disaster Med. 2017;32(5):1-5.
8. Friedman, MS, Plocki, A, Likourezos, A, et al. A prospective analysis of patients presenting for medical attention at a large electronic dance music festival. Prehosp Disaster Med. 2017;32(1):78-82.
9. Lund, A, Turris, SA. Mass-gathering medicine: risks and patient presentations at a 2-day electronic dance music event. Prehosp Disaster Med. 2015;30(3):271-278.
10. Milsten, AM, Seaman, KG, Liu, P, Bissell, RA. Variables influencing medical usage rates, injury patterns, and levels of care for mass gatherings. Prehosp Disaster Med. 2003;18(4):334-346.
11. Munn, MB, Lund, A, Golby, R, Turris, SA. Observed benefits to on-site medical services during an annual 5-day electronic dance music event with harm reduction services. Prehosp Disaster Med. 2016;31(2):228-234.
12. Westrol, MS, Koneru, S, McIntyre, N, Caruso, AT, Arshad, FH, Merlin, MA. Music genre as a predictor of resource utilization at outdoor music concerts. Prehosp Disaster Med. 2017;32(3):1-8.
13. 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.
14. Hartman, N, Williamson, A, Sojka, B, et al. Predicting resource use at mass gatherings using a simplified stratification scoring model. Am J Emerg Med. 2009;27(3):337-343.
15. Locoh-Donou, S, Yan, G, Berry, T, et al. Mass gathering medicine: event factors predicting patient presentation rates. Intern Emerg Med. 2016;11(5):745-752.
16. Ordway, EC, Sarna, N, DeGeorge, LM, Baird, AM, Reid, MJ, Nable, JV. EMS resource utilization at college campus mass gathering events. J Coll Emerg Med Serv. 2018;1(2):24-30.
17. Zeitz, K, Bolton, S, Dippy, R, et al. Measuring emergency services workloads at mass gathering events. Aust J Emerg Manage. 2007;22(3):23-30.
18. Hutton, A, Ranse, J, Verdonk, N, Ullah, S, Arbon, P. Understanding the characteristics of patient presentations of young people at outdoor music festivals. Prehosp Disaster Med. 2014;29(2):160-166.
19. Kaplan, MS, Huguet, N, McFarland, BH, et al. Use of alcohol before suicide in the United States. Ann Epidemiol. 2014;24(8):588-592.
20. Rehm, J, Room, R, Graham, K, Monteiro, M, Gmel, G, Sempos, C. The relationship of average volume of alcohol consumption and patterns of drinking to burden of disease–an overview. Addiction. 2003;98(9):1209-1228.
21. Taylor, B, Irving, HM, Kanteres, F, et al. The more you drink, the harder you fall: a systematic review and meta-analysis of how acute alcohol consumption and injury or collision risk increase together. Drug Alcohol Depend. 2010;110(1-2):108-116.
22. Rosen, JB, Olson, MH, Kelly, M. Collegiate-based emergency medical service: impact on alcohol-related emergency department transports at a small liberal arts college. J Am Coll Health. 2012;60(3):263-265.
23. Luchette, KR, Isik, OG, Rybasack-Smith, H, Asselin, N, Martin, TJ. Optimizing collegiate EMS resources during major events. J Coll Emerg Med Serv. 2018;1(Suppl 1):S39.
24. Grange, JT, Baumann, GW, Vaezazizi, R. On-site physicians reduce ambulance transports at mass gatherings. Prehosp Emerg Care. 2003;7(3):322-326.
25. Martin-Gill, C, Brady, WJ, Barlotta, K, et al. Hospital-based healthcare provider (nurse and physician) integration into an emergency medical services–managed mass-gathering event. Am J Emerg Med. 2007;25(1):15-22.
26. Luther, M, Gardiner, F, Lenson, S, et al. An effective risk minimization strategy applied to an outdoor music festival: a multi- agency approach. Prehosp Disaster Med. 2018;33(2):220-224.


Type Description Title
Supplementary materials

Friedman et al. supplementary material
Table S1

 Word (14 KB)
14 KB


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed