Skip to main content Accessibility help

Use and Analysis of Field Triage Criteria for Mass Gatherings

  • Steven D. Salhanick (a1), William Sheahan (a2) and Jeffrey J. Bazarian (a3)



Mass gatherings may result in an acute increase in the number of people seeking medical care potentially causing undue stress to local emergencymedical services (EMS) and hospitals. Often, temporary medical facilities are established within the mass gathering venue. Emergency Medical Services providers encountering patients in the field should be equipped with effective protocols to determine transport destination (venue facility vs. hospital).


Paramedics are capable of appropriately using triage criteria written specifically for a particular mass gathering. The use of triage criteria, when appliedcorrectly, decreases over-triage to the venue facility and under-triage to the hospital.


Paramedics triaged patients at a mass gathering to a temporary venue facility or to a single emergency department using criteria specific for the event. Cases were reviewed to determine if the patients transported went to an appropriate facility and if the triage criteria were applied appropriately. Results: Transport destination was consistent with that dictated by the criteria for 78% of cases. Analysis of these cases shows that the criteria had a sensitivity of 100% (95% CI = 58–100%) and a specificity of 90% (95% CI = 73–98%) for predicting which patients needed hospital services and which could be cared for safely in the temporary clinic setting.


Triage by paramedics at the point of patient contact may reduce transporting of patients to hospitals unnecessarily. Patients in need of hospital services were identified. Point-of-contact triage should be applied in mass gatherings.


Corresponding author

Program in Toxicology, Division of Emergency Medicine, Children's Hospital, Boston, I. C. Smith Building, 300 Longwood Avenue, Boston, MA 02115 USA, E-mail:


Hide All
1. 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):515519.
2. Leonard, RB: Medical Support for Mass Gatherings. Emerg Med Clin North Am 1996;14(2):383397.
3. Suy, K, Gijsenbergh, F, Baute, L: Emergency medical assistance during a mass gathering. Eur J Emerg Med 1999;6(3):249254.
4. Derlet, RW, Richards, JR: Overcrowding in the nation's emergency departments: Complex causes and disturbing effects. Ann Emerg Med 2000;53(1): 6368.
5. Nordberg, M: EMS and Mass Gatherings. Emerg Med Services 1990;19:46. (Abstract)
6. 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):219223.
7. Motalto, NJ, Janas, TB: Medical coverage of recreational cycling events. Clin Sports Med 1994;13(1):249258.
8. Gannon, DM, Derse, AR, Bronkema, PJ, Primley, DM: The emergency care network of a ski marathon. Am J Sports Med 1985;13(5):316320.
9. Laird, RH: Medicalcare at ultraendurance triathalons. Med Sci Sports and Exerc. 1989;21(5 Suppl):S222225.
10. Whipkey, RR, Paris, PM, Stewart, RD: Emergency care for mass gatherings. Postgrad Med 1984;76(2):4454.
11. Scmidt, TA, Atcheson, R, Federiuk, C, Mann, NC, Pinney, T, Fuller, D, Colbry, K: Hospital follow-up of patients categorized as not needing an ambulance using a set of emergency medical technician protocols. Prehosp Emerg Care 2001;5(4):366370.
12. Schaefer, RA, Rea, TD, Plorde, M, Peiguss, K, Goldberg, P, Murray, JA: An emergency medical services program of alternate destination of patient care. Prehosp Emerg Care 2002;6(3):309314.
13. Silvestri, S, Rothrock, SG, Kennedy, D, Ladde, J, Bryant, M, Pagane, J: Can paramedics accurately identify patients who do not require emergency department care? Prehosp Emerg Care 2002;6(4):387390.
14. Pointer, JE, Levitt, MA, Young, JC, Promes, SB, Messana, BJ, Ader, MEJ: Can paramedicsusing guidelines accurately triage patients? Ann Emerg Med 2001;38(3):268277.


Use and Analysis of Field Triage Criteria for Mass Gatherings

  • Steven D. Salhanick (a1), William Sheahan (a2) and Jeffrey J. Bazarian (a3)


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