Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-23T08:22:35.717Z Has data issue: false hasContentIssue false
  • English
  • Français

Measuring the Masses: Mass-Gathering Medical Case Reporting, Conceptual Modeling – The DREAM Model (Paper 5)

Published online by Cambridge University Press:  19 February 2021

Adam Lund ,
Sheila Turris ,
Haddon Rabb Open the ORCID record for Haddon Rabb [Opens in a new window] ,
Matthew Brendan Munn ,
Elizabeth Chasmar ,
Jamie Ranse  and
Alison Hutton Open the ORCID record for Alison Hutton [Opens in a new window]
Adam Lund*
Affiliation:
Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada Mass Gathering Medicine Interest Group, Department of Emergency Medicine, University of British Columbia, Canada University of British Columbia, School of Nursing, Vancouver, British Columbia, Canada
Sheila Turris
Affiliation:
Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada Mass Gathering Medicine Interest Group, Department of Emergency Medicine, University of British Columbia, Canada
Haddon Rabb
Affiliation:
Mass Gathering Medicine Interest Group, Department of Emergency Medicine, University of British Columbia, Canada
Matthew Brendan Munn
Affiliation:
Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada Mass Gathering Medicine Interest Group, Department of Emergency Medicine, University of British Columbia, Canada
Elizabeth Chasmar
Affiliation:
Mass Gathering Medicine Interest Group, Department of Emergency Medicine, University of British Columbia, Canada
Jamie Ranse
Affiliation:
Department of Emergency Medicine, Gold Coast Health, Southport, Queensland, Australia Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
Alison Hutton
Affiliation:
School of Nursing, Newcastle University, New South Wales, Australia
*
Correspondence: Adam Lund, BSc, MD, MEd, FRCPCMass Gathering Medicine Interest GroupUniversity of British ColumbiaVancouver, British Columbia, CanadaE-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Without a robust evidence base to support recommendations for first aid, health, and medical services at mass gatherings (MGs), levels of care will continue to vary. Streamlining and standardizing post-event reporting for MG medical services could improve inter-event comparability, and prospectively influence event safety and planning through the application of a research template, thereby supporting and promoting growth of the evidence base and the operational safety of this discipline. Understanding the relationships between categories of variables is key. The present paper is focused on theory building, providing an evolving conceptual model, laying the groundwork for exploring the relationships between categories of variables pertaining the health outcomes of MGs.

Methods:

A content analysis of 54 published post-event medical case reports, including a comparison of the features of published data models for MG health outcomes.

Findings:

A layered model of essential conceptual components for post-event medical reporting is presented as the Data Reporting, Evaluation, & Analysis for Mass-Gathering Medicine (DREAM) model. This model is relational and embeds data domains, organized operationally, into “inputs,” “modifiers,” “actuals,” and “outputs” and organized temporally into pre-, during, post-event, and reporting phases.

Discussion:

Situating the DREAM model in relation to existing models for data collection vis a vis health outcomes, the authors provide a detailed discussion on similarities and points of difference.

Conclusion:

Currently, data collection and analysis related to understanding health outcomes arising from MGs is not informed by robust conceptual models. This paper is part of a series of nested papers focused on the future state of post-event medical reporting.

Keywords

case reportingconceptual modelingmass gatheringmass-gathering healthmass-gathering medicine
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 2 , April 2021 , pp. 227 - 233
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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

Turris, S, Rabb, H, Munn, MB, et al. Measuring the masses: the current state of mass gathering medical case reporting (paper 1). Prehosp Disaster Med. 2021. In press.CrossRefGoogle Scholar
Ryan, G, Bernard, H. “Chapter 29: Data management and analysis methods.” In: Denzin, NK, Lincoln, YS, (eds). Handbook of Qualitative Research. 2nd ed. Thousand Oaks, California USA: Sage Publications; 2000:769–802.Google Scholar
Dixon-Woods, M, Cavers, D, Agarwal, S, et al. Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups. BMC Med Res Methodol. 2006;6(1):35.CrossRefGoogle ScholarPubMed
Sandelowski, M, Voils, CI, Barroso, J. Defining and designing mixed research synthesis studies. Res Sch. 2006;13(1):29.Google ScholarPubMed
Gibbs, GR. “Thematic coding and categorizing.” In: Flick, U, (ed). Analysing Qualitative Data. London, UK: Sage Publications; 2007.CrossRefGoogle Scholar
Saldana, J. The Coding Manual for Qualitative Researchers. Third ed. London, UK: Sage Publications; 2015.Google Scholar
Harding, T, Whitehead, D. “Analysing data in qualitative research.” In: Schneider, Z, Whitehead, D, (eds). Nursing and Midwifery Research: Methods and Appraisal for Evidence Based Practice. Fifth ed. NSW Australia: Elsevier Australia; 2016:127–142.Google Scholar
Ranse, J, Hutton, A, Turris, SA, Lund, A. Enhancing the minimum data set for mass-gathering research and evaluation: an integrative literature review. Prehosp Disaster Med. 2014;29(3):280–289.CrossRefGoogle Scholar
Turris, S, Lund, A, Munn, MB, et al. Measuring the masses series: domains driving data collection and analysis for the health outcomes of mass gatherings (paper 3). Prehosp Disaster Med. 2021. In press.CrossRefGoogle Scholar
Agar, C, Pickard, L, Bhangu, A. The tough guy prehospital experience: patterns of injury at a major UK endurance event. Emerg Med J. 2009;26(11):826–830.CrossRefGoogle Scholar
Alaska, YA, Aldawas, AD, Aljerian, NA, Memish, ZA, Suner, S. The impact of crowd control measures on the occurrence of stampedes during mass gatherings: the Hajj experience. Travel Med Infect Dis. 2017;15:67–70.CrossRefGoogle ScholarPubMed
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):289–296.CrossRefGoogle ScholarPubMed
Andersen, CA, Clarsen, B, Johansen, TV, Engebretsen, L. High prevalence of overuse injury among iron-distance triathletes. Br J Sports Med. 2013;47(13):857–861.CrossRefGoogle ScholarPubMed
Aitsi-Selmi, A, Murray, V, Heymann, D, et al. Reducing risks to health and wellbeing at mass gatherings: the role of the Sendai framework for disaster risk reduction. Int J Infect Dis. 2016;47:101–104.CrossRefGoogle ScholarPubMed
Government of Canada. Risk mitigation tool for gatherings and events operating during the COVID-19 pandemic. Government of Canada.Google Scholar
Major Planned Events Working Group. British Columbia Major Planned Events Guide. British Columbia, Canada; 2020.Google Scholar
Schwartz, B, Nafziger, S, Milsten, A, Luk, J, Yancey, A. II Mass gathering medical care: resource document for the national association of EMS physicians position statement. Prehospital Emerg Care. 2015;19(4):559–568.Google ScholarPubMed
World Health Organization. Public Health for Mass Gatherings: Key Considerations. Geneva, Switzerland: WHO; 2008.Google Scholar
Zeitz, KM, Tan, HM, Grief, M, Couns, P, Zeitz, CJ. Crowd behavior at mass gatherings: a literature review. Prehosp Disaster Med. 2009;24(1):32–38.CrossRefGoogle ScholarPubMed
Hutton, A, Ranse, J, Gray, KL, Turris, SA, Lund, A, Munn, MB. Environmental influences on patient presentations: considerations for research and evaluation at mass-gathering events. Prehosp Disaster Med. 2019;34(05):552–556.CrossRefGoogle ScholarPubMed
Soomaroo, L, Murray, V. Weather and environmental hazards at mass gatherings. PLoS Curr. 2012;4.Google ScholarPubMed
Ranse, J, Lenson, S, Keene, T, et al. Impacts on in-event, ambulance and emergency department services from patients presenting from a mass gathering event: a retrospective analysis. Emerg Med Australas. 2019;31(3):423–428.CrossRefGoogle ScholarPubMed
Molloy, MS, Brady, F, Maleady, K. Impact of a single large mass gathering music event, from a series of such events, on a receiving hospitals emergency department (ED). Prehosp Disaster Med. 2017;28(S1):S112.Google Scholar
Lund, A, Turris, SA, Bowles, R. Conceptualizing the impact of special events on community health service levels: an operational analysis. Prehosp Disaster Med. 2014;29(5):525–531.CrossRefGoogle ScholarPubMed
Hutton, A, Ranse, J, Lipscomb, R, Rabb, H, Crilly, J, Hutton, G. Frequency and location of mass gathering events in relation to emergency departments: a descriptive study. Australas J Paramed. 2019;16.Google Scholar
Heiby, MJ, Barnhardt, W, Berry, T, Welcher, M, Brady, WJ. The impact of a mass gathering events with an on-site medical management team on municipal 911 emergency medical services. Am J Emerg Med. 2013;31(1):256–257.CrossRefGoogle Scholar
Turris, SA, Callaghan, CW, Rabb, H, Munn, MB, Lund, A. On the way out: an analysis of patient transfers from four large-scale North American music festivals over two years. Prehosp Disaster Med. 2019;34(1):72–81.CrossRefGoogle Scholar
Crabtree, N, Mo, S, Ong, L, et al. Retrospective analysis of patient presentations at the Sydney (Australia) royal easter show from 2012 to 2014. Prehosp Disaster Med. 2017;32(2):187–194.CrossRefGoogle ScholarPubMed
Divine, JG, Daggy, MW, Dixon, EE, LeBlanc, DP, Okragly, RA, Hasselfeld, KA. Case series of exertional heat stroke in runners during early spring. Curr Sports Med Rep. 2018;17(5):151–158.CrossRefGoogle ScholarPubMed
Dutch, MJ, Austin, KB. Hospital in the field: prehospital management of GHB intoxication by medical assistance teams. Prehosp Disaster Med. 2012;27(5):463–467.CrossRefGoogle ScholarPubMed
Fizzell, J, Armstrong, PK, Adamson, S, et al. Preparing for and responding to public health issues at a major mass gathering: what happened at world youth day 2008? Prehosp Disaster Med. 2009;24(S1):S36.Google Scholar
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.CrossRefGoogle Scholar
Goyal, AV, Constantinou, V, Fokas, J, Van Duesen Phillips, S, Chan, J, Chiampas, GT. Prehospital care at a mass endurance event: the Chicago marathon experience. Prehosp Disaster Med. 2017;32(S1):S172.CrossRefGoogle Scholar
Grant, WD, Nacca, NE, Prince, LA, Scott, JM. Mass-gathering medical care: retrospective analysis of patient presentations over five years at a multi-day mass gathering. Prehosp Disaster Med. 2010;25(2):183–187.CrossRefGoogle Scholar
Gutman, SJ, Lund, A, Turris, SA. Medical support for the 2009 world police and fire games: a descriptive analysis of a large-scale participation event and its impact. Prehosp Disaster Med. 2011;26(1):33–40.CrossRefGoogle ScholarPubMed
Hardcastle, TC, Samlal, S, Naidoo, R, et al. A redundant resource: a pre-planned casualty clearing station for a FIFA 2010 stadium in Durban. Prehosp Disaster Med. 2012;27(5):409–415.CrossRefGoogle ScholarPubMed
Ho, WH, Koenig, KL, Quek, LS. Formula one night race in Singapore: a 4-year analysis of a planned mass gathering. Prehosp Disaster Med. 2014;29(5):489–493.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
Joslin, J, Mularella, J, Bail, A, Wojcik, S, Cooney, DR. Mandatory rest stops improve athlete safety during event medical coverage for ultramarathons. Prehosp Disaster Med. 2016;31(1):43–45.CrossRefGoogle ScholarPubMed
Kaji, A, Sunada, A, Yamada, M, et al. Heat stroke patients of a mass gathering festival in Japan - Kishiwada Danjiri festival. Prehosp Disaster Med. 2017;32(S1):S139.CrossRefGoogle Scholar
Kemp, AE. Mass-gathering events: the role of advanced nurse practitioners in reducing referrals to local health care agencies. Prehosp Disaster Med. 2016;31(1):58–63.CrossRefGoogle ScholarPubMed
Koçak, H, Çalışkan, C, Sönmezler, MŞ, Eliuz, K, Küçükdurmaz, F. Analysis of medical responses in mass gatherings: the commemoration ceremonies for the 100th anniversary of the battle of Gallipoli. Prehosp Disaster Med. 2018;33(3):288–292.CrossRefGoogle ScholarPubMed
Krul, J, Sanou, B, Swart, EL, Girbes, ARJJ. Medical care at mass gatherings: emergency medical services at large-scale rave events. Prehosp Disaster Med. 2012;27(1):71–74.CrossRefGoogle ScholarPubMed
Krul, J, Girbes, ARJJ. Experience of health-related problems during house parties in the Netherlands: nine years of experience and three million visitors. Prehosp Disaster Med. 2009;24(2):133–139.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
Lund, A, Turris, SA, Wang, P, Mui, J, Lewis, K, Gutman, SJ. An analysis of patient presentations at a 2-day mass-participation cycling event: the ride to conquer cancer case series, 2010-2012. Prehosp Disaster Med. 2014;29(4):429–436.CrossRefGoogle Scholar
Lund, A, Turris, SA, McDonald, R, Lewis, K. On-site management of medical encounters during obstacle adventure course participation. Curr Sports Med Rep. 2015;14(3):182–190.CrossRefGoogle ScholarPubMed
AlAssaf, WI. EMS coverage of a female-only event with 10,000 attendees: preparation and implementation in one week. Prehosp Disaster Med. 2017;32(6):694–698.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
Munn, MB, Laraya, JF, Lund, A, Turris, S. Altered mental status at music festivals: a case study examining clinical concepts and controversies. Prehosp Disaster Med. 2017;32(S1):S131–S132.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
Munn, MB, Sparrow, N, Bertagnolli, C. Mobile response by medical first responders at a music festival. Prehosp Disaster Med. 2017;32(S1):S136–S137.CrossRefGoogle Scholar
Nable, JV, Margolis, AM, Lawner, BJ, et al. Comparison of prediction models for use of medical resources at urban auto-racing events. Prehosp Disaster Med. 2014;29(6):608–613.CrossRefGoogle ScholarPubMed
Nacca, K, Scott, J, Grant, W. Diagnosis according to time of arrival at “the great New York state fair.” Prehosp Disaster Med. 2014;29(1):47–49.CrossRefGoogle Scholar
Pakravan, AH, West, RJ, Hodgkinson, DW. Suffolk show 2011: prehospital medical coverage in a mass-gathering event. Prehosp Disaster Med. 2013;28(5):529–532.CrossRefGoogle Scholar
Prager, R, Sedgwick, C, Lund, A, et al. Point of care ultrasound at a remote multi-day mass gathering: a prospective case series. Prehosp Disaster Med. 2017;32(S1):S137–S138.CrossRefGoogle Scholar
Sabra, JP, Cabañas, JG, Bedolla, J, et al. Medical support at a large-scale motorsports mass-gathering event: the inaugural formula one United States grand prix in Austin, Texas. Prehosp Disaster Med. 2014;29(4):392–398.CrossRefGoogle Scholar
Sanyal, S, Madan, A. Public health safety for traditional mass gatherings in India: a 10-year analysis. Prehosp Disaster Med. 2011;26(S1):S148.CrossRefGoogle Scholar
Anikeeva, O, Arbon, P, Zeitz, K, et al. Patient presentation trends at 15 mass-gathering events in South Australia. Prehosp Disaster Med. 2018;33(4):368–374.CrossRefGoogle ScholarPubMed
Scholliers, A, Gogaert, S, Vande Veegaete, A, Gillebeert, J, Vandekerckhove, P. The most prevalent injuries at different types of mass gathering events: an analysis of more than 150,000 patient encounters. Prehosp Disaster Med. 2017;32(S1):S136.CrossRefGoogle Scholar
Scholliers, A, Gogaert, S, Vande Veegaete, A, Gillebeert, J, Vandekerckhove, P. What skills does a physician need at mass gatherings? An analysis of more than 16,000 patient encounters that required medical attention. Prehosp Disaster Med. 2017;32(S1):S135–S136.Google Scholar
Smith, WP, Tuffin, H, Stratton, SJ, Wallis, LA. Validation of a modified medical resource model for mass gatherings. Prehosp Disaster Med. 2013;28(1):16–22.CrossRefGoogle ScholarPubMed
Turris, SA, Lund, A, Mui, J, Wang, P, Lewis, K, Gutman, SJ. An organized medical response for the Vancouver international marathon (2006–2011). Curr Sports Med Rep. 2014;13(3):147–154.CrossRefGoogle Scholar
Turris, SA, Lund, A, Bowles, RR, Camporese, M, Green, T. Patient presentations and medical logistics at full and half ironman distance triathlons. Curr Sports Med Rep. 2017;16(3):137–143.CrossRefGoogle ScholarPubMed
Turris, SA, Camporese, M, Gutman, SJ, Lund, A. Mass-gathering medicine: risks and patient presentations at a 2-day electronic dance music event - year two. Prehosp Disaster Med. 2016;31(6):687–688.CrossRefGoogle Scholar
Tyner, SE, Hennessy, L, Coombs, LJ, Fizzell, J. Analysis of presentations to on-site medical units during world youth day 2008. Prehosp Disaster Med. 2012;27(6):595–600.CrossRefGoogle ScholarPubMed
Van Dalen, M, Eikendal, T, De Cock, JS, Tan, E, Lischer, F. Evaluation of public health aspects of the 100th “walk of the world” international four-day march Nijmegen. Prehosp Disaster Med. 2017;32(S1):S130.CrossRefGoogle Scholar
Webster, M, Jones, K. Camping, cowboys, and country music: patient and resource management at Canada’s largest multi-day country music festival. Prehosp Disaster Med. 2017;32(S1):S132.CrossRefGoogle Scholar
Wendell, JC, Bitner, MD, Ossmann, EW, Greenwald, IB. Emergency medical response systems in a university athletic program: a descriptive analysis. Prehosp Disaster Med. 2011;26(S1):S149.CrossRefGoogle Scholar
Bortolin, M, Ulla, M, Bono, A, Ferreri, E, Tomatis, M, Sgambetterra, S. Holy shroud exhibition 2010: health services during a 40-day mass-gathering event. Prehosp Disaster Med. 2013;28(3):239–244.CrossRefGoogle ScholarPubMed
Woodall, J, Watt, K, Walker, D, et al. Planning volunteer responses to low-volume mass gatherings: do event characteristics predict patient workload? Prehosp Disaster Med. 2010;25(5):442–448.CrossRefGoogle ScholarPubMed
Bouslough, DB, Lemusu, S, Avegalio, F. Utilizing a unified health command structure for mass gathering preparedness and response: lessons learned from the 2008 pacific arts festival. Prehosp Disaster Med. 2011;26(S1):S149–S150.CrossRefGoogle Scholar
Burton, JO, Corry, SJ, Lewis, G, Priestman, WS. Differences in medical care usage between two mass-gathering sporting events. Prehosp Disaster Med. 2012;27(5):458–462.CrossRefGoogle ScholarPubMed
Calle, P, Sundahl, N, Maudens, K, et al. Medical emergencies related to ethanol and illicit drugs at an annual, nocturnal, indoor, electronic dance music event. Prehosp Disaster Med. 2018;33(1):71–76.CrossRefGoogle ScholarPubMed
Ceyhan, MA, Demir, GG, Güler, GB. Evaluation of health care services provided in political public meetings in turkey: a forgotten detail in politics. Prehosp Disaster Med. 2018;33(6):607–613.CrossRefGoogle ScholarPubMed
Lund, A, Turris, SA, Bowles, R, et al. Mass-gathering health research foundational theory: part 1 - population models for mass gatherings. Prehosp Disaster Med. 2014;29(6):648–654.CrossRefGoogle ScholarPubMed
Ross, C, Başdere, M, Chan, JL, Mehrotra, S, Smilowitz, K, Chiampas, G. Data value in patient tracking systems at racing events. Med Sci Sports Exerc. 2015;47(10):2014–2023.CrossRefGoogle ScholarPubMed
Schwellnus, M, Kipps, C, Roberts, WO, et al. Medical encounters (including injury and illness) at mass community-based endurance sports events: an international consensus statement on definitions and methods of data recording and reporting. Br J Sports Med. 2019;53(17):1048–1055.CrossRefGoogle ScholarPubMed
Botelho-Nevers, E, Gautret, P. Outbreaks associated to large open-air festivals, including music festivals, 1980 to 2012. Euro Surveill. 2013;18(11):20426.CrossRefGoogle ScholarPubMed
Welch, TR. Emergency department volumes and “mass events.” J Pediatr. 2014;164(2):223–225.Google Scholar
Government of Western Australia. Medical Risk Classification for Mass Gatherings. Delivering a Healthy WA. http://www.public.health.wa.gov.au/cproot/2542/2/Medical Risk Classification.pdf. Published 2014. Accessed March 16, 2014.Google Scholar