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Edited by
William J. Brady, University of Virginia,Mark R. Sochor, University of Virginia,Paul E. Pepe, Metropolitan EMS Medical Directors Global Alliance, Florida,John C. Maino II, Michigan International Speedway, Brooklyn,K. Sophia Dyer, Boston University Chobanian and Avedisian School of Medicine, Massachusetts
The mass casualty incident marks the ultimate challenge for emergency services at a mass gathering event. This chapter provides a thorough review of the unique challenges associated with the occurrence of a mass casualty incident in a mass gathering setting and summarizes a comprehensive, flexible framework to manage this specific scenario. In particular, we provide a detailed summary of the evidence and recommendations associated with the prevention, preparedness, response, and recovery efforts related to mass casualty incident management at a mass gathering event. Our discussion of prevention focuses on proper risk assessment practices and a recommended set of effective measures that can be used to promote crowd management within the mass gathering setting. Our section on disaster preparedness highlights the critical initial step to identify and engage all stakeholders associated with the mass gathering event and the particular disaster scenarios identified in the event’s risk assessment profile, as well as key measures to establish clear disaster plans and promote organized command and communication. Finally, specific recommendations are provided for efficient disaster response through the initial and longer-term phases, as well as for the recovery process that includes effective community support and psychological first aid for affected parties.
To describe the health-care resources implemented during the Italian Formula 1 Grand Prix (F1GP) and to calculate the patient presentation rate (PPR) based on both real data and a prediction model.
Methods:
Observational and descriptive study conducted from September 9 to September 11, 2022, during the Italian F1GP hosted in Monza (Italy). Maurer’s formula was applied to decide the number and type of health resources to be allocated. Patient presentation rate (PPR) was computed based on real data (PPR_real) and based on the Arbon formula (PPR_est).
Results:
Of 336,000 attendees, n = 263 requested medical assistance with most of them receiving treatment at the advanced medical post, and n = 16 needing transport to the hospital. The PPR_real was 51 for Friday, 78 for Saturday, 134 for Sunday, and 263 when considering the whole event as a single event. The PPR_est resulted in 85 for Friday, 93 for Saturday, 97 for Sunday, and 221 for the total population.
Conclusions:
A careful organization of health-care resources could mitigate the impact of the Italian F1GP on local hospital facilities. The Arbon formula is an acceptable model to predict and estimate the number of patients requesting medical assistance, but further investigation needs to be conducted to implement the model and tailor it to broader categories of MGE.
A mass gathering medicine training program was established for a 7,200-seat arena. The objectives of this study were to describe the program schema and determine its impact in preparing novice emergency medical technicians (EMTs) to manage the difficulties of large-venue emergency medical services (EMS).
Methods:
Optional, anonymous surveys were administered to EMTs. Novice EMTs were assessed pre-/post-program implementation, and both novice and experienced EMTs completed self-reported Likert scales. Data were analyzed with nonparametric methods.
Results:
A total of 43/56 responses (response rate = 76.8%) were received. Only 37.2% of providers felt prepared to work mass gatherings before the training, and 60.5% stated that their previous education did not prepare them for large-venue challenges. After the training program, novice EMTs were significantly associated with increased knowledge of large-venue EMS procedures (P = 0.0170), higher proficiency using extrication equipment (P = 0.0248), increased patient care skills (P = 0.0438), and both increased confidence working events (P = 0.0002) and better teamwork during patient encounters (P = 0.0001). The majority of EMTs reported the program as beneficial.
Conclusion:
Upon hire, EMS providers felt unprepared to work large-venue EMS. The analyses demonstrated that this training program improved select large-venue emergency skills for prehospital providers and may fill a gap in the education system regarding mass gathering medicine.
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