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The second chapter of this volume focusses on crowds, both conceptually and historically. The study of crowd influence has waxed and waned over the years and has seen a resurgence of interest in topics such as identity-based social movements, street action and social media. The chapter traces this line of inquiry to the mass psychology of LeBon and Tarde, who conceived of crowds as a powerful social force that compromises Rationality and Civilisation and leads to a 'mass society' dominated by charismatic leaders. Tarde’s laws of imitation extended this inquiry of physical crowds in public spaces to that of distributed public opinion of news readers with a shared focus of attention. These notions have corollaries with contemporary theories of agenda setting, collective attention cycles, crowd sourcing and intelligence, memes and viral beliefs, stock market bubbles and social media dynamics. Much of theory of crowds oscillates between positive and negative moral assessments. The chapter concludes by considering the role of social identification in the dynamics of crowds which distributes human cognition among individual actors and determines the relationship with the leader.
Crowd control is essential to the handling of mass-casualty incidents (MCIs).This is the task of the police at the site of the incident. For a hospital, responsibility falls on its security forces, with the police assuming an auxiliary role. Crowd control is difficult, especially when the casualties are due to riots involving clashes between rioters and police. This study uses data regarding the October 2000 riots in Nazareth to draw lessons about the determinants of crowd control on the scene and in hospitals.
Methods:
Data collected from formal debriefings were processed to identify the specifics of a MCI due to massive riots. The transport of patients to the hospital and the behavior of their families were considered.The actions taken by the Hospital Manager to control crowds on the hospital premises also were analyzed.
Results:
During 10 days of riots (01–10 October 2000), 160 casualties, including 10 severely wounded, were evacuated to the Nazareth Italian Hospital. The Nazareth English Hospital received 132 injured patients, including one critically wounded, nine severely wounded, 26 moderately injured, and 96 mildly injured. All victims were evacuated from the scene by private vehicles and were accompanied by numerous family members. This obstructed access to hospitals and hampered the care of the casualties in the emergency department. The hospital staff was unable to perform triage at the emergency department's entrance and to assign the wounded to immediate treatment areas or waiting areas. All of the wounded were taken by their families directly into the “immediate care” location where a great effort was made to prioritize the severely injured. In order to control the events, the hospital's managers enlisted prominent individuals within the crowds to aid with control. At one point, the mayor was enlisted to successfully achieve crowd control.
Conclusions:
During riots, city, community, and even makeshift leaders within a crowd can play a pivotal role in helping hospital management control crowds. It may be advisable to train medical teams and hospital management to recognize potential leaders, and gain their cooperation in such an event. To optimize such cooperation, community leaders also should be acquainted with the roles of public health agencies and emergency services systems.
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