On-site physician-level medical care at large mass gatherings significantly reduces the number of patients requiring transport to hospitals, thus reducing the impact on the local EMS system and surrounding medical facilities.

By their own report, EMS providers encounter a substantial amount of violence and injury due to assault on the job. Formal training and protocols to provide a standardized safe approach for such encounters are lacking. Although the limitations of survey data are recognized, further research characterizing the level of violence and potential interventions seems warranted.

Abstract. Objectives: To identify factors predictive of patient load at major commercial concert first-aid stations, and to characterize the spectrum of presenting injuries and illnesses at such events. Methods: This study was a retrospective case series of patients presenting to on-site first-aid stations at five major concert venues in southern California over a five-year period. The authors compared the number of patients per ten thousand attendees (PPTT) with four potential predictors (music type, overall attendance, temperature, and indoor vs outdoor location) using univariate techniques and negative binomial regression. The spectrum of chief complaints observed is described. Results: There were 1,492 total patients out of 4,638,099 total attendees at 405 separate concerts. The median patient load per concert was 2.1 PPTT, ranging from 0 PPTT at 53 concerts to 71 PPTT at a punk rock festival that turned into a riot. Patient load varied significantly by music category (p = 0.0001) but not with overall attendance, temperature, or indoor vs outdoor location. Median PPTT by music category ranged from 1.3 PPTT for rhythm and blues to 12.6 PPTT for gospel/Christian, with negative binomial regression indicating that rock concerts had 2.5 times (95% CI = 2.0 to 3.0) the overall patient load of non-rock concerts. Music type, however, was able to account for only 4% of the variability observed in the regression model. Trauma-related complaints predominated overall, with similar rates at rock and non-rock concerts. Four cardiac arrests occurred at classical concerts. Conclusion: Rock concert first-aid stations evaluated 2.5 times the patient load of non-rock concerts overall, although there was substantial concert-to-concert variability. Trauma-related complaints predominate at both rock and non-rock events. These data may assist individuals and organizations planning support for such events. Key words: concert medicine; musical concerts; trauma; rock concerts; spectators; mass gatherings; first-aid stations; patient load; prediction. AC-ADEMIC EMERGENCY MEDICINE 1999; 6:202 -207 P HYSICIANS are increasingly called upon to organize medical support for mass gatherings such as commercial concerts. Currently individuals and organizations planning such support have little reliable information to assist them in determining what specific personnel and equipment are necessary to optimally support a specific music event. Mears and Batson 1 have reported patient loads at general mass gatherings as ranging from 1.2 to 60 patients per ten thousand spectators (PPTT). The 50-fold range of this projection substantially limits its usefulness as a planning tool, and furthermore it is uncertain whether these data are applicable to the unique characteristics of a commercial concert.Previous authors have described medical support at single specific concert events (Table 1) patient loads ranging from 8 to 1,000 PPTT. The volume, acuity, and spectrum of pathology appear dependent on a number of variables, such as music type, concert lo...

Emergency medical services providers in some areas are at substantial risk for encountering violence in the prehospital setting. Certain situational factors may be used to predict the risk of encountering violence. Training, protocols, and protective gear for dealing with violent situations should be encouraged for all prehospital personnel.

Motocross is an increasingly popular but high-risk sport. This article reviews the history of motocross, the relevant medical literature, the unique medical issues, safety equipment, and the expert recommended approach to providing support for such events. Assessment of an injured rider on or near a track requires a provider to first ensure scene safety, then assess for airway, cervical spine, and head injuries before proceeding. Although extremity injuries are the most common injury, motocross riders frequently sustain significant spine and head trauma as well. Caregivers need to have a complete understanding of the protective gear used in motocross. They also need to be able to understand what injuries can be treated at the scene and which need transport to a hospital for more definitive care.