Impacts on in‐event, ambulance and emergency department services from patients presenting from a mass gathering event: A retrospective analysis

Abstract

Objective The aim of this study was to describe the in‐event, ambulance and ED impacts of patient presentations from an Australian mass gathering event (MGE) including patient demographics, provision of care, length of stay and discharge disposition. Methods This research was set at one MGE in Australia. The MGE had one first aid post and one in‐event health team staffed by doctors, nurses and paramedics. A retrospective analysis of patient care records from providers of in‐event, ambulance and ED services was undertaken. Data analysis included descriptive and inferential statistics. Results Of the 20 000 MGE participants, 197 (0.99% [95% CI 0.86–1.13], 9.85/1000) presented for in‐event first aid care, with 24/197 (12.2% [95% CI 8.33–17.49], 1.2/1000) referred to in‐event health professionals. Fifteen of the referred patients (62.5% [95% CI 42.71–78.84]) returned to the MGE following administration of intravenous fluids (n = 13) and/or anti‐emetics (n = 11). Seven (29.2% [95% CI 14.92–49.17], 0.35/1000) were referred to ambulance paramedic care, requiring endotracheal intubation (n = 1) and airway adjuncts (n = 3) prior to transportation to ED; these patients had an ED median length of stay of 7 h (5.5–12.5) receiving imaging and ventilator support. Five were discharged from ED, one required an operation and another required intensive care unit admission. Conclusions There was an impact on in‐event, ambulance and ED services from this MGE but the in‐event model of care may have limited ambulance usage and ED visits. The ED length of stay was greater than the national median, perhaps reflecting the appropriateness of transport and nature of care requirements while in the ED.

Emergency healthcare delivery for young adults during a planned mass gathering: A retrospective observational study

“…To minimise impacts on EDs several strategies have been implemented in the pre‐hospital setting. These strategies may be considered in terms of: (i) specific patient groups, such as low acuity patients, high acuity patients, or people with mental health problem; or (ii) patients requiring care at particular times such as during peak periods of ED crowding, or during mass gathering events (MGEs) . A MGE is defined as an event where a group of people come together for a common purpose within a particular space or venue.…”

“…These strategies may be considered in terms of: (i) specific patient groups, such as low acuity patients, 3 high acuity patients, 4 or people with mental health problem; 5 or (ii) patients requiring care at particular times such as during peak periods of ED crowding, 6 or during mass gathering events (MGEs). 7,8 A MGE is defined as an event where a group of people come together for a common purpose within a particular space or venue. In a health context, a mass gathering is an event 'where there is the potential for a delayed response to [health] emergencies', 9 due to challenges related to the environment and patient egress.…”

Frequency and Location of Mass Gathering Events in Relation to Emergency Departments: A Descriptive Study

“…These types of events are held internationally and include sporting events, music festivals or celebrations, and/or cultural events. As mass gathering events evolve, so does in-event health services, with developing standards on skill mix, equipment, clinical governance and procedures (4). As a result, there are many models of care that exist within the in-event health space of an event (5).…”

“…Yet regardless of size, mass gathering events can impact on a range of health services such as acute medical services, hospital EDs, paramedical and ambulance services (5,6). From an ambulance service and paramedicine perspective, there is scant literature pertaining to ambulance use resulting from mass gathering events (4). When transport from mass gathering events is discussed in the literature, the transport to hospital rate (TTHR) is commonly presented, and this rate varies between 0.0035 and 0.99 per 1000 event attendees often depending on the event (8).…”

“…Since this literature review, two case studies pertaining to the impact of mass gathering events on EDs in the US have been published; again raw numbers rather than a rate were presented (9,10). Furthermore, one Australian study has demonstrated that at a music festival event with 20,000 attendees, 1.2/1000 attendees were reviewed by in-event volunteer doctors, nurses and paramedics (4). Seven of these, or 0.35/1000, were referred to ambulance paramedic care and transported to the local ED.…”