Medical Support for the 2009 World Police and Fire Games: A Descriptive Analysis of a Large-Scale Participation Event and its Impact

Abstract

Abbreviations:ALS = advanced life support ATR = ambulance transfer rate BCAS = British Columbia Ambulance Service MGM = mass gathering medicine MTR = medical transfer rate PPR = patient presentation rate WPFG = World Police and Fire Games Abstract Introduction: In the summer of 2009, British Columbia hosted the World Police and Fire Games (WPFG). The event brought together 10,599 athletes from 55 countries. In this descriptive, Canadian study, the composition of the medical team is analyzed, the unique challenges faced are discussed, and an analysis of the illness and injury rates is presented. This event occurred during a labor dispute affecting the sole provider of emergency ambulance service in the jurisdiction, which necessitated additional planning and resource allocation. As such, the context of this event as it relates to the literature on mass gathering medicine is discussed with a focus on how large-scale public events can impact emergency services for the community. Methods: This is a case report study. Results: There were 1,462 patient encounters. The majority involved musculo-skeletal injuries (53.8%). The patient presentation rate (PPR) was 109.40/1,000. The medical transfer rate (MTR) was 2.32/1,000. The ambulance transfer rate (ATR) for the 2009 WPFG was 0.52/1,000. In total, 31 patients were transported to the hospital, the majority for diagnostic evaluation. Only seven calls were placed to 9-1-1 for emergency ambulance service. Conclusions: The 2009 WPFG was a mass-gathering sporting event that presented specific challenges in relation to medical support. Despite relatively high patient presentation rates, the widely spread geography of the event, and a reduced ability to depend on 9-1-1 emergency medical services, there was minimal impact on local emergency services. Adequate planning and preparation is crucial for events that have the potential to degrade existing public resources and access to emergency health services for participants and the public at large.

An Organized Medical Response for the Vancouver International Marathon (2006–2011)

“…Given sufficient similarity between marathons, registration numbers could be used to predict PPR accurately and thus allow for more efficient and effective medical planning. This multiyear analysis validates the approach by some MGM authors who show that retrospective data from the same event are highly predictive of PPR at subsequent events (7,23,27).…”

Conceptualizing the Impact of Special Events on Community Health Service Levels: An Operational Analysis

“…6,21,[35][36][37][38] The MG literature is replete with case reports detailing event medical services. These community stakeholders have a vested interest in ensuring adequate planning to prevent, or minimize, the vortex effect in their community by having event producers take reasonable responsibility for the safety and emergency response planning for the event.…”

“…A growing body of MG literature defines MGs in various ways, often in terms of the number of persons gathered. 5,6 As well, case reports rarely capture data regarding increased workload on health resources in the days or hours before and/or after the event. For example, the World Health Organization definition acknowledges the relationship between the size of the community and the scale of the event, when MGs are described as organized, special event(s) in which the number of people in attendance strains or overwhelms the planning and response resources of the community/state/nation hosting the event.…”

An Analysis of Patient Presentations at a 2-Day Mass-participation Cycling Event: The Ride to Conquer Cancer Case Series, 2010-2012

“…The case mix reported includes a spectrum of traumatic, orthopedic, cardiopulmonary, gastrointestinal, neurological, and dermatological injuries. [16][17][18] Rigorous theory and models regarding the number of first aid and medical team members required to safely cover an event similar to the Ride is lacking at this time. The goal is to treat on site whenever possible in order to avoid unnecessary transport of patients to local medical facilities, thus reducing the burden on local EMS.…”

“…2,14,16,33 Finally, the research team had no access to follow-up documentation for patients who were treated and released by the on-site medical service providers and then required follow-up off site, a limitation found in most of the MG literature. As a result, quick, incomplete, and abbreviated documentation was observed.…”