the impact of mass gatherings on ambulance services and hospitals

Mr Jamie RanseChair-elect, Mass Gathering Section

World Association Disaster and Emergency Medicine

The impact of mass gatherings on ambulance services and hospitals

• Challenges exist in providing adequate health care at a mass gathering.

• Minimizing impact to the health service in the surrounding community or region.

Aim• Discus what is known about the impact of mass

gatherings on health services from the literature.• Generate discussion about experiences of health

service impact from mass gatherings.

overview

Mr Jamie Ranse, A/Prof Alison Hutton, Mr Toby Keene, Mr Shane Lenson, Mr Matt Luther, Dr Amy Johnson, Dr Julia Crilly, Mr Matt Cannon, Ms Nicole Jones, Ms Courtney Hayes, Dr Brandon Burke

Health service impact from mass gatherings: A systematic literature review

Aim•The impact on both ambulance services and hospitals from mass gathering events was the focus of this literature review.

background

• This research used a systematic literature review methodology.

• Electronic databases were searched to find articles related to the aim of the review.

• Articles focused on mass gathering health, provision of in-event health services, ambulance service transportation, and hospital utilization.

method

method

Table 1: Search terms

Table 2: Inclusion and exclusion criteria

results

results

results

results

results

results

• Twenty-four studies were identified. • All case-study-based and retrospective in design. • The majority of studies (n = 23) provided details of in-

event first responder services. • Variation in reporting of the number and type of in-event

health professional services at mass gatherings. • All articles reported that patients were transported to

hospital by the ambulance service. • Nine articles reported on patients presenting to hospital. • However, details pertaining to the impact on ambulance

and hospital services were not reported.

results

• There is minimal research focusing on the impact of mass gatherings on in-event and external health services, such as ambulance services and hospitals.

Recommendation• future mass-gathering research and evaluation is to

link patient-level data from in-event mass gatherings to external health services.

conclusion

Mr Jamie Ranse, Mr Shane Lenson, Mr Toby Keene, Mr Matt Luther, Dr Brandon Burke, A/Prof Alison Hutton

Patient presentations to onsite health providers, ambulance paramedics and hospital emergency

departments from a mass gathering: a case study

• Onsite care from single events • Does not comprehensively consider the effect on

prehospital or hospital services.Aim• This research aims to enhance our understanding of

the health service requirements of, and from, an outdoor music festival.

background

methods

• Design• Setting• Data collection• Data analysis• Protection of human participants

results

results

results

results

results

results

results

Onsite first aid care•The most frequent illness was headaches (n=94), injury was superficial lacerations (n=13), environmental was substance and/or alcohol intoxication (n=12).Onsite health professional care•The most frequent illness was headaches (n=3), injury was fractures (n=2), environmental was substance and/or alcohol intoxication (n=12).

results

Ambulance transport•The most frequent injury was fractures (n=2), environmental was substance and/or alcohol intoxication (n=4). •One patient required prehospital endotracheal intubation. •Three patients required airway adjuncts.Hospital services•One patient required an ORIF.•One patient required intubation and ventilator support in the Intensive Care Unit.

discussion

• Insight into the health service usage from one event.

• Presentation to the onsite health professionals resulted in a longer length of stay in the onsite medical facility.

• Possible hospital / ambulance avoidance of 15 patients.

• Multi-site research should be undertaken to explore the health service usage from a variety of mass gatherings.

Mr Jamie RanseChair-elect, Mass Gathering Section

World Association Disaster and Emergency Medicine

The impact of mass gatherings on ambulance services and hospitals