Mass Gathering Event Medical Preparedness and Response: A Review of Canadian Legislation and Guidelines.

INTRODUCTION: The mass gathering event (MGE) industry is growing globally, including in countries such as Canada. MGEs have been associated with a greater prevalence of injury and illness when compared with daily life events, despite most participants having few comorbidities. As such, adequate health, safety, and emergency medical planning is required. However, there is no single entity regulating these concerns for MGEs, resulting in the responsibility for health planning lying with event organizers. This study aims to compare the legislative requirements for MGE medical response systems in the 13 provinces and territories of Canada. METHODS: This study is a cross-sectional descriptive analysis of Canadian legislation. Lists of publicly available legislative requirements were obtained by means of the emergency medical services directors and Health Ministries. Descriptive statistics were performed to compare legislation. RESULTS: Of the 13 provinces and territories, 10 responded. For the missing 3, a law library review confirmed the absence of specific legislation. Most (n = 6; 60%) provinces and territories referred to provisions in their Public Health laws. Four confirmed that MGE medical response was a municipal or local concern to be addressed by the event organizers. CONCLUSIONS: No provinces could list specific legislation guiding safety, health, and medical response for an MGE.

Trauma and Injuries Pattern During Hajj, 1443 (2022): A Cross-Sectional Study.

Introduction Trauma and injuries are common among pilgrims during Hajj, the biggest mass gathering event. Trauma and injury causes vary from falling and pressing in crowds to being burned by boiled water and road traffic accidents (RTA). Time to reach the hospital during highly condensed areas in Hajj are challenges for the public health authorities and the healthcare system to achieve optimum control, management, and outcome. This study aims to explore the pattern of trauma and injuries during Hajj as it is crucial to improve future preventive measures and care quality. Methods A cross-sectional questionnaire-based study was conducted in one hospital in each of the Mena and Arafat (Al-Mashaar's areas) in Makkah City, Saudi Arabia, from July 8 to 10, 2022. Data was collected through interviews with patients who visit the hospitals or enter the emergency department and are diagnosed with trauma or injury during the Hajj season of 1443 Hijri date (2022). Results A total of 264 people volunteered to participate in the survey. The mean age by years was 43.5 ± 10.7, and the majority (56%) were between 41 and 64. There were multiple nationalities - the most common nationality was Egyptian (25%), followed by Saudi (10%). The commonest type of trauma was cutting wounds (50%), and the commonest cause was falling (39%), followed by foot twisting (31%). There were 142 cases in Arafat and 122 cases in Mena in the study duration. Tissue contusions are higher in Arafat. Fractures (5%) were in both areas but higher in Mena with burns and sprains. Friction blister injuries were only in Mena and were statistically associated with walking barefoot (p<0.01), which was associated with Egyptians (p<0.05). Also, thigh chafing is only in Mena, while eye traumas and abrasion are only in Arafat. There were four causes of injury that are statistically significantly associated with the area (p<0.05): foot twisting in Arafat, pressing in overcrowding, stoning, and burning in Mena. Moreover, all the RTA cases (n=4) were in Arafat, and all the stoning and burning by boiling water were in Mena. Admission was only for burning (n=2) and falling (n=2) cases and only in Mena emergency hospital; otherwise, all trauma cases were discharged after receiving management - no deaths among the study sample. Injuries in Mena are likely to happen in the evening and night (n=91), while in Arafat, it is more likely in two periods (n=113), in the early morning and afternoon. This difference is statistically significant between the two areas (p<0.05). Most pilgrims (n=129/253) reach the hospital in 16 to 30 minutes. A statistically significant association exists between the duration and the area (p<0.05). Most patients in Arafat (88%) reach the hospital in less than 30 minutes, while only 50% take the same duration in Mena. Conclusion The Hajj season of 1443 H (2022) has a similar trauma pattern and improved outcomes compared to previous seasons. Discovering and digging into the causes of traumas and injuries should be optimized in future research for better control and customized prevention measures. Establishing new and remodeling current prevention measures is recommended for more control.

Clashes and crowds: protests, riots, and other mass gathering events in North America 2021-2022.

OBJECTIVE: This study aimed to provide an overview of the scope and challenges of historic events and help better prepare emergency healthcare services for future similar mass gathering events. STUDY DESIGN: This was a retrospective descriptive analysis of protest and conflict events in North America from 2021 to 2022. INTRODUCTION: Recent protests, riots, and other conflict events in North America have highlighted the increasing challenges hospital-based and prehospital healthcare providers face. This study provides a retrospective descriptive analysis of protest and conflict events in North America from 2021 to 2022, which may aid emergency healthcare services in understanding the scope and challenges of historic events and help better prepare for future similar mass gathering events. METHODS: Data collection was performed using a retrospective database search through the Armed Conflict Location & Event Data Project (ACLED) database. The ACLED database was searched using the internal database search functions for recorded events that occurred in North America from January 1, 2021 to December 31, 2022. Date, event type, event subtype, the country of incident, and fatality numbers were extracted. The results were exported into an Excel spreadsheet and analyzed independently by L.C., H.S., and R.H. RESULTS: There were a total of 52,529 recorded events of political conflict in North America, with 30,269 events in 2021 and 29,260 in 2022. Political conflict events included protests (40,934, 68.8%), violence against civilians (11,532, 19.4%), strategic developments (2,819, 4.7%), battles (2,293, 3.9%), riots (1,909, 3.2%), and remote violence (42, 0.1%). Violence against civilians caused the highest fatalities (13,466, 82.6%), followed by battles (2,662, 16.3%), riots (111, 0.7%), strategic developments, remote violence, and protests (57, 6, and 3 respectively). CONCLUSION: Mexico and the United States accounted for most of the political conflicts in North America across 2021 and 2022. In Mexico, protests and violence against civilians were the most common types of conflict, with the latter accounting for the comparatively high fatality compared with the other countries. Battles in Mexico between cartels were the most deadly political conflicts recorded in North America.

A retrospective review of out of hospital cardiac arrest at Gillette Stadium: 10 years of experience at a large sports venue.

Introduction: Rates of out-of-hospital cardiac arrest (OHCA) at major sporting events are as high as 0.7 per 100,000 attendees. However, factors contributing to OHCA at mass gatherings have not been well-described. We describe our experience with ten years of medical oversight and OHCA care at a professional football stadium. Methods: We performed a retrospective review of OHCA events between August 2010 and January 2020 at a 65,878-seat football stadium, with a single transporting EMS agency and a single receiving hospital. We analyzed EMS incident reports and matched patients to hospital records for outcome data. Results: A total of 7,767,345 people attended 115 football games during the study period. There were 21 OHCAs (0.27 per 100,000 attendees). Ninety-five percent of OHCAs were witnessed and 71.4% had an initial shockable rhythm, with bystander AED use in 47.6%. Median EMS response time was 2 minutes (IQR 1-6). For 7 patients defibrillated by EMS, time to defibrillation was 4 minutes (IQR 4-11). Return of spontaneous circulation (ROSC) occurred in 71%, with 47% having good 30-day neurologic survival. All patients with an initial rhythm of asystole died. Conclusion: The ROSC rate at our stadium exceeded 70% with almost half surviving with good neurologic outcomes, substantially higher than that reported for the general public. We hope that our experience will provide valuable lessons to other similarly sized stadiums.

The Impact of In-Event Health Services at Europe's Largest Electronic Dance Music Festival on Ems and Ed in the Host Community.

BACKGROUND: Electronic dance music festivals (EDMF) can cause a significant disruption in the standard operational capacity of emergency medical services (EMS) and hospitals. We determined whether or not the presence of in-event health services (IEHS) can reduce the impact of Europe's largest EDMF on the host community EMS and local emergency departments (EDs). METHODS: We conducted a pre-post analysis of the impact of Europe's largest EDMF in July 2019, in Boom, Belgium, on the host community EMS and local EDs. Statistical analysis included descriptive statistics, independent t-tests, and χ2 analysis. RESULTS: Of 400,000 attendees, 12,451 presented to IEHS. Most patients only required in-event first aid, but 120 patients had a potentially life-threatening condition. One hundred fifty-two patients needed to be transported by IEHS to nearby hospitals, resulting in a transport-to-hospital rate of 0.38/1000 attendees. Eighteen patients remained admitted to the hospital for >24 h; one died after arrival in the ED. IEHS limited the overall impact of the MGE on regular EMS and nearby hospitals. No predictive model proved optimal when proposing the optimal number and level of IEHS members. CONCLUSIONS: This study shows that IEHS at this event limited ambulance usage and mitigated the event's impact on regular emergency medical and health services.

Medical planning for mass gathering sports events in brazil / Planificación médica para eventos deportivos masivos en brasil / Planejamento médico para eventos esportivos de massa no brasil

ABSTRACT Introduction: Medical planning for mass gathering events is founded on the structuring of assistance to the population involved and the preservation of the response capacities of the local healthcare system. Large sporting events attended by crowds are increasingly common in society. These events have been shown to be dangerous, generating higher incidences of injuries and illnesses than usual. Thus, planning and the interaction among various public and private sectors are required for the prevention of and response to emergencies and incidents involving multiple victims. Methods: Recently published studies on medical planning for large sports events and current federal agency legislation were selected to conduct an updated review on the subject. Results: After reading titles and abstracts, 159 papers were chosen for a full reading, 50 of which met the eligibility criteria and were included as the basis for this review. The size of the audience, the weather, and the behavior of the crowd seem to contribute significantly to the estimated need for resources in sporting events. Conclusion: Mass events require planning for prevention and to strengthen the resilience of host communities. There is a still a lack of evidence that these events increase the risk of the mass spreading of disease. Level of Evidence: V; Expert opinion .

RESUMEN Introducción: La planificación médica de eventos masivos tiene como pilares la estructuración de la atención a la población involucrada y la preservación de las capacidades de respuesta del sistema local de salud. Los grandes eventos deportivos a los que asisten multitudes son cada vez más comunes en la sociedad. Estos eventos han demostrado ser peligrosos, generando una mayor incidencia de lesiones y enfermedades de lo habitual. Por lo tanto, es necesaria la planificación y la interacción de diversos sectores, públicos y privados, para la prevención y respuesta a emergencias o incidentes con múltiples víctimas. Métodos: Se seleccionaron estudios recientes publicados sobre la planificación médica de grandes eventos deportivos y la legislación vigente en organismos federales con el objetivo de realizar una revisión actualizada sobre el tema. Resultados: Después de leer los títulos y resúmenes, se eligieron 159 artículos para lectura completa y 50 cumplieron los criterios de elegibilidad y se utilizaron como base para esta revisión. El tamaño del público, las condiciones climáticas y el comportamiento de la multitud parecen contribuir significativamente a la estimación de los requisitos de recursos en los eventos deportivos. Conclusión: Los eventos masivos requieren una planificación para la prevención y el fortalecimiento de la resiliencia de las comunidades anfitrionas. Todavía no hay pruebas de que estos eventos aumenten el riesgo de propagación masiva de enfermedades. Nivel de Evidencia: V; Opinión experta .

RESUMO Introdução: O planejamento médico para eventos de massa tem como pilares a estruturação dos atendimentos à população envolvida e a preservação da capacidade de resposta do sistema de saúde local. Grandes eventos esportivos frequentados por multidões são cada vez mais comuns na sociedade. Esses eventos têm se mostrado perigosos, gerando maiores incidências de lesões e doenças do que o habitual. Dessa forma, é necessário planejamento e interação de diversos setores, públicos e privados, para prevenção e resposta à ocorrência de emergências ou incidentes com múltiplas vítimas. Métodos: Foram selecionados trabalhos recentes publicados sobre o planejamento médico para grandes eventos esportivos e a legislação vigente em órgãos federais com o objetivo de realizar uma revisão atualizada sobre o assunto. Resultados: Após a leitura de títulos e resumos, 159 trabalhos foram escolhidos para leitura integral e 50 preencheram os critérios de elegibilidade e foram usados como base para esta revisão. O tamanho do público, as condições climáticas e o comportamento da multidão parecem contribuir significativamente para a estimativa da necessidade de recursos em eventos esportivos. Conclusão: Eventos de massa exigem planejamento para prevenção e fortalecimento da resiliência das comunidades anfitriãs. Ainda faltam evidências de que esses eventos aumentem o risco de propagação maciça de doenças. Nível de evidência: V; Opinião do especialista .

Syndromic Surveillance Systems for Mass Gatherings: A Scoping Review.

Syndromic surveillance involves the near-real-time collection of data from a potential multitude of sources to detect outbreaks of disease or adverse health events earlier than traditional forms of public health surveillance. The purpose of the present study is to elucidate the role of syndromic surveillance during mass gathering scenarios. In the present review, the use of syndromic surveillance for mass gathering scenarios is described, including characteristics such as methodologies of data collection and analysis, degree of preparation and collaboration, and the degree to which prior surveillance infrastructure is utilized. Nineteen publications were included for data extraction. The most common data source for the included syndromic surveillance systems was emergency departments, with first aid stations and event-based clinics also present. Data were often collected using custom reporting forms. While syndromic surveillance can potentially serve as a method of informing public health policy regarding specific mass gatherings based on the profile of syndromes ascertained, the present review does not indicate that this form of surveillance is a reliable method of detecting potentially critical public health events during mass gathering scenarios.

Hockey Puck Strike Rates and Injuries at National Hockey League Games: A Retrospective Analysis of Data from Six Seasons.

IMPORTANCE: This paper provides a large-scale, per-National Hockey League (NHL) season analysis of hockey puck strike (HPS) injury data and also provides estimates of injury frequency and severity. OBJECTIVE: The study's goal was to quantify and describe the rate and type of spectator HPS injuries at NHL games. DESIGN: This was a retrospective review of summary data reports for patients evaluated by on-site health care providers over six seasons (2013-2018). Data were obtained from a single Emergency Medical Service (EMS) agency. SETTING: Location of study was one US-based NHL venue. RESULTS: There were 51 HPS recorded. This accounted for 0.93% of total patient contacts translating to a patient per 10,000 (PPTT) of 0.116. This was compared to a PPTT of 12.6 for all patient contacts. The average age of a patron with a HPS was 31 years old. There was an even split between male and female patrons with HPS. The most common location for a HPS was the head or face (75%) followed by upper extremity injuries. Laceration was most frequently diagnosed followed by contusions and pain. Approximately one-quarter of people struck by hockey pucks were transported to the hospital, with the transport to hospital rate (TTHR) being 0.027, compared to the total TTHR of 2.7. CONCLUSIONS AND RELEVANCE: Hockey is a safe sport to watch, although HPS are the spectator hazard of concern given that pucks can travel into the stands at 100mph. Most injuries are minor and occur only one percent of the time; but when they do occur, these fans tend to need transport to the hospital. Finally, HPS tend to occur along the lateral sides of the rink where the glass level is lower and there is no protective netting.

Foul Ball Rates and Injuries at Major League Baseball Games: A Retrospective Analysis of Data from Three Stadiums.

IMPORTANCE: This paper provides a large-scale, per Major League Baseball (MLB) game analysis of foul ball (FB) injury data and provides estimates of injury frequency and severity. OBJECTIVE: This study's goal was to quantify and describe the rate and type of FB injuries at MLB games. DESIGN: This was a retrospective review of medical care reports for patients evaluated by on-site health care providers (HCPs) over a non-contiguous 11-year period (2005-2016). Data were obtained using Freedom of Information Act (FOIA) requests. SETTING: Data were received from three US-based MLB stadiums. RESULTS: The review reported 0.42-0.55 FB injuries per game that were serious enough to warrant presentation at a first aid center. This translated to a patients per 10,000 fans rate (PPTT) of 0.13-0.23. The transport to hospital rate (TTHR) was 0.02-0.39. Frequently, FB injuries required analgesics but were overwhelmingly minor and occurred less often than non-FB traumatic injuries (5.2% versus 42%-49%). However, FB injured fans were more likely to need higher levels of care and transport to hospital (TH) as compared to people suffering other traumatic injuries at the ballpark. Contusions or head injuries were common. Finally, FB injured fans were often hit in the abdomen, upper extremity, face, or head. It was found that FB injuries appeared to increase with time, and this increase in injuries aligns with the sudden increase in popularity of smartphones in the United States. CONCLUSIONS AND RELEVANCE: These data suggest that in roughly every two or three MLB games, a foul ball causes a serious enough injury that a fan seeks medical attention. This rate is high enough to warrant attention, but is comparable in frequency to other diagnostic categories. Assessing the risk to fans from FBs remains difficult, but with access to uniform data, researchers could answer persistent questions that would lead to actionable changes and help guide public policy towards safer stadiums.

Do Physiological Variables Predict the Need for Transport to Hospital From Music Festivals? An Analysis of Australian Festival Data.

OBJECTIVE: Using physiological markers to detect patients at risk of deterioration is common. Deaths at music festivals in Australia prompted scrutiny of tools to identify critically unwell patients for transport to hospital. This study evaluated initial physiological parameters to identify patients selected for transport to hospital from a music festival. METHODS: A retrospective audit of 2045 presentations at music festivals in Victoria, Australia, was performed. Presentation heart rate, systolic blood pressure, respiratory rate, oxygen saturation, temperature, and Glasgow Coma Scale were assessed using area under the receiver operating characteristic curve (AUROC) analysis, with a prespecified threshold of 0.7. RESULTS: The only measured variable to exceed the prespecified cutpoint was initial systolic blood pressure, with an AUROC of 0.72 and optimal cutpoint of 122 mmHg. Using commonly accepted cutpoints for variables did not improve detection performance to acceptable levels, nor did using combination systems of cutpoints. CONCLUSIONS: Initial physiological variables are poor predictors of the decision to transport to hospital from music festivals. Systolic blood pressure was significant, but only at a clinically insignificant value. Decisions on which patients to transport from an event site should incorporate more information than initial physiology. Senior clinicians should lead decision-making about hospital transport from music festivals.

Challenges in Pandemic Disaster Preparedness: Experience of a Saudi Academic Medical Center.

In December 2019, a pneumonia of unknown etiology was detected in Wuhan, China. This outbreak was then declared an international public emergency in January 2020 by the World Health Organization (WHO), and the announcement activated disaster management plans worldwide. This global crisis created several challenges for the health-care sector. This study reviews the challenges faced by a middle-sized urban academic hospital that are likely present to some extent in all health-care sectors, regardless of their existing disaster plans and policies. While preparing this Saudi academic hospital with a capacity of 192 beds for the emerging pandemic, obstacles arose despite its extensive prior disaster planning and training. Specifically, these challenges were related to health-care workers, supplies, and patient care. We review the actions taken to overcome and resolve these difficulties and provide future planning suggestions for each area to potentially assist other hospitals in their disaster planning and preparedness.

Mass Gathering Emergency Medicine Organization for the Union of European Football Associations' Under-21 Championship 2019 in Bologna, Italy.

Football events represent a type of Mass Gathering Events (MGE) where crowd behavior, temperature and Heat Index, absence of free water, and alcohol consumption can lead to an increased need for medical assistance in participants. This report describes the environmental issues, organization, and healthcare assistance provided during the four matches of the Union of European Football Associations' (UEFA) Under-21 tournament held in Bologna in June, 2019. The four matches had a total of 72655 spectators; 31 patients required medical assistance with a mean Patient Presentation Rate (PPR) of 0.41; Mean Transport To Hospital Rate (TTHR) of 0.04; with PPR and TTHR comparable with literature findings. Majority of patients suffered from minor injuries and illnesses, and were treated directly in stadium medical sites. Medical assistance involved volunteer rescuers, emergency nurses, and physicians; resources were efficiently allocated and provided effective care to every patient.Climate factors, heat and humidity, the absence of free water, and increased alcohol consumption appear to be associated with increased requests for medical assistance. The retrospective analysis of a wider range of environmental factors, and the historical experience developed during similar MGEs suggest the need for a more comprehensive, improved approach for adequately assessing risk and planning the necessary healthcare resources.

Validation of a Belgian Prediction Model for Patient Encounters at Belgium's Largest Public Cultural Mass Gathering.

OBJECTIVE: To compare actual patient presentation rates from Belgium's largest public open-air cultural festival with predictions provided by existing models and the Belgian Plan Risk Manifestations model. METHODS: Retrospectively, actual patient presentation rates gathered from the Ghent Festivities (Belgium) during 2013-2019 were compared to predicted patient presentation rates by the Arbon, Hartman, and PRIMA models. RESULTS: During 7 editions, 8673000 people visited the Ghent Festivities; 9146 sought medical assistance resulting in a mean patient presentation rate (PPR) of 1.05. The PRIMA model overestimated the number of patient encounters for each occasion. The other models had a high rate of underprediction. When comparing deviations in predictions between the PRIMA model to the other models, there is a significant difference in the mean deviation (Arbon: T = 0.000, P < 0.0001, r = -0.8701; Hartman: T = 0.000, P < 0.0001, r = -0.869). CONCLUSION: Despite the differences between the predictions of all 3 models, our results suggest that the PRIMA model is a valid tool to predict patient presentations to IEHS during public cultural MG. However, to substantiate the PRIMA model even further, more research is needed to further validate the model for a broad range of MG.

Risk and the Republican National Convention: Application of the Novel COVID-19 Operational Risk Assessment.

The United States Centers for Disease Control and Prevention and the World Health Organization broadly categorize mass gathering events as high risk for amplification of coronavirus disease 2019 (COVID-19) spread in a community due to the nature of respiratory diseases and the transmission dynamics. However, various measures and modifications can be put in place to limit or reduce the risk of further spread of COVID-19 for the mass gathering. During this pandemic, the Johns Hopkins University Center for Health Security produced a risk assessment and mitigation tool for decision-makers to assess SARS-CoV-2 transmission risks that may arise as organizations and businesses hold mass gatherings or increase business operations: The JHU Operational Toolkit for Businesses Considering Reopening or Expanding Operations in COVID-19 (Toolkit). This article describes the deployment of a data-informed, risk-reduction strategy that protects local communities, preserves local health-care capacity, and supports democratic processes through the safe execution of the Republican National Convention in Charlotte, North Carolina. The successful use of the Toolkit and the lessons learned from this experience are applicable in a wide range of public health settings, including school reopening, expansion of public services, and even resumption of health-care delivery.

Simulated-Scenario and Peer-Mentorship Curriculum to Train Prehospital Providers in the Practice of Mass Gathering Medicine.

OBJECTIVE: A mass gathering medicine training program was established for a 7,200-seat arena. The objectives of this study were to describe the program schema and determine its impact in preparing novice emergency medical technicians (EMTs) to manage the difficulties of large-venue emergency medical services (EMS). METHODS: Optional, anonymous surveys were administered to EMTs. Novice EMTs were assessed pre-/post-program implementation, and both novice and experienced EMTs completed self-reported Likert scales. Data were analyzed with nonparametric methods. RESULTS: A total of 43/56 responses (response rate = 76.8%) were received. Only 37.2% of providers felt prepared to work mass gatherings before the training, and 60.5% stated that their previous education did not prepare them for large-venue challenges. After the training program, novice EMTs were significantly associated with increased knowledge of large-venue EMS procedures (P = 0.0170), higher proficiency using extrication equipment (P = 0.0248), increased patient care skills (P = 0.0438), and both increased confidence working events (P = 0.0002) and better teamwork during patient encounters (P = 0.0001). The majority of EMTs reported the program as beneficial. CONCLUSION: Upon hire, EMS providers felt unprepared to work large-venue EMS. The analyses demonstrated that this training program improved select large-venue emergency skills for prehospital providers and may fill a gap in the education system regarding mass gathering medicine.

Health Risks, Preventive Behaviours and Respiratory Illnesses at the 2019 Arbaeen: Implications for COVID-19 and Other Pandemics.

COVID-19 poses grave challenges for mass gatherings. One of the world's largest annual gatherings, Arbaeen, occurs in Iraq. We studied respiratory symptoms and risk and protective factors using representative sampling of Arbaeen pilgrims in 2019 to inform prevention of COVID-19 transmission. Structured sampling was used to recruit walking pilgrims. A questionnaire asked about respiratory symptoms, risk, and preventive factors, including hygiene-related resources of toilet facilities. The commonest symptom reported by the 1842 participants (63.3% male, 36.7% female) was cough (25.6%). Eating in mawkibs (rest areas) with indoor kitchens and drinking only packaged water were associated with lower risk of cough (AOR = 0.72, CI = 0.56-0.94; AOR = 0.60; CI = 0.45-0.78, p < 0.05). Facemask use was associated with increased risk of cough (AOR = 2.71, CI = 2.08-3.53, p < 0.05). Handwashing was not protective against cough, or against (one or more of) cough, fever, or breathlessness in multivariate analysis. Toilet facilities often lacked running water (32.1%) and soap (26.1%), and had shared hand towels (17%). To reduce risk of respiratory infections including COVID-19 during Arbaeen or other mass gatherings, needs include running water, soap, and hygienic hand drying options or hand sanitiser. Education on proper handwashing and facemask approaches and monitoring around food preparation and eating spaces are needed.

Use of Medical Supplies at the Roskilde Festival 2016: A Prospective Observational Study.

INTRODUCTION: Music festivals are popular events often including camping at the festival site. A mix of music, alcohol, drugs, and limited hygiene increases health risks. This study aimed to assess the use of medical supplies at a major music festival, thereby aiding planning at similar events in the future. METHOD: The Medical Health Care Organization (MHCO) at Roskilde Festival 2016 (Denmark) collected prospective data on disposable medical supply use and injuries and illnesses presenting to the MHCO. RESULTS: A total of 12,830 patient presentations were registered by the MHCO and a total of 104 different types of disposable medical supplies were used by the MHCO from June 25, 2016 through July 3, 2016. Out of 12,830 cases, 594 individuals (4.6%) had a potential or manifest medical emergency, 6,670 (52.0%) presented with minor injuries, and 5,566 (43.4%) presented with minor illnesses. The overall patient presentation rate (PPR) was 99.0/1,000 attendees and the transport-to-hospital rate (TTHR) was 2.1/1,000 attendees. For medical emergencies, the most frequently used supplies were aluminum rescue blankets (n = 627), non-rebreather masks (n = 121), and suction catheters for an automatic suction unit (ASU) for airway management (n = 83). Most used diagnostic equipment were blood glucose test strips (n = 1,155), electrocardiogram electrodes (n = 960), and urinary test strips (n = 400). The most frequently used personal protection equipment were non-sterile gloves (n = 1,185 pairs) and sterile gloves (n = 189). CONCLUSION: This study demonstrates a substantial use of disposable medical supplies at a major music festival. The results provide aid for planning similar mass-gathering (MG) events.