Ranse J. (2016). The impact of mass gatherings on ambulance services and hospitals; webinar presentation to members of the Mass Gathering Section of the World Association for Disaster and Emergency Medicine, 14th October.

1. Mr Jamie Ranse
Chair-elect, Mass Gathering Section
World Association Disaster and Emergency Medicine
The impact of mass gatherings on ambulance
services and hospitals

2. • 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

3. 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

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

5. • 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

6. method
Table 1: Search terms
Table 2: Inclusion and exclusion criteria

7. results

8. results

9. results

10. results

11. results

12. results

13. • 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

14. • 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

15. 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

16. • 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

17. methods
• Design
• Setting
• Data collection
• Data analysis
• Protection of human participants

18. results

19. results

20. results

21. results

22. results

23. results

24. 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).

25. 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.

26. 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.

27. Mr Jamie Ranse
Chair-elect, Mass Gathering Section
World Association Disaster and Emergency Medicine
The impact of mass gatherings on ambulance
services and hospitals