4 Mass Gathering

Question 1

Typically, mass gatherings are considered to be events that have at least

Answer 1

1000 people
However, this does not have to be the case. WHO does not focus on the number of attendees when defining mass gatherings; rather, they recognizee the impact on the surrounding resources

Question 2

Factors affecting planning for a mass gathering event

Answer 2

Communication
Entry and exit of venue
Potential public health threats
Environment

Question 3

Key to a successful medical response

Answer 3

Reliable communication between medical personnel, event organizers, and outsdie medical resources

Question 4

Remarks on mass gatherings

Answer 4

Despite the fact that mass gatherings are generally attended by individuals in good health, these events tend to have a higher incidence of illness and injury than that which would be found in the general population

Question 5

Remarks on the medical director

Answer 5

1. All mass gathering events should have an identified physician medical director who is responsible for developing the medical action plan
2. provides medical oversight before and during the event
3. should be a board certified in emergency medicine
4. should have experience in the medical direction of EMS and provision of medical care at mass gathering events
5. Ideally, the medical director should be on site during the event as much as possible

Question 6

one of the most well-tested and efficient methods used in the command and control of resources emergency incidents or mass gatherings

Answer 6

Incident Command System (ICS)

Question 7

Remarks on the Incident Commander

Answer 7

1. Has overall responsibility for managing the incident
2. Initially, assigning tactical resources and overseeing operations will be under the direct supervision of the
   Incident Commander.
3. Involved with the global issues of the incident/event

Question 8

While the Command function is always established, the other divisions of the Incident Command System are formed as needed. These divisions include

Answer 8

Operations
Planning
Logistics
Finance and administration

Question 9

TRUE or FALSE
The physician’s role within the Incident Command System (ICS) structure should be focused on direct oversight of patient care

Answer 9

TRUE
… and not involve the global issues that are the concern of the incident commander

Question 10

the provision of medical care to the public occurs within what division of the ICS?

Answer 10

Operations division
- it is the function of the operations section to complete the primary tasks of the mission
- it may be more beneficial to have the individual with EMS or fire service experience in the role of team lead, which ideally may be an EMS physician

Note: the medical directors)* should function as a commander within the Operations Section and report back to the section head of the Operations who ultimately reports to the incident commander

Question 11

Remarks on event reconnaisance

Answer 11

1. Check adequace of exits, routs of ingress and egress, and the georgraphical area
2. 2. Determine ideal locations for setting up a base of operations, fixed medical care sites, and staging areas for mobile units

Question 12

minimum acceptable care [or personnel] in mass gatherings

Answer 12

emergency medical technician

Question 13

remarks on critical patients

Answer 13

it is important to consider that rapid transport of the critical patient away from the incident to the controlled environment of an acute care hospital may be more beneficial for the patient and frees up the provider to care for other patients

Question 14

supplies in highest demand in mass gatherings

Answer 14

bandages
foam padding for blisters
ice for sprains
fluids
acetaminophen and ibuprofen

Question 15

Medical units should, at the very least, have access to:

Answer 15

automated eternal defibrillator

Question 16

mainstay of ground transport from the venue to outlying medical facilities

Answer 16

ambulances

Question 17

public health concerns to be considered for a mass gathering event

Answer 17

1. access to potable water
2. proper waste management for human and non-human waste
3. proper management of food service to prevent spread of foodborne illness
4. proper road/traffic management to prevent traffic-related injuries
5. other considerations for injury prevention
6. large-scale natural or man-made disasters

Question 18

remarks on the communication center

Answer 18

1. should be located in an area that affords the greatest coverage for the event
2. fully accessible to the medical director
3. if situationally appropriate, it may be advantageous to have it co-located in the event command center

Question 19

essential components of medical documentation for a mass gathering event

Answer 19

1. Patient’s name, contact information, sex, age
2. Vital signs
3. Chief complaint
4. Focused PE
5. Suspected diagnosis
6. Medical care rendered
7. Disposition

Question 20

Remarks on the liability of medical personnel in mass gatherings

Answer 20

1. If the medical personnel will be reimbursed for services in the form of legal tender or payment in kind (even in the form of a free meal at the event), they may not be protected from liability through Good Samaritan laws [depending on the state]
2. If the medical providers are advertising their medical services to the public at an event even by setting up an established medical tent, the providers have established a duty to act and are liable to the public to provide care at an established standard

Question 21

The foundational components of successful resuscitation, CPR and early defibrillation, should be delivered to a patient within _____

Answer 21

3 minutes of notification of collapse
Thus, staging of medical personnel within an appropriate response radius and equipping medical units with an AED should be a priority.

In general, the incidence of cardiopulmonary arrest and the need for major resuscitatoin at mass gatherings is low. However, cardiac arrest has been shown to be particularly susceptible to successful intervetnion in this type of setting

Question 22

Planning for a mass casualty incident (MCI) in a mass gathering

Answer 22

1. should include methods of triage, coordination of the mass casualty with local EMS, and distribution of large numbers of patients as needed to area acute care facilities.
2. the medical teams should function seamlessly in the Incident Command System (ICS) structure
3. Success is partly predicated on predetermined roles of the personnel at the event, which allows for immediate implementation of the ICS