Mass Gatherings

1. Mass Gatherings Tintinalli Chap. 5

2. Mass Gathering • Organized events or venues with relatively large numbers of people in a defined geographic area • > 1000 people • Smaller venues with a relatively high concentration of people in a limited space • Athletic events • Venues where it may not be easy to access EMS system • Airplanes • Cruise ships • Wilderness

3. Medical Action Plan • Physician Medical Oversight • Command and Control • Reconnaissance • Negotiations • HR/Level of Care/Training • Equipment • Treatment Facilities • Transportation • Public Health Concerns • Access to Care • Communications • Documentation • Liability • Continuous Quality Improvement

4. Commercial Airline Flights • Factors affecting medical care • Lower partial pressure of oxygen • Potential exposure to chemical irritants • Dry air • Virulent airborne particles • Venous stasis • Crew members • BLS • Onboard medical supplies • Limited • Decision to divert • Medical need, cost, and logistic constraints

5. Cruise Ships • Nearly 10 million people per year • Average age = 55 • Isolated environment with high probability of encountering sick patients • Average of 4 life-threatening conditions per week-long cruise of 1100 passengers

6. Wilderness Medicine • Extremes of Temperature • Challenges in extrication of patients • Alternative means of transport • Horses • Snowmobiles • Aircraft

7. Ultra-Distance Athletic Events • Massive sodium losses • Overhydration with free water • Symptomatic Hyponatremia • Risk Factors • Exercise longer than 4 hours • Female sex • Low BMI • Treatment • Oral Rehydration • IV fluids