Special Events and Mass Gatherings

1. Special Events and Mass Gatherings

2. OpeningCase Special Events and Mass Gatherings

3. Rock Concert • Your medic unit has been assigned to an all-day, open-air music concert for stand by. • It is 90°F outside, and a crowd estimated at 1,000 to 1,500 teenagers is having fun. 00108010

4. Opening Case • You have been enjoying the ambulance A/C and a DVD movie backstage when Lily approaches your ambulance. “I’m feeling dizzy,” she says.

5. Scene Size-Up • Lily is 12 years old. She and her friends were dropped off by her parents this morning. She has been dancing and singing all day. • Lily cannot walk very well. She is having leg cramps and nausea. Her skin is hot and dry. Her mucous membranes are pink and dry. • VS: BP 100/70, P 110, R 20, SpO2 98%

6. SICK? Sick or Not-yet-sick? Why? or NOT YET SICK?

7. Scene Evolution • As you get Lily comfortable, two more young girls approach your ambulance with similar complaints. • You radio is crackling. The concession stand on the opposite side of the crowd is calling with a patient who is vomiting and requesting “medical assistance.”

8. Concert Scene (continued) • There are now several security guards calling for a “medic” in front of the mosh pit, and you can see a T-shirt vending tent setup that looks like it’s filled with people seeking refuge from the heat.

9. Concert Venue Map Green dots are the patients. How should you handle this situation? T-shirt vending tent Medic unit Stage T-shirt vending tent N Gate Main Roadway

10. North triage Patient collection Medic unit South triage patient collection Concert Venue Map Medic unit Ladder truck A M B T-Shirt Vending Tent Vending A M B Stage A M B T-Shirt Vending Tent A M B N Vending A M B Gate Main roadway blocked with parked cars and pedestrian traffic

11. Preplan • Most of your patients are under the age of 18 and were dropped off by parents. How does this change your approach to the scene? • What should have been done in anticipation of this event to prevent this?

12. Introduction

13. Introduction • Disaster management principles • Preplanning • Responding • Mitigating the event • Recovering from the event

14. Preplanning for Mass Gatherings

15. When creating the medical operations plan for a mass gathering, members of the event planning team should • Strictly adhere to the policies and protocols of the local EMS agency • Take into account factors such as the time of year and the demographics of the crowd • Only take into account the conditions most likely to be encountered, such as headache and minor trauma

16. When creating the medical operations plan for a mass gathering, members of the event planning team should • Strictly adhere to the policies and protocols of the local EMS agency • Take into account factors such as the time of year and the demographics of the crowd • Only take into account the conditions most likely to be encountered, such as headache and minor trauma

17. Venue Reconnaissance • Need to be aware with each venue: • Environment (whether indoor or outdoor) • Location • Accessibility • Existing aid • Emergency facilities

18. Legal and Political Reconnaissance • Be aware of any protocol or other barriers to response due to the gathering

19. Event Timing • Be aware of potential changes due to weather or traffic

20. Event Security and Safety Concerns • Anticipate potential threats relevant to the mass gathering

21. Utilizing Existing Laws, Regulations, and Rules in the Planning Process • Legal issues that should be planned for include • Liability coverage • Jurisdictional authority • Billing • Reimbursement procedures

22. Event Participant Diversity • Be prepared for the potential of a variety of age groups and health conditions present • Also for the possibility of language barriers

23. Anticipated Types of Emergencies • Plan for the worst potential emergencies • Anaphylaxis • Cardiac arrest • Major trauma

24. Medical Personnel and Response Team Configuration • The qualification of medical personnel can vary greatly on a mass gathering • Stations

25. Event Resources and Equipment • Response vehicles • Minimum supplies • Potential for water and blankets?

26. Equipment • Place personnel who are familiar with equipment (e.g., skis, ATVs) on appropriate equipment • Place supplies with those trained to use them

27. Additional Resources Available During the Event • Community resources • Surrounding ambulances

28. Event Communication Equipment • Be familiar with radio equipment • What channel to speak on • Cell phones • Landlines • Pagers

29. Protocols • Where are protocols from? • Treating and releasing or transporting protocols

30. Standing Mass Gathering Venues • London ambulance service covers Heathrow Airport with paramedics and EMTs on bikes

31. Medical Control During the Event • Availability of online medical control for mass events

32. The Responding Phase: Immediately Prior to the Event

33. First Aid Tent at Street Fair

34. The Responding Phase: Immediately Prior to the Event • Medical response plan • Incident command post

35. The Mitigation Phase: Responding During the Event

36. You are called to a professional basketball arena where a first aid office is being overwhelmed by patients complaining of fever, nausea, and joint pain. You should first consider • Organophosphate poisoning • Release of refrigerator coolant • Food poisoning • Biochemical terrorist attack

37. You are called to a professional basketball arena where a first aid office is being overwhelmed by patients complaining of fever, nausea, and joint pain. You should first consider • Organophosphate poisoning • Release of refrigerator coolant • Food poisoning • Biochemical terrorist attack

38. The Mitigation Phase: Responding During the Event • Staffing hazard mitigation includes • Rehydration units • Providing information on safe-ride • Designated driver programs • Distributing blankets during outdoor winter events

39. The Public Safety Answering Point • PSAP calls and prearrival instructions

40. Maintaining a Safe Environment: Transportation of Patients During Events • Be on high alert for evidence of danger or foul play • Establish special treatment areas as necessary • Send medical personnel to specific areas

41. Documentation of Care During Mass Gatherings • Documentation still required • May not need as much • HIPPA still applies

42. Unforeseen Situations Arising During an Event • Possible barriers that could arise during event • Inability to transport due to the type of vehicles used

43. Street Secret • The quickest way to access some patients is by having bystanders bring the patients out of the crowd to the rescuers • If the crowd is under control and willing to assist, you can direct them regarding what needs to be done to bring the patients to you

44. Mass gatherings have a particularly high incidence of • Violence outbreaks • Celebrity attendance • Teenage attendance • Environmental emergencies

45. Mass gatherings have a particularly high incidence of • Violence outbreaks • Celebrity attendance • Teenage attendance • Environmental emergencies

46. After the Event: The Recovery Phase

47. After the Event: The Recovery Phase • Debrief staff for ideas for future events • Restock, clean, document

48. Summary • All of the public safety agencies should be involved in planning for the event • Paramedics must understand the plan and know their role

49. The END

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