Presentation Transcript
Basic Principles of Mass Gathering Medical Care: Basic Principles of Mass Gathering Medical Care
Amado Alejandro Báez MD MSc EMT-P
Matthew Sztajnkrycer MD PhD
The Department of Emergency Medicine, Mayo Clinic College of Medicine
Learning Objectives: Learning Objectives
Understand the basic principles of Mass Gathering Medical Care
Define The main elements of the Incident Command System
Performance Objectives: Performance Objectives At the end of the course the student should be able to:
Understand the needs and demands of mass gathering medical care
Understand the basic Incident Command System (ICS) structure.
Mass gathering (Definition): Mass gathering (Definition)
Mass
Attended by a large number of people
Gather \Gath"er\
To bring together; to collect, into one place, to congregate.
Merriam-Webster Medical Dictionary, © 2002 Merriam-Webster, Inc.
NAEMSP/ACEP: A group exceeding 1000 persons
Nine major Mass Gathering planning elements: Nine major Mass Gathering planning elements Crowd size
Personnel
Medical triage and facilities
Medical care
Public information and education
Medical records
Mutual aid
Data collection
Other: public access, disaster planning, weather, and event duration
Mass Gatherings: Mass Gatherings Planning Components
Type of Event
Sports, Concert, Presidential summit
Timeline for preparation
Days to years
Location and available facilities
Urban stadium vs remote rural field
Mass Gatherings Type of Event- Anticipated conditions: Mass Gatherings Type of Event- Anticipated conditions Rock concerts - Drugs, alcohol, trauma, heat-related
Auto races and Olympic Games - Serious trauma, heat- and alcohol-related problems
Athletes and primary competitors may have their own medical teams
Demonstrations - Injuries and tear gas
Mass Gatherings Type of Event: Mass Gatherings Type of Event Sporting events - Minor injuries, intoxication, heat-related problems, and cardiac problems including arrest
Citizen sporting events- Heat-related illness, exhaustion, and cold-related illness
Mass Gatherings : Mass Gatherings Data on Patient Contacts
Sporting Event 0.3 to 1.6 per 1,000
Marathons 24 per 1,000
Rock Concerts 0.96 to 17 per 1,000
Associated to ETOH and Drugs
Staffing and on-site personnel: Staffing and on-site personnel Majority of patients can be triaged and treated effectively by RN’s and EMT’s
1-2 physicians for every 50,000 people
1 paramedic/EMT team per 10,000
Anticipated usage rates, based on previous experience
Non physician staff training in CPR/ AED
Staffing and on-site personnel: Staffing and on-site personnel Management of Volunteers
Fatigue and Motivation
Shift work
2 Persons per 8 hr shift with 4 hrs of patient time and 4 hrs “off time”
Location of Treatment Facilities: Location of Treatment Facilities On-Site
Aid stations at 5 min walking or 1/8 mile
Dedicated rooms or Tents
Off-Site
BLS crew: 4 minutes away
ALS: 8 minutes
Hospital: 30 minutes away (Air or ground)
Environmental Elements: Environmental Elements Heat: Cooling, sun screen, reduced exposure time
Water: Hydration issues, water borne illness
Food: Food borne pathogens (1987 Shigella)
Waste: Management, disease transmission
Drugs of Abuse and Alcohol: Drugs of Abuse and Alcohol Rock concerts up to 48% of all patients
Limit size (<20oz), amount and times of ETOH sales
Banning entrance to intoxicated visitors
Techniques for Effective Alcohol Management (TEAM) Programs
Designated drivers or “Bus Trips”
Incident Command System (ICS): Incident Command System (ICS) Definition:
Method of Command, Control and Coordination of individual agencies as they work towards the common goal of stabilizing an emergency
Advantages of ICS: Advantages of ICS Prevents Chaos
Prevents Individualism
Prevents prolongation of the Incident
Provides supervisory authority & reporting relationships
Provides “unity” of command
Improved coordination
Applications of ICS: Applications of ICS Hazardous Materials (HazMat) incidents
Planned events (e.g. Celebrations, Parades, Concerts, Official visits etc.)
Response to Natural Hazards
Single and Multi-agency law enforcement incidents
Lack of Comprehensive resource Management Strategy
Fires
ICS Hurricane Georges Dominican Red Cross: 09/1998: ICS Hurricane Georges Dominican Red Cross: 09/1998
Medical Incident Command System: Medical Incident Command System
Conclusions: Conclusions Mass gathering can be challenging and event-specific planning considerations are needed
Basic elements of the Incident Command System are: Finance, Logistics, Operations, Planning.
Hope for the Best Prepare for the Worst: Hope for the Best Prepare for the Worst