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Avery, J.G., Chitnis, J.-G., Daly, P.J. & Pollock, G.T. (1982), "Medical planning for a major event: the Pope's visit to Coventry Airport, 30 May 1982", British Medical Journal. Vol. 285, pp. 51-53.
BibTeX:
@article{Avery1982,
  author = {J G Avery and J-G Chitnis and P J Daly and G T Pollock},
  title = {Medical planning for a major event: the Pope's visit to Coventry Airport, 30 May 1982},
  journal = {British Medical Journal},
  year = {1982},
  volume = {285},
  pages = {51-53},
  url = {http://pubmedcentralcanada.ca/picrender.cgi?artid=332060&blobtype=pdf}
}
Bock, H.C., Cordell, W.H., Hawk, A.C. & Bowdish, G.E. (1992), "Demographics of emergency medical care at the Indianapolis 500 mile race (1983-1990).", Ann Emerg Med.. , pp. 1204-1207.
BibTeX:
@article{Bock1992,
  author = {H. C. Bock and W. H. Cordell and A. C. Hawk and G. E. Bowdish},
  title = {Demographics of emergency medical care at the Indianapolis 500 mile race (1983-1990).},
  journal = {Ann Emerg Med.},
  year = {1992},
  pages = {1204-1207},
  url = {http://www.annemergmed.com/article/S0196-0644(05)81747-0/abstract}
}
Borjesson, M., Serratosa, L., Carre, F., Corrado, D., Drezner, J., Dugmore, D.L., Heidbuchel, H.H., Mellwig, K.-P., Panhuyzen-Goedkoop, N.M., Papadakis, M., Rasmusen, H., Sharma, S., Solberg, E.E., van Buuren, F. & Pelliccia, A. (2011), "Consensus document regarding cardiovascular safety at sports arenas", European Heart Journal., June, 2011. Vol. 32(17), pp. 2119-2124.
Abstract: Mass gathering events in sports arenas create challenges regarding the cardiovascular safety of both athletes and spectators. A comprehensive medical action plan, to ensure properly applied cardiopulmonary resuscitation, and wide availability and use of automated external defibrillators (AEDs), is essential to improving survival from sudden cardiac arrest at sporting events. This paper outlines minimum standards for cardiovascular care to assist in the planning of mass gathering sports events across Europe with the intention of local adaptation at individual sports arenas, to ensure the full implementation of the chain of survival.
BibTeX:
@article{Borjesson2011,
  author = {Borjesson, Mats and Serratosa, Luis and Carre, Francois and Corrado, Domenico and Drezner, Jonathan and Dugmore, Dorian L. and Heidbuchel, Hein H. and Mellwig, Klaus-Peter and Panhuyzen-Goedkoop, Nicole M. and Papadakis, Michael and Rasmusen, Hanne and Sharma, Sanjay and Solberg, Erik E. and van Buuren, Frank and Pelliccia, Antonio},
  title = {Consensus document regarding cardiovascular safety at sports arenas},
  journal = {European Heart Journal},
  year = {2011},
  volume = {32},
  number = {17},
  pages = {2119-2124},
  url = {http://www.sportmedicine.ru/recomendations/consensus_document_regarding_cardiovascular_safety_at_sports_arenas.pdf},
  doi = {http://dx.doi.org/10.1093/eurheartj/ehr178}
}
Boyer, C., Ammirati, C., Thiebaut, H. & Nemitz, B. (1999), "Couverture médicale des rassemblements de foule : essai de modélisation", Médecine de catastrophe -- urgences collectives. Vol. 2, pp. 24-30.
Abstract: L'objectif de cet article est d'analyser les facteurs de risque et les besoins médicaux pour les rassemblements de plus de 5 000 personnes en France. Une hypothèse sur un nombre d'équipe médical nécessaire pour 10 000 spectateurs en fonction du type d'événement a été avancée à partir d'un calcul ≪ temps-médecin ≫. Pour cela, un questionnaire a été envoyé à tous les Samu et SDIS de France et la littérature a été étudiée ; 179 événements ont été rapportés et analysés. L'étude statistique comparée à celle de la littérature nous a permis d'évaluer le nombre et la gravité des pathologies en fonction du type d'événement et de la quantité de population. II ressort de cette étude que pour un certain nombre d'événements, en particulier le football et les concerts de musique, il est possible de calculer une couverture médicale suffisante et pertinente pour 95 % de l'ensemble des événements, en tenant compte des probabilités de risques médicaux (issues des statistiques), du type de couverture médicale envisagée (médicalisation ou non des postes de secours, présence d'un poste médical avancé et/ou d'un poste de commandement), du temps consacré au tri et à la prise en charge des pathologies. Cette approche objective ne prend pas en compte les risques non connus par le responsable médical et la situation de catastrophe qui peut en découler. Afin d'infirmer ou confirmer ces hypothèses, un observatoire national a été crée à Amiens au Samu 80. Il permettra à partir de fiches types envoyées à tous les Samu et SDIS de France de recueillir des données précises sur les aspects médicaux de chaque rassemblement de foule.
BibTeX:
@article{Boyer1999,
  author = {C. Boyer and C. Ammirati and H. Thiebaut and B. Nemitz},
  title = {Couverture médicale des rassemblements de foule : essai de modélisation},
  journal = {Médecine de catastrophe -- urgences collectives},
  year = {1999},
  volume = {2},
  pages = {24-30},
  url = {http://www.sciencedirect.com/science/journal/12798479}
}
Chang, W.-H., Chang, K.-S., Huang, C.-S., Huang, M.-Y., Chien, D.-K. & Tsai, C.-H. (2010), "Mass Gathering Emergency Medicine: A Review of the Taiwan Experience of Long-distance Swimming Across Sun-Moon Lake", June, 2010. Vol. 4(2), pp. 53-68.
BibTeX:
@article{Chang2010,
  author = {Chang, Wen-Han and Chang, Kuo-Song and Huang, Chien-Shuan and Huang, Ming-Yuan and Chien, Ding-Kuo and Tsai, Cheng-Ho},
  title = {Mass Gathering Emergency Medicine: A Review of the Taiwan Experience of Long-distance Swimming Across Sun-Moon Lake},
  year = {2010},
  volume = {4},
  number = {2},
  pages = {53--68},
  url = {http://www.sgecm.org.tw/db/Jour/2/201006/1.pdf}
}
Chang, E.C., Koval, E., Freer, L. & Kraus, S. (2000), "Planning for an annual episodic mass gathering: emergency department and clinic utilization in Yellowstone", Wilderness & Environmental Medicine., December, 2000. Vol. 11(4), pp. 257-261.
Abstract: textlessptextgreaterObjectivetextlessbr/textgreaterPlanning and providing emergency and primary care for a large transient population of visitors and employees in a national park can be problematic. Furthermore, planning for emergency and primary health care needs of visitors and itinerant workers in a wilderness area national park has not been well documented. A study was performed to analyze emergency and primary health care utilization in a national park.Methodstextlessbr/textgreaterData was gathered from all patients presenting to Lake Hospital Emergency Department in Yellowstone in 1995, and a retrospective chart review was performed.Resultstextlessbr/textgreaterTwo distinct populations with different health care needs were identified.Conclusiontextlessbr/textgreaterUtilization analysis revealed differences between conventional mass gatherings and the mass gatherings in Yellowstone. Because of the unique conditions and populations found in a wilderness area, conventional mass gathering emergency medical service models may not be an appropriate model for planning health care in a national park. Analysis of utilization data can help plan resources for emergency and primary health care for a park population.textless/ptextgreater
BibTeX:
@article{Chang2000,
  author = {Chang, Eric C. and Koval, Elizabeth and Freer, Luanne and Kraus, Sue},
  title = {Planning for an annual episodic mass gathering: emergency department and clinic utilization in Yellowstone},
  journal = {Wilderness & Environmental Medicine},
  year = {2000},
  volume = {11},
  number = {4},
  pages = {257--261},
  url = {http://www.sciencedirect.com/science/article/pii/S1080603200708234},
  doi = {http://dx.doi.org/80/1080-6032(2000)011[0257:PFAAEM]2.3.CO;2}
}
Chapman, K.R., Carmichael, F.J. & Goode, J.E. (1982), "Medical services for outdoor rock music festivals", Canadian Medical Association Journal., April, 1982. Vol. 126(8), pp. 935-938.
Abstract: This paper describes the medical services provided at an outdoor rock music festival near Toronto and reviews similar services at other outdoor concerts as reported in the literature. Between 0.5% and 1.5% of concertgoers were reported to have used medical services, proportions that may be useful in planning for future festivals. Most of the medical problems encountered were minor, although life-threatening problems occasionally occurred. Alcohol and drug abuse were common but led to major medical problems in only small proportions of patients. Guidelines for planning are suggested that include recommendations about facilities, supplies and equipment, transportation and communications, staffing and procedures. The need for liaison with the concert promoters, the police, ambulance officials and local hospital personnel is noted, and the use of the nonmedical ancillary staff is encouraged.
BibTeX:
@article{Chapman1982,
  author = {Chapman, K R and Carmichael, F J and Goode, J E},
  title = {Medical services for outdoor rock music festivals},
  journal = {Canadian Medical Association Journal},
  year = {1982},
  volume = {126},
  number = {8},
  pages = {935--938},
  note = {PMID: 7074491},
  url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1862986/pdf/canmedaj01365-0059.pdf}
}
Deakin, C.D., Thompson, F., Gibson, C. & Green, M. (2007), "Effects of international football matches on ambulance call profiles and volumes during the 2006 World Cup", Emergency Medicine Journal : EMJ., June, 2007. Vol. 24(6), pp. 405-407.
BibTeX:
@article{Deakin2007,
  author = {Deakin, Charles D and Thompson, Fizz and Gibson, Caroline and Green, Mark},
  title = {Effects of international football matches on ambulance call profiles and volumes during the 2006 World Cup},
  journal = {Emergency Medicine Journal : EMJ},
  year = {2007},
  volume = {24},
  number = {6},
  pages = {405--407},
  note = {PMID: 17513536 PMCID: 2658274},
  url = {http://en.scientificcommons.org/57892678},
  doi = {http://dx.doi.org/10.1136/emj.2007.046920}
}
Dhondt, E. (2007), "Emergency physician managed triage at a rock concert avoids overload at the local emergency department (ED) [poster]", In 15th World Congress on Disaster and Emergency Medicine.
BibTeX:
@inproceedings{Dhondt2007,
  author = {Erwin Dhondt},
  title = {Emergency physician managed triage at a rock concert avoids overload at the local emergency department (ED) [poster]},
  booktitle = {15th World Congress on Disaster and Emergency Medicine},
  year = {2007},
  url = {http://homepages.ulb.ac.be/ccloquet/files/Dhondt2007.pdf}
}
Erickson, T.B., Aks, S.E., Koenigsberg, M., Bunney, E.B., Schurgin, B. & Levy, P. (1996), "Drug use patterns at major rock concert events", Ann Emerg Med. Vol. 28, pp. 22-26.
Abstract: STUDY OBJECTIVE: To describe alcohol and drug use patterns in patients presenting to first aid stations at major rock concerts.

METHODS: We retrospectively reviewed all charts generated at the first aid stations of five major rock concerts featuring the rock groups Pink Floyd, the Grateful Dead, and the Rolling Stones. The first aid stations, located at a sports stadium, were staffed by paramedics, emergency medicine nurses, and physicians. We recorded the following data: patient demographics, history of drug or ethanol use, time spent by patient in first aid station, treatment rendered, diagnosis, and patient disposition.

RESULTS: A total of 253, 286 spectators attended the five concert events. The rate of use of the first aid station was 1.2 per 1,000 patrons. The average age of the patrons was 26.3 +/- 7.9 years (range, 3 to 56 years). The most common diagnoses were minor trauma 130 (42%) and ethanol or illicit drug intoxication 98 (32%). Of the patients treated, 147 (48%) admitted to using illicit drugs or ethanol while attending the concerts. The median time spent in the first aid station was 15 +/- 22.5 minutes (range, 5 to 150 minutes). One hundred patients (32.5%) were treated and released, 98 (32%) were transported to emergency departments, and 110 (35.5%) signed out against medical advice.

CONCLUSION: Minor trauma and the use of illicit drugs and ethanol were common in spectators presenting to first aid stations at these concert events. Physicians and paramedical personnel working at rock concerts should be aware of the current drug use patterns and should be trained in treating such drug use.

BibTeX:
@article{Erickson1996,
  author = {T. B. Erickson and S. E. Aks and M. Koenigsberg and E. B. Bunney and B. Schurgin and P. Levy},
  title = {Drug use patterns at major rock concert events},
  journal = {Ann Emerg Med},
  year = {1996},
  volume = {28},
  pages = {22-26},
  url = {http://www.sciencedirect.com/science/article/pii/S0196064496701336}
}
Federman, J. & Giordano, L. (1997), "How to cope with a visit from the Pope", Prehosp Disaster Med. Vol. 12, pp. 86-91.
BibTeX:
@article{Federman1997,
  author = {J.H. Federman and L.M. Giordano},
  title = {How to cope with a visit from the Pope},
  journal = {Prehosp Disaster Med},
  year = {1997},
  volume = {12},
  pages = {86-91}
}
Forrest, R.D. (1999), "[Report from the medical tent at three rock festivals. Lots of music, great fun and very little drunkeness]", Läkartidningen., June, 1999. Vol. 96(23), pp. 2874-2876.
Abstract: Rock festivals are popular summer attractions in Scandinavia, and each of the largest festivals has its own voluntary medical crew of doctors, nurses and nursing auxiliaries. The medical crew is an important part of the festival safety facilities, providing free acute health care to festival visitors, and thus relieving pressure on local primary health centres and hospitals. In 1998, 797 of the 25,000 visitors to the three-day Hultsfred Festival were treated at the medical tent, 465 of them by a doctor; and 305 of the 17,000 people attending the two-day Fanclub88 event were treated at the medical tent, 132 by a doctor. No figures are available for the 1998 Roskilde Festival in Denmark, but at the 1997 festival, 3,369 of the 95,000 visitors were treated at the medical tent.
BibTeX:
@article{Forrest1999,
  author = {Forrest, R D},
  title = {[Report from the medical tent at three rock festivals. Lots of music, great fun and very little drunkeness]},
  journal = {Läkartidningen},
  year = {1999},
  volume = {96},
  number = {23},
  pages = {2874--2876},
  note = {PMID: 10405537},
  url = {http://www.ncbi.nlm.nih.gov/pubmed/10405537}
}
Grange, J.T., Green, S.M. & Downs, W. (1999), "Concert Medicine: Spectrum of Medical Problems Encountered at 405 Major Concerts", Academic Emergency Medicine. Vol. 6, pp. 202-207.
BibTeX:
@article{Grange1999,
  author = {Jeff T. Grange and Steven M. Green and Warren Downs},
  title = {Concert Medicine: Spectrum of Medical Problems Encountered at 405 Major Concerts},
  journal = {Academic Emergency Medicine},
  year = {1999},
  volume = {6},
  pages = {202-207},
  url = {http://www.symonseventsafety.com/cmsdocuments/Concert_Medicine_article_for_website.pdf}
}
Grant, W.D., Nacca, N.E., Prince, L.A. & Scott, J.M. (2010), "Mass-gathering medical care: retrospective analysis of patient presentations over five years at a multi-day mass gathering", Prehospital and Disaster Medicine., April, 2010. Vol. 25(2), pp. 183-187.
Abstract: INTRODUCTION: There is a scarcity of analytical data regarding mass-gathering medical care. The purpose of this study was to identify and evaluate the range and nature of illness and injury for patrons of an annual, multi-day, mass gathering. METHODS: Encounter data from all patients seen by emergency physicians at the New York State Fair Infirmary during the past five years were analyzed. From these data, a category list was consolidated to 36 reasons for the visit based on chief complaint, nursing notes, and physician notes. The most common reasons for being seen by a physician were analyzed to determine age and gender discrepancies. RESULTS: The average number of attendees at the Fair per year from 2004-2008 was 950,973. Emergency physicians evaluated a total of 2,075 patients from 2004-2008. The average patient presentation rate over the past four years (2005-2008) was 4.8 +/-1.1/10,000 patrons. The average transport to hospital rate over the past four years was 2.7 +/-1.1/100,000 patrons. The average age of all patients seen was 34.4 +/-21.6 years, and 58.1% of the patients were female. The most common reasons to seek medical attention included: dehydration/heat-related illness (11.4; abrasion/laceration (10.6; and fall-related injury (10.2. Two groups, dehydration/heat-related illness 74% (t (4) = 2.90, p textless0.05), and fall-related injury (68 t (4) = 5.17, p textless0.05) were disproportionately female. There also was a direct relationship between age and female gender within the fall-related injury category (X(2) (1, n = 213) = 11.41, p textless0.05). CONCLUSIONS: Patron data from fairs and expositions is a valuable resource for studying mass-gathering medical care. A majority (58 of patients seen at the infirmary were female. The most common reason for being seen was dehydration/heat-related illness, which heavily favored females, but favored no age groups. The abrasion/laceration category did not contribute to the gender discrepancy. Patients who fell tended to be females textgreater40 years of age. Further analysis is required to determine the reason for the gender discrepancies. Planners of multi-day mass gatherings should develop public education programs and evaluate their impact on the at-risk populations identified by this analysis.
BibTeX:
@article{Grant2010,
  author = {William D Grant and Nicholas E Nacca and Louise A Prince and Jay M Scott},
  title = {Mass-gathering medical care: retrospective analysis of patient presentations over five years at a multi-day mass gathering},
  journal = {Prehospital and Disaster Medicine},
  year = {2010},
  volume = {25},
  number = {2},
  pages = {183--187},
  note = {PMID: 20468001},
  url = {http://pdm.medicine.wisc.edu/Volume_25/issue_2/grant.pdf}
}
Gutman, S.J., Lund, A. & Turris, S.A. (2011), "Medical Support for the 2009 World Police and Fire Games: A Descriptive Analysis of a Large-Scale Participation Event and Its Impact", Prehosp Disaster Med. Vol. 26(01), pp. 33-40.
BibTeX:
@article{Gutman2011,
  author = {Gutman, Samuel J. and Lund, Adam and Turris, Sheila A.},
  title = {Medical Support for the 2009 World Police and Fire Games: A Descriptive Analysis of a Large-Scale Participation Event and Its Impact},
  journal = {Prehosp Disaster Med},
  year = {2011},
  volume = {26},
  number = {01},
  pages = {33--40},
  url = {http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8235578&fulltextType=RA&fileId=S1049023X10000117},
  doi = {http://dx.doi.org/10.1017/S1049023X10000117}
}
Hardcastle (2010), "The Moses Mabhida Medical Plan: medical care planning and execution at a FIFA2010 stadium; the Durban experience", Open Access Emergency Medicine. Vol. 2, pp. 91-97.
Abstract: Aim: This paper aims to outline the medical services provided at the Moses Mabhida Stadium,
Durban, South Africa for the Fédération Internationale de Football Association (FIFA) 2010
Soccer World Cup and audit the clinical services delivered to persons seeking medical
assistance.
Methods: Descriptive report of the medical facilities at the Moses Mabhida Stadium including
the staff deployment. Retrospective data review of medical incident reports from the Stadium
Medical Team.
Results: Medical staffing exceeded the local norms and was satisfactory to provide rapid intervention
for all incoming patients. Senior medical presence decreased the transport to hospital
rate (TTHR). A total of 316 spectators or support staff were treated during the seven matches
played at the stadium. The majority of patients were male (60%), mostly of local origin, with
mostly minor complaints that were treated and discharged (88.2% Green codes). The most
common complaints were headache, abdominal disorders, and soft-tissue injuries. One fatality
was recorded. The patient presentation rate (PPR) was 0.66/10,000 and the TTHR was overall
4.1% of all treated patients (0.027/10,000 spectators).
Conclusion: There was little evidence to guide medical planning for staffing from the FIFA
governing body. Most patients are treated and released in accordance with international literature,
leading to low TTHR rates, while PPR was in line with international experience. Headache
was the most common medical complaint. The blowing of Vuvuzelas® may have influenced
the high headache rate
BibTeX:
@article{Hardcastle2010,
  author = {Hardcastle},
  title = {The Moses Mabhida Medical Plan: medical care planning and execution at a FIFA2010 stadium; the Durban experience},
  journal = {Open Access Emergency Medicine},
  year = {2010},
  volume = {2},
  pages = {91-97},
  url = {http://www.dovepress.com/the-moses-mabhida-medical-plan-medical-care-planning-and-execution-at--peer-reviewed-article-OAEM}
}
Hawkins, E.R. & Brice, J.H. (2010), "Fire Jumpers: Description of Burns and Traumatic Injuries from a Spontaneous Mass Gathering and Celebratory Riot", The Journal of emergency medicine., feb, 2010. Vol. 38(2), pp. 182-187.
Abstract: Background: On April 3 and 5 of 2005, approximately 52,000 people gathered in Chapel Hill, North Carolina to celebrate the National Collegiate Athletic Association Final Four victories of the University of North Carolina men's basketball team. As crowds rejoiced and intensified into a celebratory riot, many participants lit dozens of bonfires and expressed themselves by jumping through the flames. Objective: To describe the interesting injury mechanism of celebratory fire jumping and to describe the injuries associated with two celebratory riots. Methods: We conducted a cross-sectional study analyzing all Emergency Medical Services (EMS) and hospital reports of injuries associated with each gathering. We used a standardized data collection instrument to record descriptive information on all patients with celebration-associated complaints and noted their treatment and disposition. For analysis, we abstracted data and generated basic descriptive statistics and comparisons of groups. Results: A total of 58 celebrants received medical care, including 27 patients first evaluated by EMS and 49 patients subsequently evaluated in the Emergency Department. Most were young (average age = 23.8 years), male (65%, 32/49), had complaints associated with alcohol (65%, 32/49), and were not admitted to the hospital (92%, 45/49). Of those presenting for hospital evaluation, 30% (15/49) had burns associated with fire-jumping. Conclusions: Most patients from these gatherings had relatively minor injuries or medical complaints. However, burns associated with fire-jumping represented a substantial proportion of more serious injuries and hospitalizations. These cases are presented to increase awareness of the burn injuries associated with this type of celebratory mass gathering.
BibTeX:
@article{Hawkins2010,
  author = {Eric R. Hawkins and Jane H. Brice},
  title = {Fire Jumpers: Description of Burns and Traumatic Injuries from a Spontaneous Mass Gathering and Celebratory Riot},
  journal = {The Journal of emergency medicine},
  year = {2010},
  volume = {38},
  number = {2},
  pages = {182-187},
  doi = {http://dx.doi.org/10.1016/j.jemermed.2008.08.028}
}
Helbing, D. & Mukerji, P. (2012), "Crowd Disasters as Systemic Failures: Analysis of the Love Parade Disaster", EPJ Data Science. Zurich Vol. 1(7), pp. 1-40.
BibTeX:
@article{Helbing2012,
  author = {Dirk Helbing and Pratik Mukerji},
  title = {Crowd Disasters as Systemic Failures: Analysis of the Love Parade Disaster},
  journal = {EPJ Data Science},
  year = {2012},
  volume = {1},
  number = {7},
  pages = {1-40},
  url = {http://link.springer.com/content/pdf/10.1140%2Fepjds7.pdf}
}
Hewitt, S., Jarrett, L. & Winter, B. (1996), "Emergency medicine at a large rock festival", J Accid Emerg Med. Vol. 13, pp. 6-27.
BibTeX:
@article{Hewitt1996,
  author = {Susanne Hewitt and Lyn Jarrett and Bob Winter},
  title = {Emergency medicine at a large rock festival},
  journal = {J Accid Emerg Med},
  year = {1996},
  volume = {13},
  pages = {6-27}
}
Huchet, F. (2012), "Demande de soins lors d’un grand rassemblement, étude descriptive du premier festival de musique francais". School: Université De Brest – Bretagne Occidentale., juin, 2012.
BibTeX:
@mastersthesis{Huchet2012,
  author = {François Huchet},
  title = {Demande de soins lors d’un grand rassemblement, étude descriptive du premier festival de musique francais},
  school = {Université De Brest – Bretagne Occidentale},
  year = {2012},
  url = {http://dumas.ccsd.cnrs.fr/dumas-00717248}
}
Janchar, T., Samaddar, R. & Milzman, D. (1999), "The Impact of "Mosh Pits" on Medical Incidents at Mass Gatherings", Ann Emerg Med., In Annals of Emergency Medicine. Vol. 34(4), pp. S66-S67.
Review: Près de huit fois plus de victimes par 10000 participants en présence de "mosh-pits", une forme violente de danse.
BibTeX:
@article{Janchar1999,
  author = {T. Janchar and R. Samaddar and D. Milzman},
  title = {The Impact of "Mosh Pits" on Medical Incidents at Mass Gatherings},
  booktitle = {Annals of Emergency Medicine},
  journal = {Ann Emerg Med},
  year = {1999},
  volume = {34},
  number = {4},
  pages = {S66-S67},
  url = {http://www.annemergmed.com/article/S0196-0644(99)80340-0/abstract}
}
Keane, J.W.G., Fisher, N. & Leditschke, J. (2000), "Cardiac arrest outcomes at the Melbourne Cricket Ground and Shrine of Remembrance using a tiered response strategy-a forerunner to public access defibrillation", Resuscitation. Vol. 44, pp. 97-104.
BibTeX:
@article{Keane2000,
  author = {J. Wassertheil G. Keane and N. Fisher and J.F. Leditschke},
  title = {Cardiac arrest outcomes at the Melbourne Cricket Ground and Shrine of Remembrance using a tiered response strategy-a forerunner to public access defibrillation},
  journal = {Resuscitation},
  year = {2000},
  volume = {44},
  pages = {97-104},
  url = {http://www.resuscitationjournal.com/article/S0300-9572%2899%2900168-9/abstract}
}
Kelly, J. & Gittell, M. (2010), "EMS at Woodstock", JEMS.
BibTeX:
@article{Kelly2010,
  author = {Jack Kelly and Myron Gittell},
  title = {EMS at Woodstock},
  journal = {JEMS},
  year = {2010},
  url = {http://www.jems.com/article/major-incidents/ems-woodstock}
}
Kilian, A. & Stretch, R.A. (2006), "Analysis of patient load data from the 2003 Cricket World Cup in South Africa", SAJSM. Vol. 18, pp. 52-56.
BibTeX:
@article{Kilian2006,
  author = {A. Kilian and R. A. Stretch},
  title = {Analysis of patient load data from the 2003 Cricket World Cup in South Africa},
  journal = {SAJSM},
  year = {2006},
  volume = {18},
  pages = {52-56},
  url = {http://www.sajsm.org.za/index.php/sajsm/article/viewFile/38/38}
}
Kim, J.H., Malhotra, R., Chiampas, G., d'Hemecourt, P., Troyanos, C., Cianca, J., Smith, R.N., Wang, T.J., Roberts, W.O. & Baggish, P.D.T.A.L. (2012), "Cardiac Arrest during Long-Distance Running Races", N Engl J Med. Vol. 366, pp. 130-140.
Abstract: Approximately 2 million people participate in long-distance running races in the United States annually. Reports of race-related cardiac arrests have generated concern about the safety of this activity.

Methods
We assessed the incidence and outcomes of cardiac arrest associated with marathon and half-marathon races in the United States from January 1, 2000, to May 31, 2010. We determined the clinical characteristics of the arrests by interviewing survivors and the next of kin of nonsurvivors, reviewing medical records, and analyzing postmortem data.

Results
Of 10.9 million runners, 59 (mean [±SD] age, 42±13 years; 51 men) had cardiac arrest (incidence rate, 0.54 per 100,000 participants; 95% confidence interval [CI], 0.41 to 0.70). Cardiovascular disease accounted for the majority of cardiac arrests. The incidence rate was significantly higher during marathons (1.01 per 100,000; 95% CI, 0.72 to 1.38) than during half-marathons (0.27; 95% CI, 0.17 to 0.43) and among men (0.90 per 100,000; 95% CI, 0.67 to 1.18) than among women (0.16; 95% CI, 0.07 to 0.31). Male marathon runners, the highest-risk group, had an increased incidence of cardiac arrest during the latter half of the study decade (2000–2004, 0.71 per 100,000 [95% CI, 0.31 to 1.40]; 2005–2010, 2.03 per 100,000 [95% CI, 1.33 to 2.98]; P=0.01). Of the 59 cases of cardiac arrest, 42 (71%) were fatal (incidence, 0.39 per 100,000; 95% CI, 0.28 to 0.52). Among the 31 cases with complete clinical data, initiation of bystander-administered cardiopulmonary resuscitation and an underlying diagnosis other than hypertrophic cardiomyopathy were the strongest predictors of survival.

Conclusions
Marathons and half-marathons are associated with a low overall risk of cardiac arrest and sudden death. Cardiac arrest, most commonly attributable to hypertrophic cardiomyopathy or atherosclerotic coronary disease, occurs primarily among male marathon participants; the incidence rate in this group increased during the past decade.

Dr. Roberts reports holding a board membership with UCare Minnesota, receiving writing fees from Runner's World, and serving as an unpaid, volunteer medical director for the Medtronic Twin Cities Marathon; and Dr. Thompson, receiving consulting fees from Regeneron, Furiex Pharmaceuticals, and Lupin Pharmaceuticals, legal fees for expert testimony in cases related to cardiac arrest in exercise- and statin-related muscle injury, grant funding from GlaxoSmithKline, Genomas, Novartis, Furiex Pharmaceuticals, B. Braun, and Aventis, lecture fees from Merck, Pfizer, AstraZeneca, Kowa, Abbott, and GlaxoSmithKline, support for the development of educational presentations from Merck, and holding stock in Zoll Medical, J.A. Wiley Publishing, General Electric, Zimmer, Medtronic, Johnson & Johnson, Sanofi-Aventis, and Abbott.

Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.

No other potential conflict of interest relevant to this article was reported.

We thank Ryan Lamppa at Running USA for providing race-participation numbers; Deborah McDonald for her assistance with participant correspondence and data retrieval; and, most important, the cardiac-arrest survivors and the families of deceased runners for helping us obtain the data necessary for this study

BibTeX:
@article{Kim2012,
  author = {Jonathan H. Kim and Rajeev Malhotra and George Chiampas and Pierre d'Hemecourt and Chris Troyanos and John Cianca and Rex N. Smith and Thomas J. Wang and William O. Roberts and Paul D. Thompsonand Aaron L. Baggish},
  title = {Cardiac Arrest during Long-Distance Running Races},
  journal = {N Engl J Med},
  year = {2012},
  volume = {366},
  pages = {130-140},
  note = {(for the Race Associated Cardiac Arrest Event Registry (RACER) Study Group)},
  url = {http://associationdatabase.com/aws/SCAA/asset_manager/get_file/42726/study_on_sca_marathonnejm2012.pdf}
}
Kishore, S. & Soulieres, G. (2012), "Toronto Host City: Mass Gatherings Risks and Perception"
Abstract: Mass gathering is a phenomenon that arises from the unique interactions of people, places and activities (Weed & Bull, 2004)i. It has attracted a lot of attention among scholars and practitioners. A number of literature reviews and surveys have been done with regards to event image perceptions, lessons learned, resident perceptions, risk management, risk perception, crowd behaviour, crowd management and public safety. In view of recent occurrences- ranging from Toronto’s G-20 insurgence to Vancouver’s Stanley Cup riots and the shocking London riots, cities around the world are increasingly falling prey to spontaneous mass gatherings that impact on public safety and crowd behaviour. It has become progressively obvious that the primary factor in assuring a safe and comfortable environment for crowds is planning, understanding the human behaviour dynamic and public perceptionii. This project will examine the dynamics of playing host to mega events and how it impacts all realms of life. Despite the growing importance accorded to mega event (from sports to mass gatherings), limited research has been carried out to understand and explain host perceptions of the impact of such events.iii Ultimately, this study will also engage relevant community partners playing an integral role in preparing for future event hosting, be it the 2015 Pan Am Games or ongoing socio-political , sporting and multicultural annual events that Toronto plays and will play host to, each year.
Initial ground work undertaken in this area by both teams have shown that while several cities have their ‘event risk and emergency management and policies’ in place, research suggested that public concern and perception can be managed through proper safety training and awareness, emergency response planning, and corrective actions after safety review.
BibTeX:
@techreport{Kishore2012,
  author = {Sowmya Kishore and Ginette Soulieres},
  title = {Toronto Host City: Mass Gatherings Risks and Perception},
  year = {2012},
  url = {http://www.centennialcollege.ca/pdf/EMPSI/TorontoHostCityMassGatheringsSurveyResults.pdf}
}
Korsten, A.F.A. (), "Het Heizeldrama -- Tekortkomingen in de organisatie en voorbereiding van de wedstrijd als oorzaak?"
Review: Une analyse des causes du drame du Heizel, en termes de problèmes d'organisation, ainsi qu'une courte bibliographie.
BibTeX:
@electronic{Korsten,
  author = {A. F. A. Korsten},
  title = {Het Heizeldrama -- Tekortkomingen in de organisatie en voorbereiding van de wedstrijd als oorzaak?},
  note = {consulté le 8 aout 2011},
  url = {www.arnokorsten.nl/PDF/Crises/Het%20Heizeldrama.pdf}
}
Krul, J., Blankers, M. & Girbes, A.R.J. (2011), "Substance-Related Health Problems during Rave Parties in the Netherlands (1997–2008)", Plos One. Vol. 6, pp. e29620.
BibTeX:
@article{Krul2011,
  author = {Jan Krul and Matthijs Blankers and Armand R. J. Girbes},
  title = {Substance-Related Health Problems during Rave Parties in the Netherlands (1997–2008)},
  journal = {Plos One},
  year = {2011},
  volume = {6},
  pages = {e29620},
  url = {http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0029620}
}
Krul, J., Girbes, A.R. & Sanou, B.T. (2012), "Increase in serious ecstasy-related incidents in the Netherlands", The Lancet. Vol. 380, pp. 1385.
Abstract: We have noticed a sudden increase in ecstasy-related incidents in the Netherlands. In this country, rave parties are legal and medical surveillance is provided by specifically trained health-care workers. Medical events are categorised as life-threatening (category 1), not life-threatening but requiring medical assistance (category 2), and other non-serious events (category 3).
Between 1997 and 2010, 31 cases fulfilling category 1 and 2 criteria related to ecstasy use were recorded out of more than 5 million rave attendees.1, 2 However, in 2011 alone, 26 category 1 or 2 cases were recorded, indicating a striking increase. Although no scientific data exist to indicate the cause of this increase, as workers in the field we suggest that market-related factors such as higher doses of pills and non-uniform doses per pill might be the main cause.
We therefore warn of more ecstasy-related harm in the population, indicating the need for preventive measures by responsible authorities, more awareness in the population, and better research.
BibTeX:
@article{Krul2012a,
  author = {Jan Krul and Armand RJ Girbes and Björn T Sanou},
  title = {Increase in serious ecstasy-related incidents in the Netherlands},
  journal = {The Lancet},
  year = {2012},
  volume = {380},
  pages = {1385},
  url = {http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673612618005.pdf}
}
Krul, J. & J.Girbes, A.R. (2009), "Experience of Health-Related Problems during House Parties in the Netherlands: Nine Years of Experience and Three Million Visitors", Prehosp Disaster Med. Vol. 24, pp. 133-139.
BibTeX:
@article{Krul2009,
  author = {Jan Krul and Armand R. J.Girbes},
  title = {Experience of Health-Related Problems during House Parties in the Netherlands: Nine Years of Experience and Three Million Visitors},
  journal = {Prehosp Disaster Med},
  year = {2009},
  volume = {24},
  pages = {133-139},
  url = {http://pdm.medicine.wisc.edu/Volume_24/issue_2/krul.pdf}
}
Lekka, C., Webster, J. & Corbett, C.E. (2010), "A literature review of the health and safety risks associated with major sporting events -- Learning lessons for the London 2012 Olympic and Paralympic games" (RR811)
Abstract: This work was commissioned by the Health and Safety Executive (HSE) to provide an understanding of the potential hazards and risks associated with hosting the Olympic Games in Great Britain in 2012, as well as potential control measures that could be applied to these. The literature search yielded 384 papers, of which 80 met the inclusion criteria. These papers were then reviewed by the research team and summarised by emergent topics. The topics included: construction, public health and safety risks, road accidents, injuries, musculoskeletal disorders (MSDs), crowd safety, emergency planning and response, volunteers, workplace violence, fire safety, electrical hazards and carbon monoxide/gas safety.
Each of the topics is summarised by the risks identified from previous Olympic events and major sporting events, followed by controls that were applied or identified as potentially useful. The controls often provided practical ways to reduce risks, or to mitigate negative outcomes.
BibTeX:
@techreport{Lekka2010,
  author = {Chrysanthi Lekka and Jennifer Webster and CPsychol Edward Corbett},
  title = {A literature review of the health and safety risks associated with major sporting events -- Learning lessons for the London 2012 Olympic and Paralympic games},
  year = {2010},
  number = {RR811},
  url = {http://www.hse.gov.uk/research/rrpdf/rr811.pdf}
}
Leusveld, E., Kleijn, S. & Umans, V.A.W.M. (2008), "Usefulness of Emergency Medical Teams in Sport Stadiums", The American Journal of Cardiology. Vol. 101(5), pp. 712-714.
BibTeX:
@article{Leusveld2008,
  author = {E. Leusveld and S. Kleijn and V. A. W. M. Umans},
  title = {Usefulness of Emergency Medical Teams in Sport Stadiums},
  journal = {The American Journal of Cardiology},
  year = {2008},
  volume = {101},
  number = {5},
  pages = {712-714}
}
Lewis, J.M. (1989), "A value-added analysis of the Heysel Stadium soccer riot", Current Psychology., March, 1989. Vol. 8(1), pp. 15-29.
Abstract: On May 29, 1985, a riot occurred at the European Cup Final soccer championship between Liverpool and Juventus at Heysel Stadium in Brussels, Belgium. The riot, which caused the death of thirty-nine soccer fans, had a profound effect on English society as well as on professional soccer. This essay uses Smelser's 0962) general model of collective behavior to analyze data derived from a number of sources describing the Heysel Stadium riot. In particular, this analysis focuses on a period of four hours, from the beginning of the riot at about 7:30 p.m. until the conclusion of the match around 11:30 p.m.
BibTeX:
@article{Lewis1989,
  author = {Lewis, Jerry M.},
  title = {A value-added analysis of the Heysel Stadium soccer riot},
  journal = {Current Psychology},
  year = {1989},
  volume = {8},
  number = {1},
  pages = {15--29},
  url = {http://www.springerlink.com/content/aw10162650175323/},
  doi = {http://dx.doi.org/10.1007/BF02686734}
}
Locoh-Donou, S., Guofen, Y., Welcher, M., Berry, T., O'Connor, R.E. & Brady, W.J. (2013), "Mass-gathering medicine: a descriptive analysis of a range of mass-gathering event types", American Journal of Emergency Medicine., May, 2013. Vol. 31, pp. 843-846.
Review: moyennes avec déviations standard. Confirme que ce sont des variables de Poisson.
BibTeX:
@article{Locoh-Donou2013,
  author = {Samuel Locoh-Donou and Yan Guofen and Melanie Welcher and Thomas Berry and Robert E. O'Connor and William J. Brady},
  title = {Mass-gathering medicine: a descriptive analysis of a range of mass-gathering event types},
  journal = {American Journal of Emergency Medicine},
  year = {2013},
  volume = {31},
  pages = {843-846}
}
Lorenzo, R.A.D., Boyle, M.F. & Garrison, R. (1993), "A Proposed Model for a Residency Experience in Mass Gathering Medicine: The United States Air Show", Ann Emerg Med. Vol. 22, pp. 68-71.
BibTeX:
@article{Lorenzo1993,
  author = {Robert A De Lorenzo and Michael F Boyle and Richard Garrison},
  title = {A Proposed Model for a Residency Experience in Mass Gathering Medicine: The United States Air Show},
  journal = {Ann Emerg Med},
  year = {1993},
  volume = {22},
  pages = {68-71}
}
Madzimbamuto, F.D. (2003), "A hospital response to a soccer stadium stampede in Zimbabwe", Emerg Med J. Vol. 20, pp. 556-559.
BibTeX:
@article{Madzimbamuto2003,
  author = {F. D. Madzimbamuto},
  title = {A hospital response to a soccer stadium stampede in Zimbabwe},
  journal = {Emerg Med J},
  year = {2003},
  volume = {20},
  pages = {556-559},
  url = {http://emj.bmj.com/content/20/6/556.full.pdf+html}
}
MARION, R., PAPET, F., CHIEZE, F., SAUX, Y.L. & HAN, D. (2008), "Evaluation du dispositif de sécurité mis en place pour la coupe du monde de rugby 2007"
Abstract: secours-santé spécifique et pléthorique (assurée par la
fédération nationale de la mutualité française) dont l’articulation avec le dispositif
« traditionnel » de secours-santé aurait été, en cas de besoin, difficile.
Les fonctions de coordination ont connu des difficultés en administration centrale. Les
circulaires relatives à l’événement tant du ministère de l’intérieur que du ministère de la santé
sont intervenues trop tardivement pour être pleinement utiles. La planification de la plus
grande part du dispositif de l’Etat a été assurée par les services déconcentrés sous l’autorité du
préfet.
La mission n’a pas été en mesure de porter un jugement sur le caractère suffisant du niveau
d’indemnisation de l’Etat au titre des services d’ordre assurés au bénéfice de l’organisateur.
En revanche, la mission s’est intéressée au coût global pour l’Etat de la coupe du monde de
rugby. Celui-ci est important. La mission a ainsi fourni une estimation de la charge pour les
forces de police et de gendarmerie nationales de l’événement et s’est appuyée sur les travaux
du ministère des sports pour chiffrer les autres dépenses de soutien à l’événement.
La mission s’est enfin intéressée aux relations financières entre l’Etat et le comité
d’organisation de la coupe du monde de rugby.
Elles apparaissent déséquilibrées. Ainsi alors que l’Etat aurait pris en charge près de la moitié
des éventuelles pertes d’exploitation, il n’a en revanche rien reçu des bénéfices réalisés en
application de clauses qu’il a lui-même approuvées en octobre 2004 (article 24 de la
convention constitutive du groupement d’intérêt public « coupe du monde de rugby 2007 ») et
en février 2005 (article 8 du règlement financier du GIP « coupe du monde de rugby 2007 »).
Ainsi, l’intégralité des plus de 30 millions d’euros de bénéfices de la coupe du monde de
rugby a été dévolue à la fédération française de rugby, cette dernière devant les employer en
3
faveur du « développement du rugby ». L’Etat ne dispose pas de leviers d’action sur
l’utilisation de cette somme exceptionnelle.
Ce partage asymétrique est pour le moins étonnant. L’Etat a fourni des moyens matériels et
humains et a assumé un risque financier mais n’est en rien associé aux éventuels résultats
positifs de l’exercice.
La mission estime, à tout le moins, que ce type de montage est à proscrire pour l’avenir.
La politique de soutien au développement du sport ne peut passer que par des relations
équilibrées entre la puissance publique et les fédérations sportives nationales.
BibTeX:
@techreport{MARION2008,
  author = {Roger MARION and Frédéric PAPET and and François CHIEZE and Yannick LE SAUX and Dominique HAN},
  title = {Evaluation du dispositif de sécurité mis en place pour la coupe du monde de rugby 2007},
  year = {2008},
  url = {http://www.interieur.gouv.fr/sections/a_votre_service/publications/rapports-iga/secu-civile-prev-risques/08-029-01/downloadFile/attachedFile/08-029-01_-_Coupe_du_monde_de_rugby.pdf?nocache=1288771764.1}
}
McCloskey, B. & Endericks, T. (2013), "Learning from London 2012 : A practical guide to public health and mass gatherings"
BibTeX:
@manual{McCloskey2013,
  author = {Brian McCloskey and Tina Endericks,},
  title = {Learning from London 2012 : A practical guide to public health and mass gatherings},
  year = {2013},
  url = {http://www.hpa.org.uk/Publications/EmergencyPreparationAndResponse/1303LearningfromLondon2012/}
}
McQueen, C.P. (2010), "Care of children at a large outdoor music festival in the United Kingdom", Prehosp Disaster Med., June, 2010. Vol. 25(3), pp. 223-226.
Abstract: INTRODUCTION Limited data exist on the standard of care provided for children at mass gatherings and special events (MGSE). Some studies provide valuable insight into the proportion of pediatric patients that can be expected at various types of MGSEs, but an accurate breakdown of the range of pediatric conditions treated at major events has yet to be produced. Such data are essential for the preparation of MGSEs so that the health and safety of children at such events can be adequately safeguarded. The aim of this study is to examine the care requirements for children at a large, outdoor music festival in the United Kingdom. METHODS A retrospective review of all patient report forms (PRFs) from a large, outdoor music festival held in Leeds (UK) in 2003. Data were extracted from the PRFs using a standardized proforma and analyzed using an Excel computer program. RESULTS Pediatric cases contributed approximately 15% to the overall workload at the event. Children presented with a range of conditions that varied from those seen in the adult population. Children were more likely than adults to present for medical attention following crush injuries (OR = 2.536; 95% CI = 1.537-4.187); after a collapse/syncopal episode (OR = 2.687; 95% CI = 1.442-5.007); or complaining of nausea (OR = 3.484; 95% CI = 2.089-5.813). Alcohol/drugs were less likely to be involved in the precipitating cause for medical attention in children compared to adults (OR = 0.477; 95% CI = 0.250-0.912). No critical care incidents involving children were encountered during the event. CONCLUSIONS Mass gatherings and special events in the UK, such as outdoor music festivals, can involve a large number of children who access medical care for a different range of conditions compared to adults. The care of children at large, outdoor music events should not be overlooked. Event planning in the UK should include measures to ensure that appropriately trained and equipped medical teams are used at music festivals to safeguard the welfare of children who may attend. Further research into this exciting area is required.
BibTeX:
@article{McQueen2010,
  author = {Carl PC. McQueen},
  title = {Care of children at a large outdoor music festival in the United Kingdom},
  journal = {Prehosp Disaster Med},
  year = {2010},
  volume = {25},
  number = {3},
  pages = {223--226},
  note = {PMID: 20586015},
  url = {http://pdm.medicine.wisc.edu/Volume_25/issue_3/mcqueen.pdf}
}
Michael, J.A. & Barbera, J.A. (1997), "Mass Gathering Medical Care: A Twenty-Five Year Review", Prehosp Disaster Med. Vol. 12, pp. 306-312.
BibTeX:
@article{Michael1997,
  author = {John A. Michael and Joseph A. Barbera},
  title = {Mass Gathering Medical Care: A Twenty-Five Year Review},
  journal = {Prehosp Disaster Med},
  year = {1997},
  volume = {12},
  pages = {306-312},
  url = {http://www.ncbi.nlm.nih.gov/pubmed/10179212}
}
Milsten, A.M., Maguire, B.J., Bissell, R.A. & Seaman, K.G. (2002), "Mass-gathering medical care: a review of the literature", Prehosp Disaster Med., September, 2002. Vol. 17(3), pp. 151-162.
Abstract: Mass-gatherings events provide a difficult setting for which to plan an appropriate emergency medical response. Many of the variables that affect the level and types of medical needs, have not been fully researched. This review examines these variables. METHODS: An extensive review was conducted using the computerized databases Medline and Healthstar from 1977 through May 2002. Articles selected contained information pertaining to mass-gathering variables. These articles were read, abstracted, analyzed, and compiled. RESULTS: Multiple variables are present during a mass gathering, and they interact in complex and dynamic ways. The interaction of these variables contributes to the number of patients treated at an event (medical usage rate) as well as the observed injury patterns. Important variables include weather, event type, event duration, age, crowd mood and density, attendance, and alcohol and drug use. CONCLUSIONS: Developing an understanding of the variables associated with mass gatherings should be the first step for event planners. After these variables are considered, a thorough needs analysis can be performed and resource allocation can be based on objective data.
BibTeX:
@article{Milsten2002,
  author = {Andrew M Milsten and Brian J Maguire and Rick A Bissell and Kevin G Seaman},
  title = {Mass-gathering medical care: a review of the literature},
  journal = {Prehosp Disaster Med},
  year = {2002},
  volume = {17},
  number = {3},
  pages = {151--162},
  note = {PMID: 12627919},
  url = {http://www.ncbi.nlm.nih.gov/pubmed/12627919}
}
Milsten, A.M., Seaman, K.G., Liu, P., Bissell, R.A. & Maguire, B.J. (2003), "Variables Influencing Medical Usage Rates, Injury Patterns, and Levels of Care for Mass Gatherings", Prehosp Disaster Med. Vol. 18(4), pp. 334-346.
Abstract: Abstract
Objectives: Mass gatherings create difficult environments for which to plan
emergency medical responses. The purpose of this study was to identify
those variables that are associated with increased medical usage rates
(MURs) and certain injury patterns that can be used to facilitate the planning
process.
Methods: Patient information collected at three types of mass gatherings
(professional American football and baseball games and rock concerts) over
a three-year period was reviewed retrospectively. Specific variables were
abstracted: (1) event type; (2) gender; (3) age; (4) weather; and (5) attendance.
All 216 events (total attendance 9,708,567) studied were held in the
same metropolitan region. All MURs are reported as patients per 10,000
(PPTT).
Results: The 5,899 patient encounters yielded a MUR of 6.1 PPTT. Patient
encounters totaled 3,659 for baseball games (4.85 PPTT), 1,204 for football
games (6.75 PPTT), and 1,036 for rock concerts (30 PPTT). The MUR for
Location A concerts (no mosh pits) was 7.49 PPTT, whereas the MUR for
the one Location B concert (with mosh pits) was 110 PPTT. The MUR for
Location A concerts was higher than for baseball, but not football games (p
= 0.005). Gender distribution was equal among patrons seeking medical
care. The mean values for patient ages were 29 years at baseball games, 33
years at football games, and 20 years at concerts. The MUR at events held
when the apparent temperature was £80°F significantly lower statistically
than that at events conducted at temperatures <80°F were (18°C) (4.90 vs.
8.10 PPTT (p = 0.005)). The occurrence of precipitation and increased
attendance did not predict an increased MUR. Medical care was sought
mostly for minor/basic-level care (84%) and less so for advanced-level care
(16%). Medical cases occurred more often at sporting events (69%), and
were more common than were cases with traumatic injuries (31%). Concerts
with precipitation and rock concerts had a positive association with the incidence
of trauma and the incidence of injuries; whereas age and gender were
not associated with medical or traumatic diagnoses.
Conclusions: Event type and apparent temperature were the variables that
best predicted MUR as well as specific injury patterns and levels of care.
BibTeX:
@article{Milsten2003,
  author = {Andrew M. Milsten and Kevin G. Seaman and Peter Liu and Rick A. Bissell and Brain J. Maguire},
  title = {Variables Influencing Medical Usage Rates, Injury Patterns, and Levels of Care for Mass Gatherings},
  journal = {Prehosp Disaster Med},
  year = {2003},
  volume = {18},
  number = {4},
  pages = {334-346},
  url = {http://pdm.medicine.wisc.edu/Volume_18/issue_4/milsten.pdf}
}
Moore, R., Williamson, K., Sochor, M. & Bradys, W.J. (2011), "Large-event medicine -- event characteristics impacting medical need", Am J Emerg Medicine. Vol. 29, pp. 1217-1221.
BibTeX:
@article{Moore2011,
  author = {Riley Moore and Kelly Williamson and Mark Sochor and William J. Bradys},
  title = {Large-event medicine -- event characteristics impacting medical need},
  journal = {Am J Emerg Medicine},
  year = {2011},
  volume = {29},
  pages = {1217-1221},
  url = {http://www.ajemjournal.com/article/S0735-6757(10)00384-0/abstract}
}
Morimura, N., Katsumi, A., Koido, Y., Sugimoto, K., Fuse, A., Asai, Y., Ishii, N., Ishihara, T., Fujii, C., Sugiyama, M., Henmi, H. & Yamamoto, Y. (2004), "Analysis of patient load data from the 2002 FIFA World Cup Korea/Japan", Prehosp Disaster Med. Vol. 19, pp. 278-284.
BibTeX:
@article{Morimura2004,
  author = {N. Morimura and A. Katsumi and Y. Koido and K. Sugimoto and A. Fuse and Y. Asai and N. Ishii and T. Ishihara and C. Fujii and M. Sugiyama and H. Henmi and Y. Yamamoto},
  title = {Analysis of patient load data from the 2002 FIFA World Cup Korea/Japan},
  journal = {Prehosp Disaster Med},
  year = {2004},
  volume = {19},
  pages = {278-284},
  url = {http://pdm.medicine.wisc.edu/Volume_19/issue_3/morimura.pdf}
}
n (), "A Brief History of Concert Violence"
BibTeX:
@unpublished{morga364,
  author = {n},
  title = {A Brief History of Concert Violence},
  url = {http://blog.lib.umn.edu/morga364/myblog2/2010/04/}
}
Nguyen, R.B., Milsten, A.M. & Cushman, J.T. (2008), "Injury patterns and levels of care at a marathon", Prehosp Disaster Med., December, 2008. Vol. 23(6), pp. 519-525.
Abstract: INTRODUCTION Marathons pose many challenges to event planners. The medical services needed at such events have not received extensive coverage in the literature. OBJECTIVE The objective of this study was to document injury patterns and medical usage at a category III mass gathering (a marathon), with the goal of helping event planners organize medical resources for large public gatherings. METHODS Prospectively obtained medical care reports from the five first-aid stations set up along the marathon route were reviewed. Primary and secondary reasons for seeking medical care were categorized. Weather data were obtained, and ambient temperature was recorded. RESULTS The numbers of finishers were as follows: 4,837 in the marathon (3,099 males, 1,738 females), 814 in the 5K race (362 males, 452 females), and 393 teams in the four-person relay (1,572). Two hundred fifty-one runners sought medical care. The day's temperatures ranged from 39 to 73 degrees F (mean, 56 degrees F). The primary reasons for seeking medical were medication request (26, musculoskeletal injuries (18, dehydration (14, and dermal injuries (11. Secondary reasons were musculoskeletal injuries (34, dizziness (19, dermal injuries (11, and headaches (9. Treatment times ranged from 3 to 25.5 minutes and lengthened as the day progressed. Two-thirds of those who sought medical care did so at the end of the race. The majority of runners who sought medical attention had not run a marathon before. CONCLUSIONS Marathon planners should allocate medical resources in favor of the halfway point and the final first-aid station. Resources and medical staff should be moved from the earlier tents to further augment the later first-aid stations before the majority of racers reach the middle- and later-distance stations.
BibTeX:
@article{Nguyen2008,
  author = {Nguyen, Richard B and Milsten, Andrew M and Cushman, Jeremy T},
  title = {Injury patterns and levels of care at a marathon},
  journal = {Prehosp Disaster Med},
  year = {2008},
  volume = {23},
  number = {6},
  pages = {519--525},
  note = {PMID: 19557968},
  url = {http://pdm.medicine.wisc.edu/Volume_23/issue_6/nguyen.pdf}
}
O'Donnell, J.J., Gleeson, A.P. & Smith, H. (1998), "Edinburgh's Hogmanay celebrations: beyond a major disaster.", Journal of Accident & Emergency Medicine., July, 1998. Vol. 15(4), pp. 272-273.
Abstract: OBJECTIVE: To assess the impact of Edinburgh's Hogmanay celebrations on the city's accident and emergency (A&E) service. METHODS: Retrospective analysis. RESULTS: A crowd estimated at more than 350,000 attended the celebrations. During the three day period between 00.01 h on 31 December and 23.59 h on 2 January, 1151 new patients presented to the A&E department and of these half arrived in the first 24 hours. Thirty six patients required emergency resuscitation and eight died in the department during the study period. CONCLUSIONS: The absolute number of patients presenting during the study period greatly exceeded most of the "major disasters" in contemporary UK experience. No deaths were directly attributable to the event, but the spectrum of patient pathologies, their severity and presentation is analogous to several recent major incidents. It is doubtful whether the Hogmanay celebrations are safe.
BibTeX:
@article{O'Donnell1998,
  author = {O'Donnell, J J and Gleeson, A P and Smith, H},
  title = {Edinburgh's Hogmanay celebrations: beyond a major disaster.},
  journal = {Journal of Accident & Emergency Medicine},
  year = {1998},
  volume = {15},
  number = {4},
  pages = {272--273},
  note = {PMID: 9681315 PMCID: 1343144},
  url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1343144/pdf/jaccidem00025-0062.pdf}
}
Oster, N. (1996), "The Papal Visit to New York City: A Mass Gathering Mass Casualty Incident", website.
BibTeX:
@misc{ACEP1996,
  author = {Neil Oster},
  title = {The Papal Visit to New York City: A Mass Gathering Mass Casualty Incident},
  howpublished = {website},
  year = {1996},
  url = {http://www.acep.org/content.aspx?id=43026}
}
Pecqueux-Rebora, V. (2006), "Medicalisation des rassemblements de foule : trois annees d'experience a Damblain (Vosges)". School: Universlte Henri Poincare, Nancy 1.
BibTeX:
@mastersthesis{Pecqueux-Rebora2006,
  author = {Virginie Pecqueux-Rebora},
  title = {Medicalisation des rassemblements de foule : trois annees d'experience a Damblain (Vosges)},
  school = {Universlte Henri Poincare, Nancy 1},
  year = {2006},
  url = {http://www.scd.uhp-nancy.fr/docnum/SCDMED_T_2006_PECQUEUX_REBORA_VIRGINIE.pdf}
}
Piat, S.C., Minniti, D., Traversi, D., Gianino, M.M., Massazza, G. & Siliquini, R. (2010), "Torino 2006 Winter Olympic Games: Highlight on Health Services Organization", The Journal of Emergency Medicine., October, 2010. Vol. 39(4), pp. 454-461.
Abstract: Abstract
Introduction: In the summer of 2009, British Columbia hosted the World Police and Fire
Games (WPFG). The event brought together 10,599 athletes from 55 countries. In this
descriptive, Canadian study, the composition of the medical team is analyzed, the unique
challenges faced are discussed, and an analysis of the illness and injury rates is presented.
This event occurred during a labor dispute affecting the sole provider of emergency ambulance
service in the jurisdiction, which necessitated additional planning and resource allocation.
As such, the context of this event as it relates to the literature on mass gathering
medicine is discussed with a focus on how large-scale public events can impact emergency
services for the community.
Methods: This is a case report study.
Results: There were 1,462 patient encounters. The majority involved musculo-skeletal
injuries (53.8%). The patient presentation rate (PPR) was 109.40/1,000. The medical
transfer rate (MTR) was 2.32/1,000. The ambulance transfer rate (ATR) for the 2009
WPFG was 0.52/1,000. In total, 31 patients were transported to the hospital, the majority
for diagnostic evaluation. Only seven calls were placed to 9-1-1 for emergency ambulance
service.
Conclusions: The 2009 WPFG was a mass-gathering sporting event that presented specific
challenges in relation to medical support. Despite relatively high patient presentation
rates, the widely spread geography of the event, and a reduced ability to depend on
9-1-1 emergency medical services, there was minimal impact on local emergency services.
Adequate planning and preparation is crucial for events that have the potential to degrade
existing public resources and access to emergency health services for participants and the
public at large.
BibTeX:
@article{Piat2010,
  author = {Piat, Simone Chiadò and Minniti, Davide and Traversi, Deborah and Gianino, Maria Michela and Massazza, Giuseppe and Siliquini, Roberta},
  title = {Torino 2006 Winter Olympic Games: Highlight on Health Services Organization},
  journal = {The Journal of Emergency Medicine},
  year = {2010},
  volume = {39},
  number = {4},
  pages = {454--461},
  url = {http://www.sciencedirect.com/science/article/pii/S0736467909007537},
  doi = {http://dx.doi.org/16/j.jemermed.2009.08.028}
}
Ranse, J. & Zeitz, K. (2010), "Chain of Survival at Mass Gatherings: A Case Series of Resuscitation Events", Prehosp Disaster Med. Vol. 25, pp. 457-463.
BibTeX:
@article{Ranse2010,
  author = {Jamie Ranse and Kathryn Zeitz},
  title = {Chain of Survival at Mass Gatherings: A Case Series of Resuscitation Events},
  journal = {Prehosp Disaster Med},
  year = {2010},
  volume = {25},
  pages = {457-463},
  url = {http://pdm.medicine.wisc.edu}
}
Rasschaert, F. (2011), "Analyse van de gebeurtenissen naar aanleiding van de uitzending van de voetbalwedstrijd België-Turkije op een groot scherm op de Kouter op 03-06-2011 en aanbevelingen"
BibTeX:
@electronic{Rasschaert2011,
  author = {Filip Rasschaert},
  title = {Analyse van de gebeurtenissen naar aanleiding van de uitzending van de voetbalwedstrijd België-Turkije op een groot scherm op de Kouter op 03-06-2011 en aanbevelingen},
  year = {2011},
  url = {http://www.danieltermont.be/rapport%20BelTur.pdf}
}
Roberts, W.O. (2007), "Heat and Cold -- What does the Environment do to Marathon Injury?", In Sports Med. Volume 37(4-5), pp. 40-403.
BibTeX:
@inproceedings{Roberts2007,
  author = {William O. Roberts},
  title = {Heat and Cold -- What does the Environment do to Marathon Injury?},
  booktitle = {Sports Med},
  year = {2007},
  volume = {37},
  number = {4-5},
  pages = {40-403},
  url = {http://adisonline.com/sportsmedicine/Abstract/2007/37040/Heat_and_Cold__What_does_the_Environment_do_to.33.aspx}
}
Roberts, W.O. (2000), "A 12-yr profile of medical injury and illness for the Twin Cities Marathon", Med. Sci. Sports Exerc. Vol. 32, pp. 1549-1555.
BibTeX:
@article{Roberts2000,
  author = {W. O. Roberts},
  title = {A 12-yr profile of medical injury and illness for the Twin Cities Marathon},
  journal = {Med. Sci. Sports Exerc},
  year = {2000},
  volume = {32},
  pages = {1549-1555}
}
Schauli, C. (1985), "Le drame du Heysel", reportage télévisé -- émission temps présent., juin, 1985.
Abstract: Le mercredi 29 mai 1985, les équipes de Liverpool et de la Juventus de Turin doivent s'affronter à Bruxelles en finale de la Coupe d'Europe. Par hasard, une équipe de la TSR est sur place pour un tournage sur les supporters de football. Elle se trouve sans le savoir encore au milieu de ce qui sera un des plus terrible drame du football européen et aboutira à l'exclusion pour de nombreuses années de toutes compétitions européennes du club de Liverpool.

Ces images firent le tour du monde après le drame.

Ce document a été diffusé à l'antenne sous le titre original : Les fous du football

BibTeX:
@electronic{TSR1985,
  author = {Claude Schauli},
  title = {Le drame du Heysel},
  year = {1985},
  url = {http://archives.tsr.ch/player/catastrophe-heysel}
}
Schauli, C. & Demont, P. (1985), "Le drame du Heysel", Film., june, 1985.
Abstract: Le mercredi 29 mai 1985, les équipes de Liverpool et de la Juventus de Turin doivent s'affronter à Bruxelles en finale de la Coupe d'Europe. Par hasard, une équipe de la TSR est sur place pour un tournage sur les supporters de football. Elle se trouve sans le savoir encore au milieu de ce qui sera un des plus terrible drame du football européen et aboutira à l'exclusion pour de nombreuses années de toutes compétitions européennes du club de Liverpool.

Ces images firent le tour du monde après le drame.

Ce document a été diffusé à l'antenne sous le titre original : Les fous du football

BibTeX:
@electronic{HEYSEL_RTS,
  author = {Claude Schauli and Pierre Demont},
  title = {Le drame du Heysel},
  year = {1985},
  note = {15 min 04 sec},
  url = {http://www.rts.ch/archives/tv/information/temps-present/3438604-le-drame-du-heysel.html}
}
Skjeie, H., Nygaard, S., Li, H.S., Gardasevic, B., Fetveit, A. & Brekke, M. (2008), "[Medical emergency care and patient contact at the Quart Rock Festival in Norway]", Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række., June, 2008. Vol. 128(13), pp. 1508-1511.
Abstract: BACKGROUND The annual Quart Rock Festival (1991-2007) was the largest rock festival in Norway. During festivals in 2004-06, a daily average of 3 000 personnel, guests and artists, and 10,000 visitors, 13,000 people, were present daily. The festival had a medical care organization recruited from primary care personnel. The team consisted of one general practitioner, one physiotherapist, two nurses from the municipality outpatient service, and lay personnel trained in first aid. MATERIAL AND METHODS We recorded all patient contacts at the festival in 2004, 2005, and 2006 in order to describe injuries requiring medical attention and the need for referrals. RESULTS The total number of festival participants, including personnel, was 208,000 during the registration period. Of totally 1,349 patient contacts, 254 required consultation with a nurse and 191 with the attending physician. There were no deaths, cardiac or respiratory arrests or serious penetrating trauma. 33 contacts were related to intoxication: 24 due to alcohol, five to illegal drugs and four to unknown substances. Violence-related injuries were the cause of 18 contacts, of which none were serious. 49 patients were referred for follow-up, mostly to the municipality outpatient service or their own physician, and five patients were admitted to hospital. The transport-to-hospital-ratio was 0.24 per 10,000 participants. INTERPRETATION The results are similar to those in studies of rock festivals in other countries. The need for referrals was equal to or lower than in other studies. This indicates that the primary care-based medical organization at the Quart Festival was adequate.
BibTeX:
@article{Skjeie2008,
  author = {Skjeie, Holgeir and Nygaard, Siv and Li, Henrik Stenwig and Gardasevic, Bozidar and Fetveit, Arne and Brekke, Mette},
  title = {[Medical emergency care and patient contact at the Quart Rock Festival in Norway]},
  journal = {Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række},
  year = {2008},
  volume = {128},
  number = {13},
  pages = {1508--1511},
  note = {PMID: 18587456},
  url = {http://tidsskriftet.no/article/16190/en_GB/}
}
Soomaroo, L. & Murray, V. (2012), "Disasters at Mass Gatherings: Lessons from History", PLoS Currents Disasters., fev, 2012.
BibTeX:
@article{Soomaroo2012,
  author = {Lee Soomaroo and Virginia Murray},
  title = {Disasters at Mass Gatherings: Lessons from History},
  journal = {PLoS Currents Disasters},
  year = {2012},
  note = {2012 Jan 31 [last modified: 2012 Mar 13]},
  doi = {http://dx.doi.org/10.1371/4f70cf55a7dbc}
}
Spaite, D.W., Criss, E.A., Valenzuela, T.D., Meislin, H.W., Smith, R. & Nelson, A. (1988), "A new model for providing prehospital medical care in large stadiums", Ann Emerg Med. Vol. 17(8), pp. 825-828.
Abstract: To determine proper priorities for the provision of health care in large stadiums, we studied the medical incident patterns occurring in a major college facility and combined this with previously reported information from four other large stadiums. Medical incidents were an uncommon occurrence (1.20 to 5.23 per 10,000 people) with true medical emergencies being even more unusual (0.09 to 0.31 per 10,000 people). Cardiac arrest was rare (0.01 to 0.04 events per 10,000 people). However, the rates of successful resuscitation in three studies were 85% or higher. The previous studies were descriptive in nature and failed to provide specific recommendations for medical aid system configuration or response times. A model is proposed to provide rapid response of advanced life support care to victims of cardiac arrest. We believe that the use of this model in large stadiums throughout the United States could save as many as 100 lives during each football season.
BibTeX:
@article{Spaite1988,
  author = {Spaite, Daniel W and Criss, Elizabeth A and Valenzuela, Terence D and Meislin, Harvey W and Smith, Roger and Nelson, Allie},
  title = {A new model for providing prehospital medical care in large stadiums},
  journal = {Ann Emerg Med},
  year = {1988},
  volume = {17},
  number = {8},
  pages = {825--828},
  url = {http://linkinghub.elsevier.com/retrieve/pii/S0196064488805638?showall=true}
}
Steffen, R., Bouchama, A., Johansson, A., Dvorak, J., Isla, N., Smallwood, C. & Memish, Z.A. (2012), "Non-communicable health risks during mass gatherings", Lancet Infect Dis. Vol. 12, pp. 142-149.
BibTeX:
@article{Steffen2012,
  author = {Robert Steffen and Abderrezak Bouchama and Anders Johansson and Jiri Dvorak and Nicolas Isla and Catherine Smallwood and Ziad A Memish},
  title = {Non-communicable health risks during mass gatherings},
  journal = {Lancet Infect Dis},
  year = {2012},
  volume = {12},
  pages = {142-149},
  url = {http://press.thelancet.com/mg3.pdf},
  doi = {http://dx.doi.org/10.1016/S1473-3099(11)70293-6}
}
Toresdahl, B., Courson, R., Börjesson, M., Sharma, S. & Drezner, J. (2012), "Emergency cardiac care in the athletic setting: from schools to the Olympics", Br J Sports Med. Vol. 46(Suppi I), pp. :i85–i89.
BibTeX:
@article{Toresdahl2012,
  author = {Brett Toresdahl and Ron Courson and Mats Börjesson and Sanjay Sharma and Jonathan Drezner},
  title = {Emergency cardiac care in the athletic setting: from schools to the Olympics},
  journal = {Br J Sports Med},
  year = {2012},
  volume = {46(Suppi I)},
  pages = {:i85–i89},
  url = {http://bjsm.bmj.com/content/46/Suppl_1/i85.full.pdf+html},
  doi = {http://dx.doi.org/10.1136/bjsports-2012-091447}
}
Tsouros, A.D. & Efstathiou, P.A. (2007), "Mass Gatherings and Public Health -- The Experience of the Athens 2004 Olympic Games"
Abstract: Large-scale mass gatherings, such as the Olympic Games, represent significant challenges for the entire health sector of host countries. Emerging
global public health threats of natural or deliberate nature increase considerably the health and safety vulnerability of mass gatherings. Major
areas of public health responsibility include health care capacity and mass-casualty preparedness; disease surveillance and outbreak response;
environmental health and food safety; public information and health promotion; public health preparedness and response to incidents potentially
involving the deliberate use of explosives, biological and chemical agents or radionuclear material; and leadership, operations and unified
command. This book comprehensively and systematically presents the experience of and lessons learned from the public health aspects of the
preparations and conduct of the Athens 2004 Olympic Games. Documenting this experience can be a source of valuable information and
knowledge for governments at all levels and communities in building their capacity for not only large-scale events but also preparing to deal with
the avian influenza pandemic threat or other emergencies such as flooding and phenomena often associated with climate change.
BibTeX:
@techreport{Tsouros2007,
  author = {Agis D. Tsouros and Panos A. Efstathiou},
  title = {Mass Gatherings and Public Health -- The Experience of the Athens 2004 Olympic Games},
  year = {2007},
  url = {http://www.euro.who.int/__data/assets/pdf_file/0009/98415/E90712.pdf}
}
Upton, M. (1995), "Incident at Donington Monsters of Rock 1988", In Easingworld Seminar -- Mass Crowd Events.
BibTeX:
@inproceedings{Upton1995,
  author = {Mick Upton},
  title = {Incident at Donington Monsters of Rock 1988},
  booktitle = {Easingworld Seminar -- Mass Crowd Events},
  year = {1995},
  url = {http://www.google.com/url?sa=t&source=web&cd=1&ved=0CBkQFjAA&url=http%3A%2F%2Fwww.safeconcerts.com%2Fdocuments%2FDonintondisaster1988.pdf&ei=tXVjTt6rGsLsOaiSqJEK&usg=AFQjCNFRFH7HQHUki8adUnfClYBAoaa_1g}
}
Varon, J., Fromm, R.E., Chanin, K., Filbin, M. & Vutpakdi, K. (2003), "Critical illness at mass gatherings is uncommon", Journal of Emergency Medicine. Vol. 25(4), pp. 409 - 413.
Abstract: Abstract—Gatherings of large numbers of people at
concerts, sporting events, and other occasions lead to an
assembled population with a potential for a wide variety of
illnesses and injuries. The collection of large numbers of
people in a single location has led some authors to recommend
the placement of resuscitation equipment or other
medical services in close proximity to these activities. These
recommendations not withstanding, data on the frequency
of critical illness at mass gatherings (a group exceeding
1000 persons) are difficult to ascertain. Therefore, it was
the purpose of this study to describe the incidence of critical
illnesses among assembled populations at mass gatherings.
An observational prospective study was conducted involving
patient encounters at a large, multipurpose, indoor
mass-gathering complex in Houston, Texas occurring between
Septemver 1, 1996 and June 30, 1997. Demographic,
treatment, disposition and diagnostic data were analyzed in
a computerized database. Of the 3.3 million attendants to
the 253 events analyzed during the 10-month study period,
there were 2762 (0.08%) patient encounters. Fifty-two percent
were women. Mean age was 32  15.6 years. Of these
patients, 51.1% were patrons and the remaining patients
were employees or contractors of the facility. A wide variety
of illness was seen with trauma (39.5%), headache (31%),
and other medical complaints (29.5%) being most frequent.
Disposition of the patients included 95.3% being discharged
to go back to the event and 2.2% being counseled to seek
other medical attention. One hundred twenty-nine patients
(4.7%) were referred to the Emergency Department (ED);
of these, 70 were transferred for abrasions, lacerations, or
skeletal injuries and 13 for chest pain. Of those referred to
the ED, 50 (38.7%) patients were transported by ambulance
and only 17.4% were admitted to telemetry, with
none admitted to an ICU. It is concluded that critical illness
at mass gatherings is infrequent, as seen in this study,
with very few being admitted to telemetry and none to an
ICU. Careful consideration of cost-benefit should occur
when determining allocation of resources for these
activities. © 2003 Elsevier Inc.
e Keywords—concerts; sporting events; mass-gathering
events; indoor stadium
BibTeX:
@article{Varon2003,
  author = {Joseph Varon and Robert E. Fromm and Katia Chanin and Michael Filbin and Kris Vutpakdi},
  title = {Critical illness at mass gatherings is uncommon},
  journal = {Journal of Emergency Medicine},
  year = {2003},
  volume = {25},
  number = {4},
  pages = {409 - 413},
  url = {http://www.sciencedirect.com/science/article/pii/S073646790300249X},
  doi = {http://dx.doi.org/10.1016/j.jemermed.2003.03.001}
}
Wassertheil, J., Keane, G., Fisher, N. & Leditschke, J. (2000), "Cardiac arrest outcomes at the Melbourne Cricket Ground and Shrine of Remembrance using a tiered response strategy-a forerunner to public access defibrillation.", Resuscitation. Vol. 44, pp. 97-104.
Abstract: The provision of medical, paramedical and first aid services at major public events is an important concern for pre-hospital emergency medical care providers. Patient outcomes of a cardiac arrest response strategy employed at the Melbourne Cricket Ground (MCG) and the Shrine of Remembrance by St John Ambulance Australia volunteers are reported. Twenty-eight consecutive events occurring between December 1989 and December 1997 have been analysed. Included are three cardiac arrests managed at ANZAC day parades utilising the same response strategy by the same unit. The incidence of cardiac arrest at the MCG was 1:500 000 attendances. Of the 28 patients, 24 (86%) left the venue alive and 20 (71%) were discharged home from hospital. In all cases the initial rhythm was ventricular fibrillation (VF). All 26 patients (93%) who were defibrillated by St John teams had this intervention within 5 min from the documented time of collapse. One patient in VF spontaneously reverted during CPR. Of the eight fatalities, four died at the scene. At major public venues and events, a co-ordinated emergency life support provision strategy, tailor made for the venue, is necessary for the delivery of prompt CPR, timely defibrillation and advanced life support.
BibTeX:
@article{Wassertheil2000,
  author = {J Wassertheil and G Keane and N Fisher and J.F Leditschke},
  title = {Cardiac arrest outcomes at the Melbourne Cricket Ground and Shrine of Remembrance using a tiered response strategy-a forerunner to public access defibrillation.},
  journal = {Resuscitation},
  year = {2000},
  volume = {44},
  pages = {97-104},
  url = {http://www.resuscitationjournal.com/article/S0300-9572(99)00168-9/abstract}
}
Woodall, J., Watt, K., Walker, D., Tippett, V., Enraght-Moony, E., Bertolo, C., Mildwaters, B. & Morrison, G. (2010), "Planning volunteer responses to low-volume mass gatherings: do event characteristics predict patient workload?", Prehosp Disaster Med., October, 2010. Vol. 25(5), pp. 442-448.
Abstract: INTRODUCTION Workforce planning for first aid and medical coverage of mass gatherings is hampered by limited research. In particular, the characteristics and likely presentation patterns of low-volume mass gatherings of between several hundred to several thousand people are poorly described in the existing literature. OBJECTIVES This study was conducted to: 1. Describe key patient and event characteristics of medical presentations at a series of mass gatherings, including events smaller than those previously described in the literature; 2. Determine whether event type and event size affect the mean number of patients presenting for treatment per event, and specifically, whether the 1:2,000 deployment rule used by St John Ambulance Australia is appropriate; and 3. Identify factors that are predictive of injury at mass gatherings. METHODS A retrospective, observational, case-series design was used to examine all cases treated by two Divisions of St John Ambulance (Queensland) in the greater metropolitan Brisbane region over a three-year period (01 January 2002-31 December 2004). Data were obtained from routinely collected patient treatment forms completed by St John officers at the time of treatment. Event-related data (e.g., weather, event size) were obtained from event forms designed for this study. Outcome measures include: total and average number of patient presentations for each event; event type; and event size category. Descriptive analyses were conducted using chi-square tests, and mean presentations per event and event type were investigated using Kruskal-Wallis tests. Logistic regression analyses were used to identify variables independently associated with injury presentation (compared with non-injury presentations). RESULTS Over the three-year study period, St John Ambulance officers treated 705 patients over 156 separate events. The mean number of patients who presented with any medical condition at small events (less than or equal to 2,000 attendees) did not differ significantly from that of large (textgreater2,000 attendees) events (4.44 vs. 4.67, F = 0.72, df = 1, 154, p = 0.79). Logistic regression analyses indicated that presentation with an injury compared with non-injury was independently associated with male gender, winter season, and sporting events, even after adjusting for relevant variables. CONCLUSIONS In this study of low-volume mass gatherings, a similar number of patients sought medical treatment at small (textless2,000 patrons) and large (textgreater2,000 patrons) events. This demonstrates that for low-volume mass gatherings, planning based solely on anticipated event size may be flawed, and could lead to inappropriate levels of first-aid coverage. This study also highlights the importance of considering other factors, such as event type and patient characteristics, when determining appropriate first-aid resourcing for low-volume events. Additionally, identification of factors predictive of injury presentations at mass gatherings has the potential to significantly enhance the ability of event coordinators to plan effective prevention strategies and response capability for these events.
BibTeX:
@article{Woodall2010,
  author = {Woodall, John and Watt, Kerrianne and Walker, Damien and Tippett, Vivienne and Enraght-Moony, Emma and Bertolo, Chris and Mildwaters, Brett and Morrison, Glen},
  title = {Planning volunteer responses to low-volume mass gatherings: do event characteristics predict patient workload?},
  journal = {Prehosp Disaster Med},
  year = {2010},
  volume = {25},
  number = {5},
  pages = {442--448},
  note = {PMID: 21053194},
  url = {http://pdm.medicine.wisc.edu/Volume_25/issue_5/woodall.pdf}
}
Yates, K.M., Hazell, W.C. & Schweder, L. (2001), "Medical care at the Sweetwaters Music Festival", The New Zealand Medical Journal., April, 2001. Vol. 114(1129), pp. 162-164.
Abstract: AIMS To describe medical cover and medical presentations at the four-day 1999 Sweetwaters Music Festival, and make comparisons with other festivals. METHODS All medical contacts were counted, and patients presenting to the medical tent were included in the study. Case records were studied to determine demographic data, nature of complaint, treatment and disposition. A Medline literature search was performed to obtain information on other festivals. RESULTS There were 2,231 medical contacts overall (8.9% of estimated attendees) and 217 presentations to the medical tent (0.9% of estimated attendees). 53% of patients presenting to the medical tent were men and the mean patient age was 25 years. Lacerations (16, intoxication (13, local infections (12 and soft tissue injuries (9 were the most common problems. There were no deaths or cardiac arrests. CONCLUSION Problems encountered were similar to other music festivals, with minor injuries predominant.
BibTeX:
@article{Yates2001,
  author = {Yates, K M and Hazell, W C and Schweder, L},
  title = {Medical care at the Sweetwaters Music Festival},
  journal = {The New Zealand Medical Journal},
  year = {2001},
  volume = {114},
  number = {1129},
  pages = {162--164},
  note = {PMID: 11400924},
  url = {http://www.ncbi.nlm.nih.gov/pubmed/11400924}
}
Yazawa, K., Kamijo, Y., Sakai, R., Ohashi, M. & Owa, M. (2007), "Medical Care for a Mass Gathering: The Suwa Onbashira Festival", Prehosp Disaster Med. Vol. 22, pp. 5.
Abstract: Introduction: The Suwa Onbashira Festival is held every six years and draws
approximately one million spectators from across Japan. Men ride the
Onbashira pillars (logs) down steep slopes.At each festival, several people are
crushed under the heavy log. During the 2004 festival, for the first time, a
medical care system that coordinated a medical team, an emergency medical
service, related agencies, and local hospitals was constructed.
Objective: The aims of this study were to characterize the spectrum of
injuries and illness and to evaluate the medical care system of this festival.
Methods: The festival was held 02 April–10 May 2004. The medical records
of all of the patients who presented to an on-site medical tent or who were
treated at the scene and transported to hospitals over a 12-day period were
reviewed. The following items were evaluated: (1) the emergency medical system
at the festival; (2) the environmental circumstances; and (3) patient data.
Results: All medical usage rates are reported as patients per 10,000 attendees
(PPTT). A total 1.8 million spectators attended the festival during the 12-
day study period; a total of 237 patients presented to the medical tent (1.32
PPTT), and 63 (27%) were transferred to hospitals (0.35 PPTT). Of the
total, 135 (57%) suffered from trauma—two were severely injured with pelvic
and cervical spine fractures; and 102 (43%) had medical problems including
heat-related illness.
Conclusions: Comprehensive medical care is essential for similar mass gatherings.
The appropriate triage of patients can lead to efficient medical coverage.
BibTeX:
@article{Yazawa2007,
  author = {Kazuyuki Yazawa and Yukihiro Kamijo and Ryuichi Sakai and Masahiko Ohashi and Mafumi Owa},
  title = {Medical Care for a Mass Gathering: The Suwa Onbashira Festival},
  journal = {Prehosp Disaster Med},
  year = {2007},
  volume = {22},
  pages = {5},
  url = {http://pdm.medicine.wisc.edu/Volume_22/issue_5/yazawa.pdf}
}
Zakaria, M.I., Isa, R.M., Hamzah, M.S.S.C. & Ayob, N.A. (2006), "Medical standby: an experience at the 4th national youth camping and motivation program organized by Maksak Malaysia", Malaysian Journal of Medical Sciences. Vol. 13, pp. 43-51.
Abstract: Medical standby is the provision of emergency medical care and first aid for participants and/or spectators in a pre-planned event. This article describes the framework and the demographics of a medical standby at the 4th National Youth Camping and Motivation Program in Pasir Puteh, Kelantan from 30th July until the 3rd August 2004. The framework of the medical team is described based on the work process of any medical stand by. A medical encounter form was created for the medical standby defining the type of case seen (medical or trauma), name, age, race and diagnosis of the patient. We concluded that interagency collaboration during the initial planning and during the event itself is needed to ensure the smooth running of the medical standby. Most of the medical encounters were minor illnesses which are similar to previous studies and there was no case transferred to the hospital during that period.
BibTeX:
@article{Zakaria2006,
  author = {Mohd Idzwan Zakaria and Ridzuan Mohd Isa and Mohd Shaharudin Shah Che Hamzah and Noor Azleen Ayob},
  title = {Medical standby: an experience at the 4th national youth camping and motivation program organized by Maksak Malaysia},
  journal = {Malaysian Journal of Medical Sciences},
  year = {2006},
  volume = {13},
  pages = {43-51},
  url = {http://ernd.usm.my/journal/journal/mjms%20Jan%202006.pdf}
}
Zeitz, K.M., Schneider, D.P., Jarrett, D. & Zeitz, C.J. (2002), "Mass Gathering Events: Retrospective Analysis of Patient Presentations over Seven Years at an Agricultural and Horticultural Show", Prehosp Disaster Med. , pp. 147-150.
BibTeX:
@article{Zeitz2002,
  author = {Kathryn M. Zeitz and David P.A. Schneider and Dannielle Jarrett and Christopher J. Zeitz},
  title = {Mass Gathering Events: Retrospective Analysis of Patient Presentations over Seven Years at an Agricultural and Horticultural Show},
  journal = {Prehosp Disaster Med},
  year = {2002},
  pages = {147-150},
  url = {http://pdm.medicine.wisc.edu/Volume_17/issue_3/zeitz.pdf}
}
Zeitz, K.M., Zeitz, C.J. & Kadow-Griffin, C. (2005), "Injury occurrences at a Mass Gathering Event", Journal of Emergency Primary Health Care. Vol. 3, pp. 990098.
BibTeX:
@article{Zeitz2005a,
  author = {K. M. Zeitz and C. J. Zeitz and C. Kadow-Griffin},
  title = {Injury occurrences at a Mass Gathering Event},
  journal = {Journal of Emergency Primary Health Care},
  year = {2005},
  volume = {3},
  pages = {990098}
}
(1999), "Atelier d'auto-formation -- médecine de catastrophe -- analyse des méthodes et pratiques utilisées dans les pays membres de l'Union Européenne" NAINVILLE-LES-ROCHES, fév, 1999.
BibTeX:
@techreport{MIM1999,,
  title = {Atelier d'auto-formation -- médecine de catastrophe -- analyse des méthodes et pratiques utilisées dans les pays membres de l'Union Européenne},
  year = {1999},
  url = {http://ec.europa.eu/echo/civil.../civil/.../major_incident_medicine_fr.pdf}
}
(1995), "Provision of emergency medical care for crowds"
BibTeX:
@techreport{ACEP1995,,
  title = {Provision of emergency medical care for crowds},
  year = {1995},
  url = {http://www.acep.org/workarea/downloadasset.aspx?id=4846}
}

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