Medical Response to Mass Gatherings

Mr Jamie Ranse, RN FRCNA

Chief Nursing Officer, St John Ambulance Australia

Clinical Manager (Research Portfolio), Emergency Department – Calvary Health Care ACT

Research Associate, Flinders University Research Centre for Disaster Resilience and Health

Overview

• Definition• Conceptual models• Workload characteristics• Workload prediction• Event design• Implications• Case studies• Where to from here...• Questions

Definition

• Variable• Based on:

– Spectator / participant numbers– Duration– Location

Definition

Class Subclass Persons Resources Example

Mass gathering

Small 200 – 1,500 Local area Local fair

Medium 1,500 – 10,000 Local area Local sports game

Large 10,000 – 100,000 Local +/- State Concert

Major mass gathering 100,000 – 250,000 State +/- Interstate Music festivalAgricultural show

Super mass gathering 250,000 – 500,000 State and Interstate Motor sports event

Extreme mass gathering

500,000 – 1,000,00National +/- international

Religious festival

Mega mass gathering 1,000,000+National and International

Olympics

Conceptual Model

Workload characteristics

• Other extreme events• Can we predict workload?

temperature

bounded or not

ETOH / drug availability

humidity

participant numbers

day / nightindoors / outdoors

crowd behaviour

• What factors influence workload?

level of onsite care

age of participants

duration

geography

Workload characteristics and conceptual model

Workload prediction

• Why predict workload?• What to predict?

– Patient presentation rate (PPR) 0.14 to 90/1,000 (majority 0.5 and 2.6/1,000)

– Transport to hospital rate (TTHR) 0.01 to 0.55/1,000

– Referral to hospital rate 5% - 10% of PPR

• How?– Predictive models --– Historical prediction

Workload prediction

Royal Adelaide show: 1996 - 2001

Event design

• Crowd mood– Music festivals– Spaces

• Patient access

Implications

• Pre-ambulance• Pre-hospital

Implications

• Pre-ambulance• Pre-hospital• Emergency Department

Implications

• Pre-ambulance• Pre-hospital• Emergency Department• Hospital

Case studies

Case studies

Case studies

Where to from here…

• Education• Research• Mass gathering management in the ACT and

surrounds

Questions?

Mr Jamie Ranse, RN FRCNA

Chief Nursing Officer, St John Ambulance Australia

Clinical Manager (Research Portfolio), Emergency Department – Calvary Health Care ACT

Research Associate, Flinders University Research Centre for Disaster Resilience and Health