Patient presentations to onsite health providers, ambulance paramedics and hospital emergency departments from a mass gathering: a case study

Mr Jamie Ranse, Mr Shane Lenson, Mr Toby Keene, Mr Matt Luther, Dr Brandon Burke, Associate Professor Alison Hutton

BACKGROUND

• A number of challenges exist in providing adequate health care at a mass gathering. • Health providers aim to maximise their efficiency in responding to health emergencies within the mass gathering environment, whilst

minimising potential impact of surge presentations to the health service in the surrounding community or region. • The mass gathering literature commonly reports on the onsite care from single events, and does not consider the effect on prehospital or

hospital services.

Aim This research aims to enhance our understanding of the health service requirements of an outdoor music festival

DISCUSSION

• This is the first research to describe patient presentations to onsite care providers, prehospital services and hospitals from a mass gathering.

• This research provides insight into the health service usage from one event.

• Presentation to the onsite health professionals resulted in a longer length of stay in the onsite medical facility.

• Onsite health professionals may have diverted 15 patients who would have otherwise been seen by local ambulance and hospital services.

• Multi-site research should be undertaken to explore the health service usage from a variety of mass gatherings.

1. Ranse J, Hutton A. (2012). Minimum data set for mass gathering health research and evaluation: A discussion paper. Prehospital and Disaster Medicine. 27(6):1-8.

197 Presentations to onsite

first aid care

24 Presentations to onsite

doctors, nurses and paramedics

15 Returned to the event

7 Transported to hospital

2 Discharged to police

RESULTS

5 Emergency / short stay

< 24 hours

1 Operating theatre

admission

1 Intensive Care Unit

admission

ONSITE FIRST AID CARE

Gender Male: n=54 (31%) Female: n= 119 (64%)

Treatment Length of Stay Mean: = 11 Minutes (SD 11)

Primary Presentation Injury: n=40 (23%) Illness : n=119 (69%) Environmental: n= 12 (7%) Mental Health: n= 2 (1%)

ONSITE HEALTH PROFESSIONAL CARE

Gender Male: n=12 (50%) Female: n= 12 (50%)

Treatment Length of Stay Mean: = 76 Minutes (SD 45)

Primary Presentation Injury: n=5 (20%) Illness : n=7 (30%) Environmental: n= 12 (50%)

METHODS

Design Retrospective review of patient report forms from onsite health services at outdoor music festival.

Setting One outdoor music festival in 2012 in the Australian Capital Territory with approximately 20,000 participants. The festival had one first aid post and a health team staffed by doctors, nurses and paramedics.

Data collection Data was obtained and linked between onsite care providers (St John Ambulance Australia), prehospital (ACT Ambulance Service) and hospitals (Canberra Hospital and Calvary Health Care ACT).

A pre-exisiting and used minimum data set1 was used to code patient characteristics from this event.

Data analysis Descriptive statistics such as frequency distributions and means of central tendency.

Onsite first aid care • The most frequent illness was headaches (n=94), injury was superficial

lacerations (n=13), environmental was substance and/or alcohol intoxication (n=12).

Onsite health professional care • The most frequent illness was headaches (n=3), injury was fractures (n=2),

environmental was substance and/or alcohol intoxication (n=12).

Ambulance transport • The most frequent injury was fractures (n=2), environmental was substance

and/or alcohol intoxication (n=4). • One patient required prehospital endotracheal intubation, • Three patients required airway adjuncts, • Six patients received intravenous medications from paramedics including

opioids.

Hospital services • One patient required an open reduction and internal fixation in the operating

theatre. • One patient required intubation and ventilator support in the Intensive Care

Unit.