Development of a unique decentralized rapid-response capability and contingency mass-casualty field hospital for the 1996 democratic national convention

Abstract

This article describes the planning, development, and execution of a unique, decentralized, and flexible medical response capability that was developed for the 1996 Democratic National Convention in Chicago. Concerns for coordinated acts of violence, terrorism, toxicologic exposures, and logistic problems posed by the United Center prompted the development of a decentralized and flexible rapid-response plan. Contingency planning for the remote possibility of a full-scale disaster led to the additional development of a contingency mass-casualty field hospital on site. The plans for this mass-gathering response are described in considerable detail. Forty-four patient encounters across the four days of the convention were recorded, with a combination of minor injuries and potentially serious medical presentations. The 1.46 EMS encounters per 1,000 attendees at the Democratic National Convention is comparable to other utilization rates for mass gatherings in the literature. Proactive attention to comprehensive contingency planning for equipment, supplies, personnel, and organizational needs, especially when multiagency response and cooperation are required, is essential.

Ambulance Need at Mass Gatherings

“…Internationally, there has been a wide range of patient presentation rates reported at mass gatherings, from as few as 0.1-1.9 physician encounters per 1,000 observers at a stadium, 7 convention, 8 and outdoor festival, 9 respectively, to as many as 192 physician encounters per 1,000 participants in an endurance sports event. 10 There is also a wide range of ambulance transport rates reported from mass gatherings, from as few as 0.002-0.09 transports per 1,000 observers at festivals and large public events, 9 '"' 12 to as many as 20.…”

Emergency Medical Consequence Planning and Management for National Special Security Events After September 11: Boston 2004

“…No formalized planning, communication, or command structure between the security and medical communities previously existed. 1,2,7,8,10,[12][13][14] In contrast, for the 2004 Boston DNC, medical issues received the highest priority through a new organizational structure. The USSS appointed a local agency, BEMS, to the executive steering committee and designated BEMS as the lead medical consequence agency.…”

“…In previous NSSE events and political conventions, medical coverage was generally coordinated by local fire departments (typically a city’s primary EMS provider) and a selection of medical partners, such as local hospitals. No formalized planning, communication, or command structure between the security and medical communities previously existed 1,2,7,8,10,12–14…”

“…Medical utilization rates of 11.6/1000 visitors were consistent with prior published studies on medical care at political conventions. The literature notes reported medical utilization rates at political conventions ranging from lows of 1.46 and 3.53/1000 attendees (at the 1996 DNC in Chicago and 2000 RNC in Philadelphia, where documentation was not completed for patients with minor complaints) to highs of 12.7 and 21.23/1000 attendees (at the 1984 DNC and RNC 1984 in San Francisco and Dallas, respectively) 10,12–14. The types of medical complaints (headaches, extremity injuries and lacerations, syncope, chest pain, and abdominal pain) were likewise typical of prior reports and may be reflective of the age demographics of the attendees as well as the crowded nature of the venues 10,12–14…”

“…10,[12][13][14] The types of medical complaints (headaches, extremity injuries and lacerations, syncope, chest pain, and abdominal pain) were likewise typical of prior reports and may be reflective of the age demographics of the attendees as well as the crowded nature of the venues. 10,[12][13][14] Just as important were long-term outcomes. Since 2004 the legacy of the planning and coordination has led to critical national collaborations.…”