Health Service Impact from Mass Gatherings: A Systematic Literature Review

Abstract

Methods: A handheld GE V-Scan™ with Dual Probe ultrasound was available for use by physicians in the main medical tent. All treating physicians consented to participate and self-reported their training and proficiency using POCUS. After each use of POCUS, physicians completed a survey recording the indication, scans performed, and impact on diagnosis, management, and disposition of patients. Results: In total, POCUS was used on 28 patients out of the 686 patients seen in the main medical tent. The three most common indications for ultrasound were abdominal pain, gynecological complaints, and dyspnea. POCUS narrowed the differential diagnosis in 64% (18/28) and altered the working diagnosis in 21% (6/28) of patients. It confirmed the management plan in 57% (16/28) and altered it in 39% (11/28) of patients. Use of POCUS reduced the burden on the local healthcare infrastructure in 46% (13/28) of patients and prevented ambulance transport to a higher level of care in 32% (9/28) of patients. Conclusion: Physicians reported that POCUS aided in the diagnosis, management, and disposition of select patients at a remote multi-day mass gathering. POCUS helped to reduce the local healthcare burden caused by hosting a large-scale mass gathering by preventing or altering the urgency of transport to hospital for higher level care or diagnostic imaging. Background: Mass gatherings are events where a large number of people congregate for a common purpose, such as sporting events, agricultural shows, and music festivals. When definitive care is required for participants of mass gatherings, municipal ambulance services provide assessment, treatment, and transport of participants to acute care settings, such as hospitals. The impact on both ambulance services and emergency department services from mass gathering events was the focus of this literature review. Methods: This research used a systematic literature review methodology. Databases were searched to find articles related to aim of the review. Articles focused on mass gathering health, provision of in-event health services, ambulance service transportation and hospital utilization. Results: Twenty-four studies were identified for inclusion in this review. These studies were all case-study based and retrospective in design. The majority of studies (n = 23) provided details of in-event first responder services. There was variation in reporting of the number and type of in-event health professional services at mass gatherings. All articles reported that patients were transported to hospital by the ambulance Prehospital and Disaster MedicineVol. 32, Supplement 1 s138 Mass Gatherings

Emergency healthcare delivery for young adults during a planned mass gathering: A retrospective observational study

“…As recommended for MGE research and evaluation, data were collected to enable the reporting of event, patient presentation and outcome characteristics from the EHS, [15][16][17] as well as ED patient presentation and outcome characteristics. 7 Data were extracted from the ED Information System for the 21-day study period and included: healthcare facility (ED or EHS), age, gender, residential postcode, date and time of arrival, mode of arrival, presenting problem, assigned Australasian Triage Scale (ATS) category, International Classification of Diseases (ICD-10) group, 18 diagnosis description, time and date of discharge and discharge destination.…”

“…These strategies may be considered in terms of: (i) specific patient groups, such as low acuity patients, 3 high acuity patients, 4 or people with mental health problem; 5 or (ii) patients requiring care at particular times such as during peak periods of ED crowding, 6 or during mass gathering events (MGEs). 7,8 A MGE is defined as an event where a group of people come together for a common purpose within a particular space or venue. In a health context, a mass gathering is an event 'where there is the potential for a delayed response to [health] emergencies', 9 due to challenges related to the environment and patient egress.…”

“…Opportunity exists to further explore ways to minimise impacts on the ED during MGEs, which include music festivals, sporting events, religious gatherings and 'Schoolies'. 7 'Schoolies' is a MGE for youth to celebrate the end of their schooling years. 11 The term 'Schoolies' is used interchangeably to describe the event itself (i.e.…”

Impacts on in‐event, ambulance and emergency department services from patients presenting from a mass gathering event: A retrospective analysis

“…In a systematic literature review exploring the health service impact from 24 different types of MGEs, variation was noted in the type of reporting of the impacts of MGEs on ambulance usage and ED visits. 3 The literature review reported that the transport to hospital rate from a MGE is approximately 1/1000 participants. 3 Furthermore, the review highlighted an absence of literature relating to the impact from MGEs on EDs beyond reporting the transport to hospital rate or raw number of patients that were transported to hospital by ambulance.…”

“…3 The literature review reported that the transport to hospital rate from a MGE is approximately 1/1000 participants. 3 Furthermore, the review highlighted an absence of literature relating to the impact from MGEs on EDs beyond reporting the transport to hospital rate or raw number of patients that were transported to hospital by ambulance. 3 From an ambulance perspective the literature is scant relating to ambulance usage at MGEs.…”