Role of Emergency Physicians Stationed in Mass-Gathering Area

Abstract

Objective: Our tertiary emergency medical center is located near an amusement park, with an emergency physician from our emergency room (ER) being positioned at the first-aid station in the park. In this study, we examined patients transported from the amusement park to our ER facility, in order to clarify the role and efficiency of emergency physicians stationed at massgathering locations. Materials:Patients that were transported from an amusement park to our ER facility between April 2008 and March 2013 were included. Methods: We retrospectively investigated the pathophysiology, pre-hospital care, and prognosis of patients. Results:During the 5-year study period, 1,601 visitors transported by ambulance from the park to a hospital. Among these park visitors, 1, 107 were transported to our ER facility, with 189 being immediately hospitalized, including 66 critical cases that admitted to the intensive care unit (ICU). No mass-casualty accidents occurred at this amusement park during the study period.Nine patients had initial cardiopulmonary arrest (CPA) at the amusement park. All the patients suffering from CPA showed a return of spontaneous circulation (ROSC), but 2 of these patients eventually died. The 1-month survival rate was 77.8%. When limited to cardiogenic CPA, the 1-month survival rate was 85.7%. Conclusion:Mass-gathering areas, such as amusement parks, have the risk of medical emergencies that require critical care.Emergency physicians stationed onsite could promptly respond to medical events and offer pre-hospital care. To establish a ʻchain of survivalʼ that involves the emergency physicians may contribute to good prognosis for critical patients.