A proposed model for a residency experience in mass gathering medicine: the United States Air Show.
OBJECTIVE
Mass gathering medicine is an increasingly important responsibility for emergency physicians. A formal experience in mass gathering medicine can introduce emergency medicine residents to this aspect of community medicine.


METHODS
Educational model based on field experience and retrospective chart review from 1981 through 1991.


METHODS
The US Air Show is a summer event that attracts an average of 223,000 spectators annually. Medical care is provided by physicians, nurses, and technicians operating within an organized system of care. Emergency medicine resident physicians (first-, second-, and third-year) evaluate and treat patients appropriate for the resident's level of responsibility. Residents provide immediate medical control and are integrated into the event disaster plan. On-site attending physician supervision is available at all times. Didactic instruction and event orientation are integrated into the residency curriculum. Residents participate in the planning stages of the event.


RESULTS
During the study period, 2,091 patients were seen. The most common presenting problems were heat illness (28%), blisters and scrapes (25%), headaches (23%), fractures and lacerations (9%), and eye injuries (5%). One hundred forty-eight patients (7%) required transportation to the hospital. Approximately 16 residents participate each year and treat an average of 13.7 patients during their four-hour shift. A resident training model for a mass gathering experience is proposed to include adequate crowd size to generate useful patient volumes; a regularly scheduled event; organized medical and disaster preparations meeting local or published standards; didactic instruction on history, principles, and current issues; on-site attending supervision; degree of responsibility appropriate for training level; participation in planning and organizing the event; and postevent debriefing.


CONCLUSIONS
A residency experience and training program in mass gathering medicine can introduce the principles of planning and providing care for crowds attending large public events.
De Lorenzo
R A
RA
Department of Emergency Medicine, Wright State University of Medicine, Dayton, Ohio.
Boyle
M F
MF
Garrison
R
R
D003479:Curriculum; D004189:Disaster Planning; D004635:Emergency Medicine / Q000193:education*; D007396:Internship and Residency; D014481:United States