Chain of survival at mass gatherings: a case series of resuscitation events.
BACKGROUND
At a large public event, or mass gathering, various factors influence patient presentations that brings challenges to patient care. The chain of survival has been investigated in the prehospital setting. However, this has not explicitly included the mass-gathering environment.


OBJECTIVE
This study sought to determine the facilitators and barriers to the chain of survival at mass gatherings.


METHODS
This case-series research was exploratory and descriptive, using the analysis of personal experiences of resuscitation. Participants were members of St John Ambulance Australia who had participated actively in a resuscitation event in 2007. Telephone interviews were used as a means of data collection. Participant narrative was recorded electronically, transcribed verbatim, and analyzed thematically using a well established human science approach.


RESULTS
The thematic analysis revealed five main themes and a number of sub-themes. Four of the main themes were aligned easily with the four chain of survival links. The remaining main theme outlined a new link in the chain of survival of specific importance to mass gatherings, 'early planning'. Additionally, a number of sub-themes were identified, which exemplified various facilitators and barriers to the chain of survival in this environment.


CONCLUSIONS
This research highlights various barriers and facilitators to the chain of survival in the mass-gathering environment. Additionally, the unique "early planning" link in the chain of survival as described in this research highlights the importance of a preparatory phase for responders at mass gatherings.
Emergency Department, Calvary HealthCare ACT, Australia. jamie.ranse@calvary-act.com.au
Jamie
J
Ranse
Kathryn
K
Zeitz
D000293:Adolescent; D000328:Adult; D001315:Australia; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008399:Mass Behavior; D008875:Middle Aged; D012151:Resuscitation; D016019:Survival Analysis; D055815:Young Adult