title: Mass-gathering medicine: a descriptive analysis of a range of mass-gathering event types.
abstract: OBJECTIVE
  To identify and evaluate the volume, nature, and severity of patient presentations encountered by emergency medical services (EMS) at all mass-gathering events held at or near a southeastern US university. In addition, to compare the existing literature base (single mass-gathering event held in large urban population centers) with a broader variety of events varying in crowd size and locations.
  
  
  METHODS
  This was a retrospective review of all EMS records from mass-gathering patient presentations (individual-patient cases) between October 24, 2009, and August 27, 2011. All patrons seen by event-based EMS were included. Events categories included the following: football, concerts, public exhibitions, and nonfootball athletic events. Event volumes were defined as follows: low (<1000 patrons), medium (between 1001 and 15 000 patrons), and large (>15 000 patrons). Case presentation-management categories included the following: trauma, medical, and support (minimal medical intervention required, eg, minor dressing for abrasion, water, etc). Severity categories included the following: mild, moderate, and severe based on the following definitions using both provider assessment and the use of transport to a hospital: minor cases were considered non-life threats and did not result in a transport to a hospital; moderate cases were associated with transports to a hospital; and severe cases were life threats with transport to a hospital.
  
  
  RESULTS
  We studied 79 events over the study period. Event volumes were 16.45% high, 79.75% medium, and 3.80% low. A total of 670 cases presented, with a mean of 8.48 cases/event. The football category had the highest mean number of cases with 37.09 cases/event, for a total of 408 cases. The nonfootball, athletic event category had the lowest mean number of cases at 1.83 cases/event. Most (81.82%) of the football events were classified as large volume. Support cases were the most common presentation (43.13%), followed closely by medical complaints (41.94%). Most cases were mild in severity (95.97%). There were 27 cases requiring transport to hospital, with 3 cases being life-threatening. The average patient age was 33 years, with 60.3% female sex. These features are similar to the published information on large event medical attendance.
  
  
  CONCLUSIONS
  In this retrospective, descriptive study of a broad range of event type, the most common patient presentations at mass-gathering events were mild in severity, requiring minimal medical intervention. Both transports from the event to a hospital and the occurrence of life threats were uncommon. Our findings are similar to the data found in the existing medical literature.
authors: Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA 22908, USA.
authors: Samuel
authors: S
authors: Locoh-Donou
authors: Yan
authors: Y
authors: Guofen
authors: Melanie
authors: M
authors: Welcher
authors: Thomas
authors: T
authors: Berry
authors: Robert E
authors: RE
authors: O'Connor
authors: William J
authors: WJ
authors: Brady
mesh_terms: D000293:Adolescent; D000328:Adult; D016638:Critical Illness / Q000453:epidemiology; D003441:Crowding; D004630:Emergencies / Q000453:epidemiology; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007899:Leisure Activities; D008297:Male; D008399:Mass Behavior; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015599:Trauma Severity Indices; D014768:Virginia / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology; D055815:Young Adult