EMS Mass Gatherings

Excerpt

The World Health Organization (WHO) defines mass gatherings as spontaneous or organized events with a large amount of attendees that challenge local resources. The Federal Emergency Management Administration (FEMA) refers to them as “special events” that bring together many people large enough to affect the ability of the community to respond to a significant emergency. Both of these definitions have emphasized the focus to be on the ability of the community to respond effectively and the resultant strain on essential resources rather than solely on the number of attendees. While the specific attendee threshold varies, most mass gatherings exceed 25,000 participants; however, the term could be broadened to include events involving more than 1,000 participants. Essential resources include local emergency medical services (EMS), hospitals, transportation networks, and law enforcement.

Mass gatherings include concerts, sporting events, religious celebrations, street fairs, parades, and political rallies, each exhibiting distinct risk profiles. The nature of the event, whether bounded (eg, stadium events) or unbounded (eg, marathons), influences the associated risks. Additionally, concerts have an increased risk of recreational drug and alcohol use and injury from mosh pits, while sporting events could result in physical altercations. Religious gatherings attended by a higher percentage of older individuals introduce additional considerations.

Additional risks associated with mass gatherings include crowd disturbances, fires, structural collapses, disease outbreaks, terrorist attacks, stampedes, toxicological incidents, and environmental emergencies. These gatherings become particularly vulnerable due to the sheer size of crowds, adverse weather conditions, infectious diseases, or food and water shortages or contamination. Disease outbreaks present a heightened risk, with modes of transmission ranging from respiratory droplets to foodborne and skin contact, amplifying the potential for contagion.

The defining characteristic of mass gatherings lies in their potential to strain local resources. This strain intensifies when confronted with a mass casualty incident (MCI) due to preexisting resource saturation, highlighting the need for comprehensive emergency planning and resource management.