Medical Events

[DesertMedic66]

My company just finished the biggest music events that we have every year. It got me wondering about how other companies prepare, respond to, and staff events.

What kind of service are you? (IFT, 911, Fire, Event medical service, etc)
How many people attend your biggest event?
What kind of staffing do you have? (EMT, Medic, RN, PA, DR.)
How do you operate during the event?

We are a 911/IFT service.

For the event we just finished, it's estimated that 100,000 people attended the events each day.

Per day we staffed about 40 EMTs, 25 Medics, 4-6 RNs, and 2-3 Drs. A whole communications center (dispatchers), and support staff.

We treat it as a MCI and have plans made up that include where to land multiple HEMS.

We use roughly 6-8 Foot Patrols which are made up of 2 EMT's in each patrol. They get a call over the radio from dispatch and respond. We also have a couple of Bike Medic Teams who are a mix of EMTs and Medics that also respond to calls. We have 1 BLS shuttle golf cart (can transport many stable patients). We have 6-8 ALS equipped golf carts who respond when requested by foot patrol or bike team. If needed the patients can be transported to 1 of 2 BLS medical tents or to 1 of 2 main medical tents that is staffed with the Medics, RNs, and Drs.

 

[chaz90]

Interesting idea for a thread! I'm curious to see how other services handle events. Here in Delaware, our county based 911 ALS service does event coverage, but I'm not completely sure how it works yet. My old service was hospital based ALS. We handled primarily 911, but also did IFT as we were the only ambulance service in town, and IFT was always going out of or into our own hospital. We also did event coverage, the largest of which were several festivals over the summer with probably 20000 attendees downtown. We also provided medical coverage for our local University's Division I home football games. We did a ton of smaller events for the community, the majority of which were staffed by the volunteer arm of the EMS service staffed by all EMTs. Being in Colorado, EMTs could still start IVs at events and carried Narcan, D50, and Albuterol. Transport out of events was handled by calling in an ALS 911 ambulance from our service, unless it was one of the huge events that would also be staffed by paid paramedics and have transporting ambulances pre staged. We rarely had RNs or MDs at our events, but our Medical Director or other ED physicians would occasionally be staged at our medical tents.

DesertEMT
How were your doctors, RNs, and PAs worked into the event? I'm assuming your agency doesn't normally employ them. Are they employed on a seasonal, part time basis by you guys, or do they contract separately? I'd be curious how everyone works together when they don't normally and how they deploy themselves pre hospitally. What kind of capabilities did your physicians have at the main medical tent?

 

[DesertMedic66]

The nurses were mostly ones that our company has hired on for CCT transports. The doctors were provided by our parent company so pretty much we had a different doctor every day.

We hired 20+ EMTs just for the events. So now those EMTs don't have a job but do have a nice paycheck.

The doctors didn't have too much capabilities on site. They had a long list of meds and OTC meds that we had on site. Our hospital is about 5 miles away from the event and we always have one ambulance on site to transport.

We didn't have any full arrests this year. We had about 3 patients get transported to the hospital in respiratory arrest caused by a bad dose of GHB going around (one of the music events is famous for drug usage). This past weekend the most critical patient we had was a hip fracture.

 

[Tigger]

At the small rural place I work we will put the duty crew and ambulance at the event. A part time EMT will be brought on for the whole 24 (instead of a 14 hour night) to run calls with the captain out of the station. Depending on call and event location the ambulance at the event may leave to go on a call and the captain's ambulance will move to the event. None of these events are sufficiently large enough to justify more coverage, there just aren't that many people in the district so mostly we just cover small outdoor concerts and high school contact sports.

In the city where I live in I volunteer for the fire department's special events team. The FD is ALS and has scene control but does not transport. They do all civic event coverage. For large events they bring out a big trailer that has a MULE, several bikes, a small treatment area, and several tents to set up first aid stations. For large events they staff with 4 paramedics and 4 EMTs, plus a lieutenant. Then there is the community health team (that's what I volunteer for) that is one firemedic and a couple of EMT volunteers that do BP checks and BGLs and help with setup and minor care. AMR will sometimes send an ambulance to post with us but they are generally not dedicated. Events can choose to contract with AMR if they choose, but public events are provided with free city coverage.

 

[johnrsemt]

How would you handle something in your area that turns into the 2nd largest city in your state for 10 days?

national Boy Scout Jamboree is now in West Virginia and for 10 days is the 2nd largest city in the state.

 

[JPINFV]

How would you handle something in your area that turns into the 2nd largest city in your state for 10 days?

national Boy Scout Jamboree is now in West Virginia and for 10 days is the 2nd largest city in the state.

Obviously it depends on the state. I'd be more In California, you've just described a city between 1.3 million and 3.8 million people. On the other hand, in Alaska, that's going to be between 310k and 31k people. It's also going to be a question of what's going on (BS Jamboree is going to be relatively high risk if something does happen), where it's located (nearest city, access, etc. One of the BS summer camps I went to as a kid was down a narrow, winding dirt road and they maintained a grass heliport set up in case anything did happen), and what resources you can bring to the event.

 

[Akulahawk]

Many Football seasons ago, my company used to work the Stanford Home Games. They usually had about 60k attendees per game. We'd team up with Stanford Hospital to provide much of the on-site care. Normally we'd have 4-5 ambulances staffed & ready (1 is ALS, 1 is dedicated to the field), 3-5 golf carts staffed with a Physician and a Nurse, 2 first aid stations in the stadium with 2 EMTs each, and an aid station outside the stadium with an EMT, Nurse, and Physician. Of course, about 2 miles away, we also had the Stanford ED, which NEVER was closed to us. If necessary we could also bring LifeFlight over (never had to though).

We'd usually have 2-3 transports to the ED. The first aid stations would see about 30-50 people for minor complaints. The golf cart teams would see maybe 10 people. The field ambulance(s) usually got to watch the game.

 

[yowzer]

How would you handle something in your area that turns into the 2nd largest city in your state for 10 days?

national Boy Scout Jamboree is now in West Virginia and for 10 days is the 2nd largest city in the state.

Black Rock City is something like the 10th biggest city in Nevada for one week a year. We have our own dispatch system, volunteer fire department, BLS-level EMS (Using 4 gators, able to transport ambulatory patients, and as backup, FF/EMTs in brush engines), 2 BLS first aid stations (Staffed by EMTs, medics, nurses and MDs), and contract with an area hospital to set up an urgent care center and provide ALS ambulances. Patients that they can't handle either get air lifted or driven in to Reno.

At the 2011 Burning Man there were 5700 patient contacts, and 33 transports to Reno, out of a population of 54,000.

 

[johnrsemt]

We have 12 private ambulances at the Jamboree during the day,6 ALS and 6 BLS plus up to 20 FLA (Field Litter Ambulances on a HMMVV) from the military that can transport up to 4 litter patients.
Plus Med-Bed gators, and UTV's and ATV's that have litter trailers on them.

There are 9 medical tents that can handle 15-25 patients each that are staffed 24/7 and about 20 aid stations that are manned during activity times.

We have a Health Net helicopter on site during the day, plus BlackHawk helicopters from the WVANG for backup.

We have areas that have pretty rough terrain, including 52 miles of Mountain bike trails, some of which are only accessible by foot (we have stokes litters mounted on a big wheel that can be rolled by 4 people out to a UTV or FLA.

 

[Jim37F]

We have 12 private ambulances at the Jamboree during the day,6 ALS and 6 BLS plus up to 20 FLA (Field Litter Ambulances on a HMMVV) from the military that can transport up to 4 litter patients.
Plus Med-Bed gators, and UTV's and ATV's that have litter trailers on them.

There are 9 medical tents that can handle 15-25 patients each that are staffed 24/7 and about 20 aid stations that are manned during activity times.

We have a Health Net helicopter on site during the day, plus BlackHawk helicopters from the WVANG for backup.

We have areas that have pretty rough terrain, including 52 miles of Mountain bike trails, some of which are only accessible by foot (we have stokes litters mounted on a big wheel that can be rolled by 4 people out to a UTV or FLA.

Wow, do you mean all that is for the Boy Scouts of America National Jamboree?

 

[mycrofft]

Tell us how useful foot patrols and various small transport vehicles are.
My field experience was supporting Guard exercises, sometimes with +/- 2000 troops by max three med techs and myself. Area covered: up to a square mile.

Foot patrols: most useful for making troops drink and refill their water. Mostly waste of time. (Ditto at civilian events). However, these events did have a lot of commo going so any injury or illness cold be radioed in promptly.

Small vehicles (ATV's, etc): didn't have, used a pickup truck. Very rare but very useful when needed.

Anyone else rate the utility of ATV's, special litter carts or wheels, foot patrols etc? Bicycles?

 

[abckidsmom]

Tell us how useful foot patrols and various small transport vehicles are.
My field experience was supporting Guard exercises, sometimes with +/- 2000 troops by max three med techs and myself. Area covered: up to a square mile.

Foot patrols: most useful for making troops drink and refill their water. Mostly waste of time. (Ditto at civilian events). However, these events did have a lot of commo going so any injury or illness cold be radioed in promptly.

Small vehicles (ATV's, etc): didn't have, used a pickup truck. Very rare but very useful when needed.

Anyone else rate the utility of ATV's, special litter carts or wheels, foot patrols etc? Bicycles?

I agree- in my experience foot patrols are just a walk in the park, and you don't tend to be where you need to be when something happens. Bike patrols seem way better for that, chased down by a gator or something to get the patient out.

Our main type of event we set up for is a triathlon. We have a medic on the boat in the water for the swim portion, medics in the transition areas, and a medic at the finish line with band aids and ice packs.

Our biggest kinds of injuries are cold injuries and scrapes, but we did have a cardiac arrest at the swim transition area last year.

Evening-long concerts seem to be a waste to staff those, but large-scale camping events and civil war reenactments have more need. Those wool uniforms...

 

[DesertMedic66]

Foot patrols for our large events are very useful. Each team (2 EMTs) carry BLS equipment (from band-aids to AED). Both members have a radio and a headset so they can hear dispatch over the music. They can get walk up medical aids or get dispatched out to them.

They are treated kind of like SSM units so where they are changes depending on how many patrols are available and where the concerts are at.

We have a bike patrol team that will respond with foot patrol to calls that are a distance away from the main event.

On foot patrol we can have patients sign AMAs, walk them to either a BLS medical tent or the doctor tents. If they patient can't want we can call for either an ALS golf cart or a BLS golf cart.

 

[johnrsemt]

Yes it is for the Boy Scout Jamboree.

No foot patrols that I know about.

UTVs/Gators with Med Beds are great, even without them they can transport ankle/foot and wrist injuries to a Med tent.

there is about 43,000 here for 10 days, and upto 10,000 visitors.

New thing for this Jamboree is a Day of Service. Split the 35,000 Scouts and leaders into 5 groups and each day 7,000 go out to the surrounding 9 counties and perform about 8 hours each of community service: works out to 280,000 hours of service

 

[EMDispatch]

large-scale camping events and civil war reenactments have more need. Those wool uniforms...

Been there... and been treated before. The good thing is most guys get very good at reading their bodies after being out in that gear a few times. I;ve also get to witness some pretty ugly trauma out there too.

Our county hosts a large triathlon in generally low populated area. It's been handled in past years with 2 assigned ALS units and Volunteer Fire staffing cooling and general aid stations, as well as the water rescue component.

It's gotten bigger in the past few years, and is now an ironman qualifier event. This past year I believe we dedicated 2 ALS units to the scene, plus 3 that were able to respond along the route as needed. We were able to borrow a heavy duty MCI trailer from a neighboring county which even had an OR setup. We were able to get a medical reserve corps to man the tent. We also had a command post with a dedicated dispatcher, as well as a large number of sheriff deputies, and the volunteer fire departments at cooling and aid stations.

We also have a powerboat race series, but the group provides most of their own rescue services. we just dedicate an ALS unit to stand-by, along with volunteer fire crews for additional rescue.