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Chapter 3 - Prediction of Medical Need and Event Risk Assessment at Mass Gathering Events

Published online by Cambridge University Press:  11 April 2024

William J. Brady
Affiliation:
University of Virginia
Mark R. Sochor
Affiliation:
University of Virginia
Paul E. Pepe
Affiliation:
Metropolitan EMS Medical Directors Global Alliance, Florida
John C. Maino II
Affiliation:
Michigan International Speedway, Brooklyn
K. Sophia Dyer
Affiliation:
Boston University Chobanian and Avedisian School of Medicine, Massachusetts
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Summary

A key aspect of preparing to offer appropriate medical care during a mass gathering is anticipating the number and severity of patient contacts, as well as the number of patients who require transport to an outside hospital. Planning for appropriate medical support is not only critical to providing care to attendees of the event but also to minimize the strain on the surrounding region. The inherent variability between events and circumstances that are unknowable prior to the event makes estimations difficult; however, several prediction models have been developed to provide estimates for the number of medical resources that an event is likely to require. This chapter first discusses the typical number of patient presentations, the required level of care, and hospital transports reported for most mass gatherings. It then provides an overview of the most important factors that influence patient volumes. Four of the most commonly used prediction models are presented and the uses and limitations are discussed. Elements of an event that may lead to significant underestimation then are explored separately. Finally, the risk of critical illness occurring at mass gathering events is considered.

Type
Chapter
Information
Mass Gathering Medicine
A Guide to the Medical Management of Large Events
, pp. 21 - 40
Publisher: Cambridge University Press
Print publication year: 2024

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References

Arbon, P. Mass-Gathering Medicine: A Review of the Evidence and Future Directions for Research. Prehospital and Disaster Medicine. 2007;22(2):131135.CrossRefGoogle ScholarPubMed
Preparedness Team. Public health for mass gatherings: key considerations [Internet]. World Health Organization; 2015 [cited September 20, 2021]. www.who.int/publications-detail-redirect/public-health-for-mass-gatherings-key-considerationsGoogle Scholar
Turris, S. A., Lund, A., Hutton, A., Bowles, R., Ellerson, E., Steenkamp, M., et al. Mass-Gathering Health Research Foundational Theory: Part 2 – Event Modeling for Mass Gatherings. Prehospital and Disaster Medicine. 2014;29(6):655663.CrossRefGoogle ScholarPubMed
Arbon, P., Bridgewater, F. H., Smith, C. Mass Gathering Medicine: A Predictive Model for Patient Presentation and Transport Rates. Prehospital and Disaster Medicine. 2001;16(3):150158.CrossRefGoogle ScholarPubMed
Locoh-Donou, S., Guofen, Y., Welcher, M., Berry, T., O’Connor, R. E., Brady, W. J. Mass-Gathering Medicine: A Descriptive Analysis of a Range of Mass-Gathering Event Types. American Journal of Emergency Medicine. 2013;31(5):843846.CrossRefGoogle ScholarPubMed
Michael, J. A., Barbera, J. A. Mass Gathering Medical Care: A Twenty-Five Year Review. Prehospital and Disaster Medicine. 1997;12(4):7279.CrossRefGoogle ScholarPubMed
Van Remoortel, H., Scheers, H., De Buck, E., Haenen, W., Vandekerckhove, P. Prediction Modelling Studies for Medical Usage Rates in Mass Gatherings: A Systematic Review. PLoS ONE [Internet]. June 23, 2020 [cited June 11, 2021];15(6). www.ncbi.nlm.nih.gov/pmc/articles/PMC7310685/Google Scholar
Maleczek, M., Rubi, S., Fohringer, C., Scheriau, G., Meyer, E., Uray, T., et al. Medical Care at a Mass Gathering Music Festival: Retrospective Study over 7 Years (2011–2017). Wien Klin Wochenschr [Internet]. April 26, 2021 [cited June 11, 2021]. https://link.springer.com/10.1007/s00508-021-01856-5CrossRefGoogle Scholar
Westrol, M. S., Koneru, S., McIntyre, N., Caruso, A. T., Arshad, F. H., Merlin, M. A. Music Genre as a Predictor of Resource Utilization at Outdoor Music Concerts. Prehospital and Disaster Medicine. 2017;32(3):289296.CrossRefGoogle ScholarPubMed
Arbon, P. The Development of Conceptual Models for Mass-Gathering Health. Prehospital and Disaster Medicine. 2004;19(3):208212.CrossRefGoogle ScholarPubMed
Baird, M. B., O’Connor, R. E., Williamson, A. L., Sojka, B., Alibertis, K., Brady, W. J. The Impact of Warm Weather on Mass Event Medical Need: A Review of the Literature. American Journal of Emergency Medicine. 2010;28(2):224229.CrossRefGoogle Scholar
Hartman, N., Williamson, A., Sojka, B., Alibertis, K., Sidebottom, M., Berry, T., et al. Predicting Resource Use at Mass Gatherings Using a Simplified Stratification Scoring Model. American Journal of Emergency Medicine. 2009;27(3):337343.CrossRefGoogle ScholarPubMed
The Event Safety Guide: A Guide to Health, Safety and Welfare at Music and Similar Events. 2nd ed. Norwich: HSE Books; 1999. 218 p.Google Scholar
Milsten, A. M., Seaman, K. G., Liu, P., Bissell, R. A., Maguire, B. J. Variables Influencing Medical Usage Rates, Injury Patterns, and Levels of Care for Mass Gatherings. Prehospital and Disaster Medicine. 2003;18(4):334346.CrossRefGoogle ScholarPubMed
Zeitz, K. M., Schneider, D. P. A., Jarrett, D., Zeitz, C. J. Mass Gathering Events: Retrospective Analysis of Patient Presentations over Seven Years. Prehospital and Disaster Medicine. 2002;17(3):147150.CrossRefGoogle ScholarPubMed
Anikeeva, O., Arbon, P., Zeitz, K., Bottema, M., Lund, A., Turris, S., et al. Patient Presentation Trends at 15 Mass-Gathering Events in South Australia. Prehospital and Disaster Medicine. 2018;33(4):368374.CrossRefGoogle ScholarPubMed
Arbon, P., Bottema, M., Zeitz, K., Lund, A., Turris, S., Anikeeva, O., et al. Nonlinear Modelling for Predicting Patient Presentation Rates for Mass Gatherings. Prehospital and Disaster Medicine. 2018;33(4):362367.CrossRefGoogle ScholarPubMed
Bortolin, M., Ulla, M., Bono, A., Ferreri, E., Tomatis, M., Sgambetterra, S. Holy Shroud Exhibition 2010: Health Services During a 40-Day Mass-Gathering Event. Prehospital and Disaster Medicine. 2013;28(3):239244.CrossRefGoogle ScholarPubMed
Burdick, T. E. Wilderness Event Medicine: Planning for Mass Gatherings in Remote Areas. Travel Medicine and Infectious Disease. 2005;3(4):249258.CrossRefGoogle ScholarPubMed
Alquthami, A. H., Pines, J. M. A Systematic Review of Noncommunicable Health Issues in Mass Gatherings. Prehospital and Disaster Medicine. 2014;29(2):167175.CrossRefGoogle ScholarPubMed
Ranse, J., Hutton, A., Keene, T., Lenson, S., Luther, M., Bost, N., et al. Health Service Impact from Mass Gatherings: A Systematic Literature Review. Prehospital and Disaster Medicine. 2017;32(1):7177.CrossRefGoogle ScholarPubMed
Burton, J. O., Corry, S. J., Lewis, G., Priestman, W. S. Differences in Medical Care Usage Between Two Mass-Gathering Sporting Events. Prehospital and Disaster Medicine. 2012;27(5):458462.CrossRefGoogle ScholarPubMed
Goldberg, S. A., Maggin, J., Molloy, M. S., Baker, O., Sarin, R., Kelleher, M., et al. The Gillette Stadium Experience: A Retrospective Review of Mass Gathering Events from 2010 to 2015. Disaster Medicine and Public Health Preparedness. 2018;12(6):752758.CrossRefGoogle ScholarPubMed
Krul, J., Sanou, B., Swart, E. L., Girbes, A. R. J. Medical Care at Mass Gatherings: Emergency Medical Services at Large-Scale Rave Events. Prehospital and Disaster Medicine. 2012;27(1):7174.CrossRefGoogle ScholarPubMed
Woodall, J., Watt, K., Walker, D., Tippett, V., Enraght-Moony, E., Bertolo, C., et al. Planning Volunteer Responses to Low-Volume Mass Gatherings: Do Event Characteristics Predict Patient Workload? Prehospital and Disaster Medicine. 2010;25(5):442448.CrossRefGoogle ScholarPubMed
Bossarte, R. M., Sullivent, E. E., Sinclair, J., Bixler, D., Simon, T. R., Swahn, M. H., et al. Injury, Violence, and Risk Among Participants in a Mass Gathering of the Rainbow Family of Living Light. Journal of Health Care for the Poor and Underserved. 2008;19(2):588595.CrossRefGoogle Scholar
Sanders, A. B., Criss, E., Steckl, P., Meislin, H. W., Raife, J., Allen, D. An Analysis of Medical Care at Mass Gatherings. Annals of Emergency Medicine. 1986;15(5):515519.CrossRefGoogle ScholarPubMed
Locoh-Donou, S., Yan, G., Berry, T., O’Connor, R., Sochor, M., Charlton, N., et al. Mass Gathering Medicine: Event Factors Predicting Patient Presentation Rates. Internal and Emergency Medicine. 2016;11(5):745752.CrossRefGoogle ScholarPubMed
Dutch, M. J., Senini, L. M., Taylor, D. J. Mass Gathering Medicine: The Melbourne 2006 Commonwealth Games Experience. Emergency Medicine Australasia. 2008;20(3):228233.CrossRefGoogle ScholarPubMed
Feldman, M. J., Lukins, J. L., Verbeek, R. P., MacDonald, R. D., Burgess, R. J., Schwartz, B. Half-a-Million Strong: The Emergency Medical Services Response to a Single-Day, Mass-Gathering Event. Prehospital and Disaster Medicine. 2004;19(4):287296.CrossRefGoogle ScholarPubMed
Grange, J. T., Baumann, G. W., Vaezazizi, R. On-Site Physicians Reduce Ambulance Transports at Mass Gatherings. Prehospital Emerg Care Off J Natl Assoc EMS Physicians Natl Assoc State EMS Dir. 2003;7(3):322326.Google ScholarPubMed
Hutton, A., Ranse, J., Verdonk, N., Ullah, S., Arbon, P. Understanding the Characteristics of Patient Presentations of Young People at Outdoor Music Festivals. Prehospital and Disaster Medicine. 2014;29(2):160666.CrossRefGoogle ScholarPubMed
Varon, J., Fromm, R. E., Chanin, K., Filbin, M., Vutpakdi, K. Critical Illness at Mass Gatherings Is Uncommon. Journal of Emergency Medicine. 2003;25(4):409413.CrossRefGoogle ScholarPubMed
Chang, W.-H., Chang, K.-S., Huang, C.-S., Huang, M.-Y., Chien, D., Tsai, C.-H. Mass Gathering Emergency Medicine: A Review of the Taiwan Experience of Long-Distance Swimming Across Sun-Moon Lake. International Journal of Gerontology. 2010; 4(2):5368. https://doi.org/10.1016/S1873-9598(10)70025-9.CrossRefGoogle Scholar
Morimura, N., Katsumi, A., Koido, Y., Sugimoto, K., Fuse, A., Asai, Y., et al. Analysis of Patient Load Data from the 2002 FIFA World Cup Korea/Japan. Prehospital and Disaster Medicine. 2004;19(3):278284.CrossRefGoogle ScholarPubMed
Steffen, R., Bouchama, A., Johansson, A., Dvorak, J., Isla, N., Smallwood, C., et al. Non-Communicable Health Risks During Mass Gatherings. Lancet Infectious Diseases. 2012;12(2):142149.CrossRefGoogle ScholarPubMed
Bullock, M., Ranse, J., Hutton, A. Impact of Patients Presenting with Alcohol and/or Drug Intoxication on In-Event Health Care Services at Mass-Gathering Events: An Integrative Literature Review. Prehospital and Disaster Medicine. 2018;33(5):539542.CrossRefGoogle ScholarPubMed
McQueen, C. P. Care of Children at a Large Outdoor Music Festival in the United Kingdom. Prehospital and Disaster Medicine. 2010;25(3):223226.CrossRefGoogle Scholar
Thierbach, A. R., Wolcke, B. B., Piepho, T., Maybauer, M., Huth, R. Medical Support for Children’s Mass Gatherings. Prehospital and Disaster Medicine. 2003;18(1):1419.CrossRefGoogle ScholarPubMed
Hutton, A., Ranse, J., Zimmerman, P.-A. Rethinking Mass-Gathering Domains for Understanding Patient Presentations: A Discussion Paper. Prehospital and Disaster Medicine. 2021;36(1):121124.CrossRefGoogle ScholarPubMed
Bowdish, G. E., Cordell, W. H., Bock, H. C., Vukov, L. F. Using Regression Analysis to Predict Emergency Patient Volume at the Indianapolis 500 Mile Race. Annals of Emergency Medicine. 1992;21(10):12001203.CrossRefGoogle ScholarPubMed
Johansson, A., Helbing, D., Al-Abideen, H. Z., Al-Bosta, S. From Crowd Dynamics to Crowd Safety: A Video-Based Analysis. Advances in Complex Systems. 2008;11(04):497527.CrossRefGoogle Scholar
Khademipour, G., Nakhaee, N., Anari, S. M. S., Sadeghi, M., Ebrahimnejad, H., Sheikhbardsiri, H. Crowd Simulations and Determining the Critical Density Point of Emergency Situations. Disaster Medicine and Public Health Preparedness. 2017;11(6):674680.CrossRefGoogle ScholarPubMed
Kman, N. E., Russell, G. B., Bozeman, W. P., Ehrman, K., Winslow, J. Derivation of a Formula to Predict Patient Volume Based on Temperature at College Football Games. Prehospital Emergency Care. 2007;11(4):453457.CrossRefGoogle ScholarPubMed
Perron, A. D., Brady, W. J., Custalow, C. B., Johnson, D. M. Association of Heat Index and Patient Volume at a Mass Gathering Event. Prehospital Emerg Care Off J Natl Assoc EMS Physicians Natl Assoc State EMS Dir. 2005;9(1):4952.Google Scholar
Selig, B., Hastings, M., Cannon, C., Allin, D., Klaus, S., Diaz, F. J. Effect of Weather on Medical Patient Volume at Kansas Speedway Mass Gatherings. Journal of Emergency Nursing. 2013;39(4):e3944.CrossRefGoogle ScholarPubMed
Van Remoortel, H., Scheers, H., De Buck, E., Haenen, W., Vandekerckhove, P. Prediction Modelling Studies for Medical Usage Rates in Mass Gatherings: A Systematic Review. PLoS ONE [Internet]. June 23, 2020 [cited June 11, 2021];15(6). www.ncbi.nlm.nih.gov/pmc/articles/PMC7310685/CrossRefGoogle ScholarPubMed
Hutton, A., Munn, M. B., White, S., Kara, P., Ranse, J. Does the Presence of On-Site Medical Services at Outdoor Music Festivals Affect Attendees’ Planned Alcohol and Recreational Drug Use? Prehospital and Disaster Medicine. 202;36(4):403407.CrossRefGoogle Scholar
Milsten, A. M., Maguire, B. J., Bissell, R. A., Seaman, K. G. Mass-Gathering Medical Care: A Review of the Literature. Prehospital and Disaster Medicine. 2002;17(3):151162.CrossRefGoogle ScholarPubMed
Grange, J. T., Green, S. M., Downs, W. Concert Medicine: Spectrum of Medical Problems Encountered at 405 Major Concerts. Academic Emergency Medicine. 1999;6(3):202207.CrossRefGoogle ScholarPubMed
Smith, W. P., Tuffin, H., Stratton, S. J., Wallis, L. A. Validation of a Modified Medical Resource Model for Mass Gatherings. Prehospital and Disaster Medicine. 2013;28(1):1622.CrossRefGoogle ScholarPubMed
Bledsoe, B., Songer, P., Buchanan, K., Westin, J., Hodnick, R., Gorosh, L. Burning Man 2011: Mass Gathering Medical Care in an Austere Environment. Prehospital Emerg Care Off J Natl Assoc EMS Physicians Natl Assoc State EMS Dir. 2012;16(4):469476.Google Scholar
Gutman, S. J., Lund, A., Turris, S. A. Medical Support for the 2009 World Police and Fire Games: A Descriptive Analysis of a Large-Scale Participation Event and Its Impact. Prehospital and Disaster Medicine. 2011;26(1):3339.CrossRefGoogle Scholar
Lund, A., Turris, S. A. Mass-gathering Medicine: Risks and Patient Presentations at a 2-Day Electronic Dance Music Event. Prehospital and Disaster Medicine. 2015;30(3):271278.CrossRefGoogle Scholar
Lange, R. A., Hillis, L. D. Cardiovascular Complications of Cocaine Use [Internet]. http://dx.doi.org/10.1056/NEJM200108023450507. Massachusetts Medical Society; 2009 [cited December 8, 2021]. www.nejm.org/doi/10.1056/NEJM200108023450507Google Scholar
Evans, C. Alcohol, Violence and Aggression. Br J Alcohol Alcohol. 1980;15:104117.Google Scholar
Anthenien, A. M., Fredrickson, G., Riggs, N. R., Conner, B. T., Jurica, J., Neighbors, C. Tailgating Protective Behavioral Strategies Mediate the Effects of Positive Alcohol Outcome Expectancies on Game Day Drinking. Journal of Primary Prevention. 2019;40(3):357365.CrossRefGoogle ScholarPubMed
Puryer, J., Wignall, R. Tobacco, , Alcohol and Drug Use among Dental Undergraduates at One UK University in 2015. Dentistry Journal. 2016;4(1):2.CrossRefGoogle ScholarPubMed
Lim, M. S. C., Hellard, M. E., Hocking, J. S., Spelman, T. D., Aitken, C. K. Surveillance of Drug Use Among Young People Attending a Music Festival in Australia, 2005–2008. Drug and Alcohol Review. 2010;29(2):150156.CrossRefGoogle ScholarPubMed
Bahora, M., Sterk, C. E., Elifson, K. W. Understanding Recreational Ecstasy Use in the United States: A Qualitative Inquiry. International Journal of Drug Policy. 2009;20(1):6269.CrossRefGoogle ScholarPubMed
Friedman, M. S., Plocki, A., Likourezos, A., Pushkar, I., Bazos, A. N., Fromm, C., et al. A Prospective Analysis of Patients Presenting for Medical Attention at a Large Electronic Dance Music Festival. Prehospital and Disaster Medicine. 2017;32(1):7882.CrossRefGoogle Scholar
Lu, T. S., Flaherty, G. T. Tuning into the Travel Health Risks of Music Tourism. Journal of Travel Medicine [Internet]. January 1, 2018 [cited November 4, 2021];25(1). Available from: https://academic.oup.com/jtm/article/doi/10.1093/jtm/tay106/5139594Google Scholar
DeMott, J. M., Hebert, C. L., Novak, M., Mahmood, S., Peksa, G. D. Characteristics and Resource Utilization of Patients Presenting to the ED from Mass Gathering Events. American Journal of Emergency Medicine. 2018;36(6):983987.CrossRefGoogle Scholar
Turris, S. A., Lund, A. Mortality at Music Festivals: Academic and Grey Literature for Case Finding. Prehospital and Disaster Medicine. 2017;32(1):5863.CrossRefGoogle ScholarPubMed
FitzGibbon, K. M., Nable, J. V., Ayd, B., Lawner, B. J., Comer, A. C., Lichenstein, R., et al. Mass-Gathering Medical Care in Electronic Dance Music Festivals. Prehospital and Disaster Medicine. 2017;32(5):563567.CrossRefGoogle ScholarPubMed
Spaepen, K., Haenen, W. A., Kaufman, L., Beens, K., Vandekerckhove, P., Hubloue, I. Validation of a Belgian Prediction Model for Patient Encounters at Music Mass Gatherings. Prehospital and Disaster Medicine. 2020;35(5):561566.CrossRefGoogle ScholarPubMed
Zeitz, K. M., Zeitz, C. J., Arbon, P. Forecasting Medical Work at Mass-Gathering Events: Predictive Model Versus Retrospective Review. Prehospital and Disaster Medicine. 2005;20(3):164168.CrossRefGoogle ScholarPubMed
Nable, J. V., Margolis, A. M., Lawner, B. J., Hirshon, J. M., Perricone, A. J., Galvagno, S. M., et al. Comparison of Prediction Models for Use of Medical Resources at Urban Auto-racing Events. Prehospital and Disaster Medicine. 2014;29(6):608613.CrossRefGoogle ScholarPubMed
Spaepen, K., Haenen, W. A., Hubloue, I. The Development of PRIMA – A Belgian Prediction Model for Patient Encounters at Mass Gatherings. Prehospital and Disaster Medicine. 2020;35(5):554560.CrossRefGoogle Scholar
Smith, W. P., Wessels, V., Naicker, D., Leuenberger, E., Fuhri, P., Wallis, L. A. Development of a Mass-Gathering Medical Resource Matrix for a Developing World Scenario. Prehospital and Disaster Medicine. 2010;25(6):547552.CrossRefGoogle ScholarPubMed
Allgaier, R. L., Shaafi-Kabiri, N., Romney, C. A., Wallis, L. A., Burke, J. J., Bhangu, J., et al. Use of Predictive Modeling to Plan for Special Event Medical Care During Mass Gathering Events. Disaster Medicine and Public Health Preparedness. 2019;13(5–6):874879.CrossRefGoogle ScholarPubMed
NAEMSP. Mass Gathering Medical Care. Prehospital Emergency Care. 2015;19(4):558568.Google Scholar
Lund, A., Turris, S. A., Wang, P., Mui, J., Lewis, K., Gutman, S. J. An Analysis of Patient Presentations at a 2-Day Mass-Participation Cycling Event: The Ride to Conquer Cancer Case Series, 2010–2012. Prehospital and Disaster Medicine. 2014;29(4):429436.CrossRefGoogle Scholar
Hodgetts, T. J., Cooke, M. W. The Largest Mass Gathering: Medical Cover for Millennium Celebrations Needs Careful Planning. BMJ. 1999;318(7189):957958.CrossRefGoogle Scholar
Ounanian, L. L., Salinas, C., Shear, C. L., Rodney, W. M. Medical Care at the 1982 US Festival. Annals of Emergency Medicine. 1986;15(5):520527.CrossRefGoogle ScholarPubMed
Zeitz, K., Zeitz, C., Kadow-Griffin, C. Injury Occurrences at a Mass Gathering Event. Australasian Journal of Paramedicine [Internet]. 2005 [cited December 3, 2021];3(1). https://ajp.paramedics.org/index.php/ajp/article/view/307CrossRefGoogle Scholar
Krul, J., Girbes, A. R. J. Experience of Health-Related Problems During House Parties in the Netherlands: Nine Years of Experience and Three Million Visitors. Prehospital and Disaster Medicine. 2009;24(2):133139.CrossRefGoogle ScholarPubMed
Ridpath, A., Driver, C. R., Nolan, M. L., Karpati, A., Kass, D., Paone, D., et al. Illnesses and Deaths Among Persons Attending an Electronic Dance-Music Festival – New York City, 2013. MMWR (Morbidity and Mortality Weekly Report). 2014;63(50):11951198.Google ScholarPubMed
Dijkstra, B. A. G., Beurmanjer, H., Goudriaan, A. E., Schellekens, A. F. A., Joosten, E. A. G. Unity in Diversity: A Systematic Review on the GHB Using Population. International Journal of Drug Policy. 2021;94:103230.CrossRefGoogle ScholarPubMed
Dutch, M. J., Austin, K. B. Hospital in the Field: Prehospital Management of GHB Intoxication by Medical Assistance Teams. Prehospital and Disaster Medicine. 2012;27(5):463467.CrossRefGoogle ScholarPubMed
Caldicott, D. G. E., Chow, F. Y., Burns, B. J., Felgate, P. D., Byard, R. W. Fatalities Associated with the Use of Gamma-Hydroxybutyrate and Its Analogues in Australasia. Medical Journal of Australia. 2004;181(6):310313.CrossRefGoogle ScholarPubMed
Milsten, A. M., Tennyson, J., Weisberg, S. Retrospective Analysis of Mosh-Pit-Related Injuries. Prehospital and Disaster Medicine. 2017;32(6):636641.CrossRefGoogle ScholarPubMed
Kahn-Harris, K. Extreme Metal: Music and Culture on the Edge. Oxford: Berg; 2006. 204 p.Google Scholar
Janchar, T., Samaddar, C., Milzman, D. The Mosh Pit Experience: Emergency Medical Care for Concert Injuries. American Journal of Emergency Medicine. 2000;18(1):6263.CrossRefGoogle ScholarPubMed
Laskowski-Jones, L., Caudell, M. J., Hawkins, S. C., Jones, L. J., Dymond, C. A., Cushing, T., et al. Extreme Event Medicine: Considerations for the Organisation of Out-of-Hospital Care During Obstacle, Adventure and Endurance Competitions. Emergency Medical Journal. 2017;34(10):680685.CrossRefGoogle ScholarPubMed
Weaver, W. D., Sutherland, K., Wirkus, M. J., Bachman, R. Emergency Medical Care Requirements for Large Public Assemblies and a New Strategy for Managing Cardiac Arrest in This Setting. Annals of Emergency Medicine. 1989;18(2):155160.CrossRefGoogle Scholar
Wassertheil, J., Keane, G., Fisher, N., Leditschke, J. F. Cardiac Arrest Outcomes at the Melbourne Cricket Ground and Shrine of Remembrance Using a Tiered Response Strategy: A Forerunner to Public Access Defibrillation. Resuscitation. 2000;44(2):97104.CrossRefGoogle Scholar
Weisfeldt, M. L., Becker, L. B. Resuscitation After Cardiac Arrest: A 3-Phase Time-Sensitive Model. JAMA. 2002;288(23):30353038.CrossRefGoogle ScholarPubMed
Luiz, T., Kumpch, M., Metzger, M., Madler, C. Management of Cardiac Arrest in a German Soccer Stadium. Anaesthesist. 2005;54(9):914922.CrossRefGoogle Scholar
Shirah, B. H., Al Nozha, F. A., Zafar, S. H., Kalumian, H. M. Mass Gathering Medicine (Hajj Pilgrimage in Saudi Arabia): The Outcome of Cardiopulmonary Resuscitation during Hajj. Journal of Epidemiology and Global Health. 2019;9(1):7175.CrossRefGoogle ScholarPubMed
Hewitt, S., Jarrett, L., Winter, B. Emergency Medicine at a Large Rock Festival. Emergency Medicine Journal. 1996;13(1):2627.CrossRefGoogle Scholar
Madzimbamuto, F. D., Madamombe, T. Traumatic Asphyxia During Stadium Stampede. 2004 [cited December 9, 2021]; https://opendocs.ids.ac.uk/opendocs/handle/20.500.12413/6305Google Scholar
Hsieh, Y.-H., Ngai, K. M., Burkle, F. M., Hsu, E. B. Epidemiological Characteristics of Human Stampedes. Disaster Medicine and Public Health Preparedness. 2009;3(4):217223.CrossRefGoogle ScholarPubMed

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