Emergency medical services (EMS) responses tomass gatherings have been described frequently,but there are few reports describing the responseto a single-day gathering of large magnitude.

This report describes the EMS response to thelargest single-day, ticketed concert held in NorthAmerica: the 2003 “Toronto Rocks!” Rolling StonesConcert.

Medical care was provided by paramedics,physicians, and nurses. Care sites includedambulances, medically equipped, all-terrainvehicles, bicycle paramedic units, first-aidtents, and a 124-bed medical facility thatincluded a field hospital and a rehydration unit.Records from the first-aid tents, ambulances,paramedic teams, and rehydration unit wereobtained. Data abstracted included patientdemographics, chief complaint, time of incident,treatment, and disposition.

More than 450,000 people attended the concert and1,870 sought medical care (42/10,000 attendees).No record was kept for the 665 attendees simplyrequesting water, sunscreen, or bandages. Of theremaining 1,205 patients, the average of the ageswas 28 ±11 years, and 61% were female.Seven-hundred, ninety-five patients (66%) werecared for at one of the first-aid tents.Physicians at the tents assisted in patientmanagement and disposition when crowds restrictedambulance movement. Common complaints includedheadache (321 patients; 27%), heat-relatedcomplaints (148; 12%), nausea or vomiting (91;7.6%), musculoskeletal complaints (83; 6.9%), andbreathing problems (79; 6.6%). Peak activityoccurred between 14:00 and 19:00 hours, when 102patients per hour sought medical attention.Twenty-four patients (0.5/10,000) were transferredto off-site hospitals.

This report on the EMS response, outcomes, androle of the physicians at a large single-day massgathering may assist EMS planners at futureevents.