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Chapter 19 - Crowd-Related Considerations at Mass Gathering Events: Management, Safety, and Dynamics
- Edited by William J. Brady, University of Virginia, Mark R. Sochor, University of Virginia, Paul E. Pepe, Metropolitan EMS Medical Directors Global Alliance, Florida, John C. Maino II, Michigan International Speedway, Brooklyn, K. Sophia Dyer, Boston University Chobanian and Avedisian School of Medicine, Massachusetts
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- Book:
- Mass Gathering Medicine
- Published online:
- 11 April 2024
- Print publication:
- 18 April 2024, pp 268-283
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- Chapter
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Summary
Providing medical care during a mass event requires important situational awareness and preparation. Significant planning and relationship building provides a foundation for creating an operational outline, and establishing crowd dynamics and expectations for related medical activities. Collaboration with stakeholders will provide insight into the operations of various other event management entities, and allows for more seamless operations during the event. Once an operational plan has been established and circulated, the event medical team can be prepared for the expected external and crowd conditions and respond appropriately, while maintaining vigilance for any emergency that may arise. Contingency planning is key for the medical team to have appropriate emergency response defaults. Special attention is also needed on communications strategies for real-time intel, information dissemination, and crowd management. Once the event reaches its end, it is important to establish stand-down procedures to be followed as the crowd disperses to ensure an orderly event closure. After action reports can provide valuable insights for future crowd management.
Evaluation of Hospitals’ Disaster Preparedness Plans in the Holy City of Makkah (Mecca): A Cross-Sectional Observation Study
- Ali S. Al-Shareef, Loui K. Alsulimani, Hattan M. Bojan, Taha M. Masri, Jennifer O. Grimes, Michael S. Molloy, Gregory R. Ciottone
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- Journal:
- Prehospital and Disaster Medicine / Volume 32 / Issue 1 / February 2017
- Published online by Cambridge University Press:
- 14 December 2016, pp. 33-45
- Print publication:
- February 2017
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- Article
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Background
Makkah (Mecca) is a holy city located in the western region of the Kingdom of Saudi Arabia. Each year, millions of pilgrims visit Makkah. These numbers impact both routine health care delivery and disaster response. This study aimed to evaluate hospitals’ disaster plans in the city of Makkah.
MethodsStudy investigators administered a questionnaire survey to 17 hospitals in the city of Makkah. Data on hospital characteristics and three key domains of disaster plans (general evaluation of disaster planning, structural feasibility of the hospitals, and health care worker knowledge and training) were collated and analyzed.
ResultsA response rate of 82% (n=14) was attained. Ten (71%) of the hospitals were government hospitals, whereas four were private hospitals. Eleven (79%) hospitals had a capacity of less than 300 beds.
Only nine (64%) hospitals reviewed their disaster plan within the preceding two years. Nine (64%) respondents were drilling for disasters at least twice per year. The majority of hospitals did not rely on a hazard vulnerability analysis (HVA) to develop their Emergency Operations Plan. Eleven (79%) hospitals had the Hospital Incident Command Systems (HICS) present in their plans.
All hospitals described availability of some supplies required for the first 24 hours of a disaster response, such as: N95 masks, antidotes for nerve agents, and antiviral medications. Only five (36%) hospitals had a designated decontamination area. Nine (64%) hospitals reported ability to re-designate inpatient wards into an intensive care unit (ICU) format. Only seven (50%) respondents had a protocol for increasing availability of isolation rooms to prevent the spread of airborne infection. Ten (71%) hospitals had a designated disaster-training program for health care workers.
ConclusionsMakkah has experienced multiple disaster incidents over the last decade. The present research suggests that Makkah hospitals are insufficiently prepared for potential future disasters. This may represent a considerable threat to the health of both residents and visitors to Makkah. This study demonstrated that there is significant room for improvement in most aspects of hospital Emergency Operations Plans, in particular: reviewing the plan and increasing the frequency of multi-agency and multi-hospital drills. Preparedness for terrorism utilizing chemical, biologic, radiation, nuclear, explosion (CBRNE) and infectious diseases was found to be sub-optimal and should be assessed further.
,Al-Shareef AS ,Alsulimani LK ,Bojan HM ,Masri TM ,Grimes JO ,Molloy MS .Ciottone GR Evaluation of Hospitals’ Disaster Preparedness Plans in the Holy City of Makkah (Mecca): A Cross-Sectional Observation Study . Prehosp Disaster Med.2017 ;32 (1 ):33 –45 .