Mass Gathering Medicine: A Guide to the Medical Management of Large Events

Book Title: Mass Gathering Medicine: A Guide to the Medical Management of Large Events

Editors: William J. Brady, Mark R. Sochor, Paul E. Pepe, John C. Maino II, K. Sophia Dyer

Publication Details: Cambridge University Press, 2024, 436 pp., $115.00

Mass gathering medicine is more than simply parking an ambulance and its crew at the field for the big game. Mass gatherings have the potential to strain local resources, including public safety and the health care system, even under the best of circumstances and more so when things go awry such as at the Boston Marathon or the Duisberg Love Parade music festival. ^{1, 2} William J. Brady and colleagues have produced the first textbook specifically addressing the nuances that mass gatherings bring to medicine and public health. They have been quite successful in their endeavor! Beginning with a brief history of the development of mass gathering medicine as a philosophy and practice, they move on to an overview of the levels of clinical care required for mass gatherings and the overall coordination within other aspects of the event.

Several chapters are devoted to planning the medical presence, including assessing risks, staffing, anticipating equipment needs, and managing other logistical needs. The authors provide numerous very useful worksheets, tables, and calculators to aid in this planning. While some of these tools are duplicated in different chapters, the redundancy is appropriate. Potential local, state, and federal resources to aid in successfully preparing for (and responding to) mass gatherings are the topic of one chapter, and another presents a valuable tutorial on the Incident Command System, the means by which multiple agencies and resources are coordinated in responding to complex situations.

After laying the common foundation of mass gathering medicine, additional chapters are devoted to specific types of mass gatherings. Sporting events (including motor sports), music concerts, VIP gatherings, political gatherings, religious gatherings, and other community events all get their close-up look. The needs of special populations (including children, women, the elderly, and the disabled) are addressed within the CMIST Framework (Communication, Maintaining health, Independence, Support/safety, and Transportation).

Potential extenuating circumstances are addressed. Climate and severe weather, civil unrest, terrorism, crowd dynamics, mass casualty events, infectious disease, and toxicology all have the potential to change the medical needs of a mass gathering. Each of these is well-addressed within this volume. Finally, more mundane but essential logistical considerations are included: medicolegal and financial/business issues each have their own chapter.

Though this volume has more than 60 contributors to its 27 chapters, it reads as a unified whole—a real strength of this first-on-the-topic book. The authorship is very heavily weighted toward those specialized in emergency medicine, and thus very limited in its discussion of continuity of care and aftercare of individuals whose health has been affected as a result of their presence at the gathering. That is the most significant limitation of this offering; perhaps the next edition will extend the content to include this aspect of mass gathering medicine.

Family physicians, especially in rural areas, are often tapped to offer aid at mass gatherings in their community, whether the local high school football game, the county fair, or the town’s festival. Generally, such involvement is reactive, not proactive. While not a Superbowl or political convention, engagement of the physician earlier in the planning phase of these events could improve the efficiency and efficacy of the provision of care that might be needed. This book offers guidance for organizing and providing better care, and effectively advising event organizers and others in leadership during the planning phase of the mass gathering.