Preparing for a Medical Emergency

04 August 2008

The following was adapted from Risk Management for Meetings and Events (Butterworth-Heinemann, 2008) and published as a two-part series in the July and August 2008 issues of Meetings & Conventions magazine, a publication of Northstar Travel Media, LLC (http://www.mcmag.com).

Every event should be prepared to respond to a medical emergency. Deciding what level of on-site medical services should be provided by the organizer will depend on the type, nature, and size of the event, its audience, and the site. The following checklist may be useful when devising a medical emergency response plan specific to your event. Please note that these are guidelines only and should not be considered definitive advice.

General preparation

£     Confirm an organizational commitment to emergency preparedness, including the provision of the necessary resources and support

£     Conduct an event-specific risk assessment to identify hazards or vulnerabilities and expected emergency medical needs (attendee demographics, event purpose and activities, site features, etc.)

£     Consult with venue to determine their response procedures (e.g. call security) and existing on-site medical capabilities including equipment (e.g. AED quantity and locations), facilities (e.g. first aid rooms), and personnel (e.g. trained in first aid, CPR, AED use, Heimlich maneuver)

£     Liaise with local authorities (public safety, health, ambulance service, etc.) to provide details of the event and determine statutory and recommended levels and nature of on-site medical services

£     Determine the scope, nature and capabilities of external medical facilities and services including locations, response times, transport routes, and contact information

£     Make certain that the medical emergency response plan encompasses the full scope of the event, including travel and off-premise or ancillary events for attendees and move-in through move-out for event workers

Specify the scope and level of on-site medical service

£     Every event should have a designated first aid area with a fully stocked first aid kit

£     Events with fewer than 500 attendees and in close proximity to a medical facility typically do not require on-site medical personnel beyond staff member(s) trained in first aid

£     Events with an attendee population of more than 500 should consider a baseline ratio of one EMT per every 1,000 to 3,000 people

£     Events with more than 10,000 attendees should consider subcontracting a medical services organization to coordinate and oversee medical response plans

£     Events using remote, undeveloped, or under-developed sites should consider on-site ambulances or mobile medical facilities, and may need to consider aero-medical services

£     Events involving strenuous or potentially hazardous activities, at-risk attendee demographics, special circumstances or individuals (e.g. VIPs or performers), or other specific risk factors should consider on-site paramedics, registered nurses, or physicians as appropriate

£     Events with large attendee populations or expansive event sites should consider numerous medical aid posts (e.g. first aid station, room, tent, on-site ambulance, infirmary, mobile hospital)

£     Determine whether first aid personnel will be stationary or roaming (often based on crowd density or site complexity/configuration)

£     First aid personnel should be clearly identified with distinctive clothing, uniforms, badges, or other insignia

Integrate medical services and emergency response into site plan

£     Identify access and egress routes for on-call ambulances and other medical service providers; determine if routes need to be dedicated exclusively to emergency vehicles

£     Detailed grid maps of site plan, including surrounding roads and access routes, should be prepared and provided to all medical response personnel and providers

£     Determine the appropriate positioning of medical response services, typically situated on perimeter with direct access to ambulance exit route

£     Events with numerous medical aid posts should designate one as the main medical facility, typically the one nearest the event entrance or the location with the best ambulance access and capacity

£     Medical aid posts should be highly visible and rapidly accessible (within five minutes) from anywhere within the event site

£     Ensure location(s) of medical aid posts are clearly identified with signage and included on navigational or informational signage throughout the event site

£     Determine the need for special equipment or vehicles for casualty extraction and/or transport to medical aid post

£     Identify infrastructure needs such as hazardous waste disposal (clinical waste and sharps), access to utilities, or designated parking areas, sanitary facilities and rest areas for medical workers

Determine medical incident procedures

£     Ensure all event personnel know where all on-site medical services are located and how to access or contact them

£     Define the time limits and site boundaries of on-site care (e.g. during show hours, within venue and parking lot) and procedures for incidents outside these confines

£     Specify that personnel responding to an incident should immediately notify medical or other designated personnel, and only provide such aid as they are trained to do

£     An illness or injury report form should be prepared for any medical incident or contact with medical personnel, including the casualty’s contact information, the nature of the illness or how an injury occurred, and the disposition (particularly if care or treatment was refused)

£     Determine if specific records or forms must be collected to satisfy insurance providers or public health requirements (e.g. numerous cases of gastrointestinal illness could suggest contaminated food)

£     Ensure the creation and retention of all incident reports, treatment logs, and other documentation complies with medico-legal requirements and best practice confidentiality procedures

£     Post-incident procedures should be established for assisting attendees that require extended medical care or have died, including contacting family members, arranging housing or transportation, or other services

Establish communications structure and procedures

£     Include the review of medical emergency plans, procedures, and communications structure in the agenda for pre-con meetings

£     Specify roles, responsibilities, lines of authority, and unambiguous delegation of duties for all event personnel, venue personnel, and medical service providers included in the response plan

£     Establish and implement notification procedures for internal and external responders, including specification of primary contact numbers and protocols, as well as how responders will be notified of or summoned to individuals needing medical assistance

£     Specify communications equipment and protocols (e.g. two-way radios, channel designations, calls signs, etc.)

£     Define special protocols necessary for using cellular phones to call Enhanced 911 systems (e.g. providing specific locations or notifying venue of the call and imminent arrival of emergency vehicles)

£     Provide attendees with information in distinctive formats (e.g. topic-specific printed materials or emails, on-site signage, public address announcements, etc.) regarding the location of on-site medical services or the nearest hospital, and what they should do if ill or injured

£     Prepare basic public relations and other crisis communication background materials that may be used in the event of a mass casualty or severe medical incident, including designation of an official spokesperson(s) for the event organization.

£     Establish procedures that ensure patient privacy is protected within any communication mode (e.g. written, verbal, etc.).