Royal Columbian Hospital and Eagle Ridge Hospital
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Mass Gathering Medicine Elective

Background

Dr. Sam Gutman and Dr. Adam Lund are ER physicians and are involved in organizing and providing medical care for events and mass gatherings in BC. Since 2008, residents have been participating as physicians with the medical teams for numerous events. A formal application was made to the residency program directors to participate and that application was approved.

Having recognized the value of this formal educational experience, it is our intent to offer this learning opportunity to additional resident physicians and medical students at UBC. The following outline describes both a longitudinal formal EM residency elective in Mass Gathering Medicine for FRCPC EM residents as well an opportunity for CCFP(EM) and other residents to participate. We propose that participation on the medical teams for various events be considered as equivalent to an ER shift and that EM residents receive credit toward their shift requirements and that they be excused from duty to attend these events. For non-EM residents, they be offered the opportunity to participate in these events as “electives at large” that are appropriately supervised by UBC faculty, but not specifically counted toward work requirements. Additonally, a formal longitudinal elective block in Mass Gathering Medicine be offered for EM residents as described below.

 

 

Residents: FRCPC EM and CCFP(EM)

Other residents

Preceptors: Dr. Adam Lund adamlund@gmail.com & Dr. Samuel Gutman sam@rockdoc.ca

Events:

  • BMO - Vancouver International Marathon
  • Boots & Hearts Music Festival (Ontario)
  • Deer Lake Summer Concert in the Park Series
  • Live Nation Concert Venues
  • Mudderella
  • Olympic and Paralympic Games 2010
  • Pemberton Music Festival
  • Scotia Half Marathon
  • U2 Concert - BC Place
  • Vancouver Folk Music Festival
  • Vancouver Sun Run
  • Way Home Music Festival (Ontario)
  • World Police and Fire Games

* And many more

Deliverables:

  • FRCPC EM - 15 clinical shifts would be required over 4 years to be considered as an elective block for the EM program
    • Clinical Experience - Each event is 1 - 3 days long.
    • Academic Experience - Literature review on mass gatherings with collected articles available to other residents and faculty
    • Presentation Experience – One grand rounds presentation in R4 or R5 year on the topic of mass gathering medicine.
  • CCFP(EM)- Event shifts would be credited as EM shifts and the resident would be excused from an equivalent number of hospital ER shifts.
  • Other Residents- Opportunity to participate and gain exposure to the variety of medical practice opportunities in an appropriately supervised clinical environment.

 Resources:

  1. Accommodation and/or food to be arranged between resident, preceptor and each event. Any honorarium from any event (rare) will go to resident to recoup costs
  2. Literature
    1. Grange, JT et al. “On-site Physicians Reduce Ambulance Transports at Mass Gatherings.” Prehospital Emergency Care, July 2003; 7(3):32-326.
    2. EMS and Mass Gatherings: http://www.emedicine.com/emerg/topic812.htm
    3. Varon J et al. “Critical Illness at mass gatherings is uncommon.” Journal of Emergency Medicine. 2003 Nov;25(4):463
    4. Arbon P et al. “Mass gathering medicine: a predictive model for patient presentation and transport rates.” Prehospital Disaster Med – 01-Jul-2001; 16(3): 150-8
    5. Grange, JT. “Planning for large events”. Curr Sports Med Rep – 01-Jun-2002; 1(3): 156-61
    6. Jaslow, D, et al. “Mass Gathering Medical Care: The Medical Director’s Checklist”. National Association of EMS Physicians, April 24, 2000.
    7. Equipment – provided by each event
    8. Liability – Malpractice coverage through educational umbrella as a supervised educational activity under UBC Emergency Medicine faculty, and additional liability coverage as organized by each event

Overall Goals:

At the completion of this elective experience, the learner will be able:

  • to understand what medical capabilities are required to respond effectively to mass gatherings of various sizes in a variety of locations
  • to craft/design incident specific plans for a mass gathering. This includes consideration of: staffing, equipment, triage, treatment, transport capabilities, means of communication, emergency /evacuation plans and protocols
  • to understand the responsibilities of the various leadership roles including: medical operator, triage, treatment, transport, and logistics.
  • to prepare for and anticipate potential hazards
  • to itemize what medical supplies are available, how they are obtained, stored and how they are resupplied.

Learning Objectives Specific to CanMEDS roles include:

  • Medical Expert:
    • Assess/manage common patient presentations within mass gathering situations
    • Become comfortable treating patients outside of a controlled environment, where resources and capabilities are limited. i.e. bloodwork, imaging, backup
    • Properly prioritize and triage patients
    • Identify patients requiring transfer to a hospital facility
  • Communicator:
    • Converse effectively with patients
    • Communicate effectively with colleagues as a member of the medical response team
    • Learn how medical interactions are properly documented
  • Collaborator:
    • Work effectively as part of the medical response team
    • Understand the roles of the various participants in the overall emergency response
    • Coordinate with event planners to ensure that the medical team is represented in overall event planning
  • Manager:
    • Understand triage principles in mass gathering events
    • Learn effective time management
    • Identify medicolegal issues/risks associated with medical aid in this environment and understand how it is addressed
    • Balance the “ideal needs” of the medical team with the realities of limited budgets for non-permanent infrastructure
  • Advocate:
    • Aid in preventative health initiatives at mass gathering events relevant to minimizing injury/illness
  • Professional:
    • Be a reliable, responsible and accountable member of the medical team