(P2-41) Emergency Medical Response Systems in a University Athletic Program: A Descriptive Analysis

Abstract

Background: Unpredictable environmental conditions, crowd dynamics, and a variety of acute medical emergencies create logistical and clinical obstacles when planning emergency medical response coverage for mass gathering events. Preparations must be made to cover both frequent, low acuity, as well as infrequent, high acuity medical problems, such as sudden cardiac arrest. In a collaborative endeavor between a university athletics program and an academic division of emergency medicine, emergency medical response plans were created for varied sporting events. These plans resulted in an emergency medical response system consisting of out-of-hospital and hospital-based health care providers. Study Objectives: Provide descriptive statistics relevant to the nature and frequency of injury/illness, location of treatment within stadium confines, and resources used in the care of students, event staff, and spectators during athletics venue medical operations for collegiate football and basketball, to assist in future planning and predictive modeling of resource allocation for mass-gathering events with a focus on sudden cardiac arrest. Methods: A continuously updated, quality assurance database of de-identified, aggregate statistics was utilized to analyze trends regarding aspects of medical operations. Results: During a 7-game home football and 20-game home basketball season, 465 total patient encounters occurred [15 "life-threatening" (3.23%), 134 "urgent" (28.82%), and 316 "routine" (67.96%)] with 387,528 total attendees (12 patient encounters per 10,000). Thirty-five patients were transported (0.9 per 10,000), with 14 resultant hospital admissions. Four cardiac arrests occurred during the season, (0.86% of all patients, 0.1 per 10,000). In each cardiac arrest, professional rescuers made patient contact within 2 minutes and achieved return of spontaneous circulation; survival to hospital discharge occurred in 3 of 4 patients. Remaining encounters varied by complaint, with skin (39%) comprising the largest number of encounters. Other categories included heat-related (20.6%), neurologic (12.7%), musculoskeletal (5.6%), cardiopulmonary (5.2%), gastrointestinal (3.8%), and allergic (3.2%). Encounters increased noticeably during football games when the heat index was greater than 80degreeF (29.4 vs. 10.5 per 10,000 attendees), whereas minimal variability in number of patient encounters existed for basketball games. Conclusions: The collaborative, multi-level provider model provided adequate medical support for all presenting medical conditions. Consistent with previous literature, the majority of presenting medical conditions were minor. A strong correlation existed between heat index and number of patient encounters deemed urgent and routine at foot ballgames; less variability occurred in the number of "life-threatening" encounters with heat index. Minimal variability in the number of patient encounters andacuity existed for basketball games. The cardiac arrest rate at all venues was significantly higher than previously published data. Our emergency medical response plans provided for professional rescuer response to cardiac arrests within 2 minutes of event notification, likely contributing to the high cardiac arrest survival rate. Further studies of medical presentations and resource utilization could facilitate more precise predictive modeling of future emergency medical response plans.