One of the hardest aspects of planning Event Medical Services is deciding on the resources to have onsite. Scheduling too little will result in you being overrun with patients and delivering a poor level of service. Schedule too many and you will find providers appearing to be doing nothing but trip over one another while earning you a reputation for excess in an environment where financial success is paramount. There needs to be a balance found between the two, and finding it begins with the initial Resource Recommendation.
In order to develop an initial Resource Recommendation, I came up with the following charts to establish base levels from the overall score on the Event Risk Assessment. The Resource Recommendations are derived from experience while also keeping in mind the New York State Part 18 Requirements. Because New York is my home state in my planning I have to maintain compliance with the minimums required. I also have to remember that, while well intentioned, Part 18 was developed in the 1970s in response to the original Woodstock. Since that time we have seen an increase in the utilization of the Emergency Medical Services and, subsequently, the need for Event Medical Services has also increased. The Part 18 requirements only takes one(1) variable of attendance into consideration for an event, but that has become wholly inadequate in today’s environment.
While these Resource Recommendation Charts take into account the Event Risk Assessment and it’s fourteen (14) variables, it is important to understand that this is a guideline that I use to create a base staffing plan. Resources can increase and decrease as other more specific risks are identified, event timelines are taken into account, and other factors come into focus.
Very Low Risk
For the Very Low Risk Events, such as corporate functions and church picnics, a single EMT with response equipment will often suffice. As attendance grows, so do onsite resources with the tipping point being the 10,000 attendee threshold. Once attendance goes beyond that point, deployment ups itself substantially but not to excess. The majority of the issues will be able to be handled at the Basic Life Support level, which is why there is no indication for Advanced Life Support until you reach the 35,000 attendee threshold.
Low Risk Events, your typical street fair or large calm gathering, are another example of taking a minimalist approach until the 10,000 attendee threshold. Although the risk is still Low comparatively, Advanced Life Support is brought in once the attendee tipping point is reached. Because the event is still a Low Risk, the event can generally be maintained with only two ambulances up to the 35,000 attendee mark.
The Medium Risk Events will (hopefully) be where you find most of your events categorized under. Professional sporting events in stadiums and arenas will most often fall under this category. An important side note to this is that the recommended levels encompass the venue and the attendees, not the actual participants of the sport being played. There are differing requirements for medical coverage amongst the professional organizations of Major League Baseball (MLB), National Basketball Association (NBA), National Hockey League (NHL), National Football League (NFL), Major League Soccer (MLS), and the United States Tennis Association (USTA). It is important to understand what each organization requires and, although those resources will still operate under your oversight, not include them when staffing for the rest of the event.
High Risk Events is often where you will find your music concerts and festivals falling under and occasionally a sporting event when there is a known and historic rivalry with the opposing team or some sort of playoff/championship event. Transports are more than likely for these types of events, which is why regardless of attendee population the recommendation starts with an ambulance onsite. This rated event is also where I begin including the EMS Information Officer in the recommendation. Although I will have more on this role later, it is important to understand that this is NOT a traditional Public Information Officer. In essence, this is the person pulling together the numbers from throughout the venue to provide the supervisory staff the “big picture” of how things are progressing. The information they collect is NOT for the public.
Very High Risk
Events categorized as Very High Risk have been rated that way for a few reasons. The most common events I have categorized under this rating are music festivals with numerous acts, poor infrastructure, and a culture that partakes heavily in uncontrolled and illegal substances. In other words, most outdoor concerts and every Electronic Dance Music (EDM) genre show fall under here. There will be medical calls, there will be transports, there will be surges of patients that will undoubtedly put your personnel and your planning to the test. Once again, please remember that this is just base numbers of what would be in the Initial Recommendation. For that matter, I’ll usually double the base numbers for an EDM show and may even triple it depending on the intelligence gathered on the lineup.
It’s A Start
Having an initial Resource Recommendation is a good start, but there are other things that will affect what becomes our Final Resource Recommendation. We’ll talk about some of those Special Considerations next, and how it changes what we are going to put into the Event Medical Plan.