Chapter 10 Crowded Health

Abstract

Crowds carry real health risks. By definition, crowds bring large numbers of people in to close proximity and confined spaces. The risk of injury is real, due to accident, crush or malice and the medical risk of disease transmission and demographic-specific presentations must also be considered. Selecting health service providers is a key early decision. Consulting with local ambulance and health services to build relationships and to seek advice on local providers, legislative requirements and existing health system capacity is time well spent. It is critical that the provider(s) chosen have the skills, resources and experience to service the event and predictable escalation. Pre-hospital health service provision is a niche industry and is variably regulated. The accumulation of clinical, command and logistical experience takes many years and is a truly heuristic process. A tiered service delivery model, discussed further below, should be adopted with centralized call-taking and management of resources. Finalizing the size, scope and cost of this model can be a time-consuming and stressful process. This will be informed by the health risk assessment, with mitigation strategies according to ALARP principles, although high consequence outcomes (long tail risks) like cardiac arrest and major trauma will require additional resources.