Soomaroo Lee, Murray Virginia
Emergency Specialist Registrar in the UK, and member of the World Health Organisation/Health Protection Agency UK, Collaboration of Mass Gathering Emergency Medicine and Head of Extreme Events and Health Protection Centre for Radiation, Chemicals and Environmental Hazards, Health Protection Agency, London UK.
PLoS Curr. 2012 Feb 2;4:RRN1301. doi: 10.1371/currents.RRN1301.
IntroductionReviews of mass gathering events have traditionally concentrated on crowd variables that affect the level and type of medical care needed. Crowd disasters at mass gathering events have not been fully researched and this review examines these aiming to provide future suggestions for event organisers, medical resource planners, and emergency services, including local hospital emergency departments.MethodsA review was conducted using computerised data bases: MEDLINE, The Cochrane Library, HMIC and EMBASE, with Google used to widen the search beyond peer-reviewed publications, to identify grey literature. All peer-review literature articles found containing information pertaining to lessons identified from mass gathering crowd disasters were analysed and reviewed. Disasters occurring in extreme weather events, and environmental leading to participant illness were not included. These articles were read, analysed, abstracted and summarised.Results156 articles from literature search were found detailing mass gathering disasters identified from 1971 - 2011. With only 21 cases found within peer-review literature. Twelve events were further documented as a case reports. Five events were examined as review articles while four events underwent commissioned inquiries. Analysis of cases were categorised in to crowd control, event access, fire safety, medical preparedness and emergency response.ConclusionsMass gathering events have an enormous potential to place a severe strain on the local health care system, and a mixture of high crowd density, restricted points of access, poor fire safety, minimum crowd control and lack of on-site medical care can lead to problems that end in disaster.
引言
对大型群众活动的审查传统上集中于影响所需医疗护理水平和类型的人群变量。大型群众活动中的人群灾难尚未得到充分研究，本综述对这些灾难进行了考察，旨在为活动组织者、医疗资源规划者和应急服务部门（包括当地医院急诊科）提供未来建议。
方法
MEDLINE、考克兰图书馆、英国医学期刊数据库和EMBASE，并利用谷歌扩大搜索范围，以识别灰色文献，搜索范围不限于同行评审出版物。对所有发现的包含从大型群众活动人群灾难中吸取的教训的同行评审文献文章进行分析和审查。不包括极端天气事件中发生的灾难以及导致参与者患病的环境因素。对这些文章进行阅读、分析、摘要和总结。
结果
从文献搜索中发现了156篇详细描述1971年至2011年期间大型群众活动灾难的文章。其中只有21例在同行评审文献中找到。12起事件被进一步记录为病例报告。5起事件作为综述文章进行了研究，4起事件接受了委托调查。对案例的分析分为人群控制、活动入口、消防安全、医疗准备和应急响应几类。
结论
大型群众活动极有可能给当地医疗系统带来巨大压力，人群密度高、入口受限、消防安全差、人群控制不力以及缺乏现场医疗护理等多种因素可能导致问题并最终酿成灾难。
