Castro-Marin Franco, Maher Steven A, Navarro Tomas, Nuño Tomas, Whitney John, McDonald Andrew, Razo Albert, Marcuzzo Christopher, Chick Russell, Gaither Joshua B
Prehosp Emerg Care. 2018 May-Jun;22(3):326-331. doi: 10.1080/10903127.2017.1380093. Epub 2018 Jan 3.
Alcohol consumption has been implicated as an important factor driving the demand for medical care at mass gatherings. Patients exhibiting signs of possible alcohol intoxication are frequently diverted from traditional medical support facilities located within mass gathering events due to their disruptive behavior or need for prolonged observation. This conventional strategy can place additional stress on Emergency Medical Services (EMS) and Emergency Department (ED) resources. The purpose of this study was to determine if incorporation of an on-site alcohol sobering facility to supplement existing on-site medical support resources was associated with changes in EMS and ED resource utilization during an annual mass gathering.
This retrospective observational study of a large, annual mass gathering included prospectively collected data from before and after the deployment of an on-site alcohol sobering facility. One year of EMS data along with 2 years of ED data from the pre-deployment time period were compared to 3 years of post-deployment data. The primary outcomes for this study were the number of EMS transports and ED visits.
Average single day event attendance was 176,116 during the 2012-13 time period before the ACS was deployed and 183,544 in the 3 years following. The odds of an EMS transport from the event to the ED decreased in the post-deployment period, OR 0.37 (95% CI = 0.16-0.86; p = 0.01). ED volume increased by 7.23% (p = 0.56) and ED LOS increased by 1.29% (p = 0.97) in the post-deployment period.
This study reports on a unique strategy to improve resource utilization at large mass gatherings and the impact of this strategy on EMS and ED resource utilization. It appears that the addition of an on-site alcohol sobering facility to existing medical support services was associated with a significant decrease in EMS transports but no change in ED resource utilization. Further work is needed to determine if these findings can be reproduced at other mass gatherings.
饮酒被认为是推动大型集会医疗护理需求的一个重要因素。表现出可能酒精中毒迹象的患者，因其破坏性行为或需要长时间观察，常常会被从大型集会活动中的传统医疗支持设施转移。这种传统策略会给紧急医疗服务（EMS）和急诊科（ED）资源带来额外压力。本研究的目的是确定在年度大型集会期间，增设现场酒精清醒设施以补充现有的现场医疗支持资源，是否与EMS和ED资源利用的变化相关。
这项对大型年度集会的回顾性观察研究，纳入了现场酒精清醒设施部署前后前瞻性收集的数据。将部署前一年的EMS数据以及两年的ED数据与部署后三年的数据进行比较。本研究的主要结局是EMS转运次数和ED就诊次数。
在部署ACS之前的2012 - 13年期间，单日活动平均参与人数为176,116人，在之后的三年中为183,544人。在部署后期间，从活动现场转运至ED的EMS转运几率降低，比值比为0.37（95%置信区间 = 0.16 - 0.86；p = 0.01）。在部署后期间，ED就诊量增加了7.23%（p = 0.56），ED住院时间增加了1.29%（p = 0.97）。
本研究报告了一种在大型集会中改善资源利用的独特策略，以及该策略对EMS和ED资源利用的影响。在现有医疗支持服务中增设现场酒精清醒设施似乎与EMS转运次数显著减少相关，但ED资源利用没有变化。需要进一步开展工作以确定这些发现能否在其他大型集会上重现。
