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Physicians have been integrated into the emergency medical services during these events, which has resulted in a reduction in patient transports to emergency departments due to definitive care being provided on-scene and disposition being affected in situations which supersede the scope of practice of pre-hospital providers (also known as treat and release).

As explained in an article by Lund et al, many aspects of the provision of medical support for mass gathering events overlap with the expertise required to plan and implement a successful medical response to a natural disaster, terrorist incident, or mass-casualty event.听The provision of medical care during mass gatherings is an important opportunity for health care providers to gain experience that would be applicable in a disaster situation.

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Due to the intense planning required prior to a mass gathering event, and due to the fact that mass gathering events are spread out over the course of a year, this rotation is best served in a longitudinal format over a one-year period, ideally in the PGY3 and PGY4 year. Fifteen days of work over a one-year period would be required for a complete rotation. One 8-hour shift devoted to clinical mass gathering (on event days) will be equivalent to one ED shift. In other words, one event shift would be credited as one EM shift and the resident would be excused from an equivalent number of hospital ER shifts whenever the resident is scheduled during an EM rotation.

The resident doing this elective will also be encouraged to attend, whenever possible, meetings related to hospital disaster preparedness (also known as Code Orange). These meetings occur on a monthly basis between September and June. Also, the resident may be encouraged to take part in the planning of a disaster drill if applicable. These hours will be logged and count for the 15 days of the rotation but will not be credited for any ER shifts. Only a disaster simulation day could serve as equivalence for an ER shift.

The resident will receive formal training on the different types of hazards (chemical, biological, radionuclear, and explosions) and their impact on the disaster response. In addition, the resident will be introduced to the MUHC Emergency Department disaster response protocol (Code Orange). Opportunities for participating in a research or educational project related to disaster medicine will be presented to the resident. The disaster medicine part of the rotation will be under the supervision of Dr. Valerie Homier and its content can be adapted to meet each resident鈥檚 needs.

Mass Gathering

• Understand what local capabilities and resources are required for providing medical support for mass gathering events
• Develop operations management skills focused on the logistics for providing medical care at mass gathering events, specifically related to transport, medical personal, equipment, medications, communication, emergency contingency plans and treatment protocols
• Develop a risk assessment plan which includes potential hazards and obstacles to providing medical care
• Collaborate with local authorities to mobilize available resources in the context of a mass gathering event

Disaster Medicine

• Understand the concept of surge capacity and the importance of a multidisciplinary approach to disaster medicine 听in healthcare institutions
• Develop an approach to disaster preparedness at departmental and institutional levels
• Comprehend the steps involved in the MUHC Emergency Department disaster response protocol
• Appreciate the impact of chemical, biological, and radionuclear threats on the disaster response and understand the specific patterns of injury expected after an explosion.