The largest mass gathering

An organised mass gathering has predictable medical problems. Yet emergency care at these events has been criticised as haphazard at best and dangerous at worst, with a wide variation of medical care provision.1 On 31 December 1999 potentially the largest ever series of mass gatherings will occur. What lessons should we apply when planning the millennium celebrations?

No clear definition of a mass gathering exists. Large crowds are commonly associated with leisure events but may occur at religious festivals, parades, and demonstrations and during public disorder. A figure of 1000 has been suggested to constitute a mass gathering,1 and this is reflected in the recommendations for first aid support of one first aider per 1000 people.2 Casualty rates vary considerably with the type of event, category 1 events (short all seater events such as football matches or a concerts) having a lower rate than category 2 (spectators mobile within a defined area often over a long period, as in a fairground or golf tournament).3 At the Los Angeles Olympic Games in 1984, a predominantly all seater event, the casualty rate was 1.6 per 1000 spectators.4 …