Level of medical care required for mass gatherings: the XV Winter Olympic Games in Calgary, Canada.

STUDY OBJECTIVE: To determine the level of medical care required for mass gatherings and describe the types of medical problems encountered in a major winter event. DESIGN: Standard charts were available for 3,395 encounters. Interviews with medical staff showed that the few unrecorded encounters were for very minor medical problems. A four-tiered triage system (low, moderate, urgent, and emergent) developed before the Games was applied to each chart retrospectively by a single emergency physician. Chi-squared tests were used to test significant differences. SETTING: This winter sporting and entertainment event had 12 urban and rural venues. Medical staff (98 physicians, 161 nurses, and 337 first-aid attendants) were based in 28 advanced life support (ALS) clinics. The medical service operated for four weeks. TYPE OF PARTICIPANTS: There were 1.8 million spectator-days. Patients included spectators, athletes, and support staff. INTERVENTIONS: First-aid attendants referred patients to the clinics, where nurses conducted initial assessments and referred patients to physicians at the venue, or more rarely, to local hospital emergency departments. Paramedic ambulances were stationed at the venues. The triage system was not used for patient management. MEASUREMENTS AND MAIN RESULTS: Only 40 urgent and one emergent medical problems were encountered. The majority of patients could have been managed by trained nurses working alone under standing orders. Fifty patients were transported to the hospital by ground ambulance and three by helicopter. No significant differences were found in the low acuity levels experienced at indoor urban venues, outdoor urban venues, and the rural cross-country ski venue. The Alpine ski venue was characterized by significantly higher acuity and a long prehospital transfer phase. CONCLUSION: Owing to the low acuity encountered and the availability of Calgary's ALS ambulance service, we concluded that physician-based ALS teams were not required for patient management at the urban venues. Such teams were found to be required at the rural Alpine ski venue. Other reasons for using physicians are discussed, as is development of a standard triage system for mass gatherings.

Medical services program for the 1988 winter olympics.

The Medical Services Program for the 1988 winter Olympic games in Calgary involved detailed planning to co-ordinate facilities, equipment, supplies, transportaion, staff, and auxiliary support. The successful delivery of health care to athletes, Olympic officials, and spectators depended upon the efforts of medical volunteers, who enabled the Medical staff to provide adequate, timely service as required.

Teleconferencing cme programs to rural physicians: the university of calgary teleconference program.

Continuing medical education (CME) provides practising family physicians with the cornerstone of maintenance and improvement of skills. In rural areas the problems of isolation and distance are a barrier to continuing medical education. Provision of CME programs by audio-teleconferencing is an attempt to overcome these problems. This article describes the teleconference program of The University of Calgary, how it has developed over the five years of its existence, and its impact on rural physicians.

The community - an essential in medical education.

This paper outlines some of the components of community medical practice and community physicians. These, although not peculiar to this area alone, certainly in toto make the community an essential area for the doctor in training to become involved in some of the students' problems. The latter part of the paper attempts to illustrate some potential ways to utilize the community as part of the educational program of doctors. The need for this type of training is essential.