Pulse
When Pucks Fly and Corn Dogs Fry
At many large public gatherings, event medicine has emerged as the most valuable player.
If you have ever been to a professional sporting event or concert, you know that the size of the crowd can easily match the population of a small city. Not surprising, among the masses, anything can happen medically. And it usually does.
Thankfully, during major happenings in the Twin Cities, you’ll find physicians and other health care providers working behind the scenes to make sure an errant hockey puck, a slippery bleacher, or an overheated arena don’t bring you down—literally.
The concept of treating and managing illnesses and injuries at large public gatherings is generating so much awareness that it even has its own name: event medicine. Rob LeFevere, M.D., an emergency medicine physician at Regions Hospital in St. Paul who helps coordinate volunteer physician staffing at the nearby Xcel Energy Center, says event medicine is becoming important for two reasons: Physicians or paramedics can get to the scene sooner when someone suffers an urgent, life-threatening incident such as ventricular fibrillation. And, spectators with minor medical problems can get the care they need without having to leave the venue.
Event medicine is not classified as a board-certified specialty (informally, it’s regarded as a type of emergency medicine), so specifics surrounding the “field” are nebulous at best. For instance, no one knows exactly how many physicians serve as “event medicine docs,” and the qualifications for such a role are not usually well-defined. “I cringe when I hear about the ‘practice’ of event medicine because it’s not like I have a shingle out there that advertises myself as some sort of event-medicine specialist,” says Jeff Ho, M.D., assistant medical director for emergency medical services at Hennepin County Medical Center (HCMC) in Minneapolis and medical director for the first-aid team at the Metrodome. “People just come to us saying that they are holding XYZ event, and they want some help in the medical area.”
That said, more people are recognizing a need for structured, organized medical care at places where large crowds gather. “I would say for at least the last 10 years, it’s really taken off, says LeFevere. In fact, some hospitals and health care centers, including HCMC, now offer exposure to event medicine through their fellowships in emergency medical services. “In the Twin Cities, however, events are usually staffed by emergency docs, nurses, and paramedics—the people who do this stuff every day,” LeFevere says. Physicians and others who lead the medical teams at large events agree that one “must” for event medicine is a stellar support staff. During the Minnesota State Fair, for example, Kerry McCarthy, senior associate of emergency medical services for the American Red Cross in St. Paul, enlists a team composed of first responders, EMTs, paramedics, and charge nurses who are emergency- or ICU-trained. This past summer, Kerry and his colleagues saw 3,484 patients during the event. “During those 12 days, we are considered the busiest ER in the state,” he says, adding that they treat everything from broken limbs to indigestion.
At the Minnesota Wild games and other Xcel Energy Center events, American Red Cross volunteers, most of whom are first responders, are stationed throughout the arena. They also staff the Regions Hospital Health Station, a two-bed, L-shaped emergency room that’s equipped with everything from defibrillators and intravenous fluids to Band-Aids and Benadryl. Volunteer physicians—usually from Regions Hospital—receive free tickets to the event and are paged if needed.
LeFevere remembers one incident in which he was called to the health center during a Wild game. A man was struck by a wayward puck and had a significant laceration over his eye and an injury to the eye globe. For the most part, however, the problems LeFevere and his colleagues see at events aren’t much different from those they see in the emergency department—chest pain, asthma exacerbations, alcohol-related injuries, ankle sprains, or burns.
In most cases, the sponsors or owners of the facility where the gathering takes place foot the cost of event medicine. (The St. Paul Arena Company, for example, pays for event medicine charges incurred at the Xcel Energy Center, and the Metrodome Arena Council pays the bills associated with spectator care at Vikings games.) While McCarthy estimates that 98 percent of the American Red Cross’s event medicine services are volunteer-based, those holding the event may end up paying for medical supplies, which can include anything from cough drops to cots.
Amid squeezed budgets and the logistical limitations of the event medicine venue, planning is critical. Before the organized protest at the animal genetics conference at the Hyatt Regency Hotel in Minneapolis in July 2000, the Minneapolis Police Department enlisted Ho’s expertise to orchestrate medical care for officers (and potentially demonstrators) who sustained injuries. The team was composed of Ho, nine paramedics, two volunteer nurses, and one volunteer emergency medical services fellow. Altogether, they treated more than 80 officers, saving the city a whopping $24,500 in ambulance charges and emergency medicine fees.
Ho is quick to credit his colleagues as the most valuable players in any such event. “Coordinating medical services at large-scale events takes a lot of bodies behind the scenes and a lot of volunteer time on the part of many, many people—from basic first aid personnel to physicians. I am thankful for every one of them—every day.” So, too, are thousands of spectators who can rest assured that medical help isn’t far from any seat in the house. —Jeanne Mettner