What sports will look like as the pandemic eases

CrowdRx discusses what sports and entertainment venues in the U.S. will look like post-pandemic for CNBC.

One-stop-shop consulting to get your venue or workplace open and back in the game.

Comprehensive Center for Disease Control and physician-guided policies and procedures designed to allow you to open your public spaces quickly and safely. Led by experienced physicians and industry executives with Disaster, Emergency Medical Services and Public Health training, the CrowdRx™ GO! services team stands out as a leader in this fast moving field.

COVID-19 Situation Summary

Source: Center for Disease Control (CDC)

The CDC is responding to a pandemic of respiratory disease spreading from person-to-person caused by a novel (new) coronavirus. The disease has been named “coronavirus disease 2019” (abbreviated “COVID-19”). This situation poses a serious public health risk. The federal government is working closely with state, local, tribal, and territorial partners, as well as public health partners, to respond to this situation. COVID-19 can cause mild to severe illness; most severe illness occurs in older adults.

Different parts of the United States are seeing different levels of COVID-19 activity. Nationally, the U.S. is in the initiation phase of the pandemic. States in which community spread is occurring are in the acceleration phase. The duration and severity of each pandemic phase can vary depending on the characteristics of the virus and the public health response.

Who’s At Risk & How to Stay Safe

Older adults and people of any age who have serious underlying medical conditions may be at higher risk for more serious complications from COVID-19. These conditions include heart disease, diabetes, lung disease and auto-immune diseases. 

There is currently no vaccine to prevent COVID-19. The best way to prevent illness is to avoid being exposed to this virus. The virus is thought to spread mainly from person-to-person, between people who are in close contact with one another. It is transmitted through respiratory droplets produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. 

  • Wash hands often with soap and water, use hand sanitizer.
  • Avoid touching your nose, mouth or eyes.
  • Avoid close contact with people who are sick.
  • Distance yourself from other people, especially if you are in the at-risk popluation.

Get the most up-to-date information on the CDC website 

CrowdRx Joins Global Medical Response

Provider of On-Site Medical Services will Enhance GMR’s Ability to Provide Care

(GREENWOOD VILLAGE, Colo.) — Global Medical Response (GMR) officials announced today that CrowdRx has joined the GMR family of companies. Randy Strozyk, GMR Senior Vice President of Operations, said CrowdRx’s expertise in site-based medicine and resources combined with GMR’s solid reputation in the event medical arena is exciting news for those who attend large gatherings throughout the United States.

“For more than 30 years, CrowdRx and its physician-led teams have prescribed and delivered medical services for large events across the country,” Strozyk said. “Their commitment to compassionate, discrete medical attention—regardless of the location—dovetails perfectly with our guiding principles. This is a very exciting addition to the GMR family that immediately adds value and experience to our services and raises the quality of care for our patients.”

Connor Fitzpatrick, Executive Director for CrowdRx, said the company is currently implementing medical screening services for select clients and venues.

“CrowdRx uses a portable, rapid deployable thermal imaging fever screening system that is used as a first level mass screening test,” Fitzpatrick said. “The system can detect fevers for large-scale public gatherings, including conventions and major events. In addition, we offer the industry-leading mobile emergency room, CrowdRx RAMPART. This versatile unit is used for major event coverage, and provides immediate access to critical care.”

In addition to thermal screening and the RAMPART Mobile Emergency Room, CrowdRx offers physician-led and medic-level services for the following:

  • On-Site Physician Services
  • EMT Standby and Staffing
  • First Aid Stations
  • Public Access AED and Bleeding Control programs
  • Emergency Operations Plans
  • Consulting Services
  • Concierge Medical (Athletes, Touring Artists, VIPs, etc.)

About CrowdRx

Founded by physicians and staffed by a global network of MDs, paramedics, EMTs, RNs and other medical support personnel, CrowdRx keeps events uneventful by providing urgent care for patients and minimizing risk for its clients. Physician-led or medic-level event services can be tailored to the size of both the client’s crowd budget.  We are on call to deliver quality medical services scaled to the unique needs and requirements of each and every gathering. CrowdRx is part of the Global Medical Response family. 

About Global Medical Response

With more than 38,000 employees, Global Medical Response delivers compassionate, quality medical care, primarily in the areas of emergency and patient relocation services in the United States and around the world. GMR was formed by combining the industry leaders in air, ground, managed medical transportation, and community, industrial/specialty and wildland fire services. Each of our companies has a long history of proudly serving the communities where we live: American Medical Response (AMR), Rural Metro Fire, Air Evac Lifeteam, REACH Air Medical Services, Guardian Flight, Med-Trans Corporation and AirMed International. For additional information, visit us on LinkedIn or at www.GlobalMedicalResponse.com.

EP Monthly: Rattlesnakes, Stabbings, Hyperthermia and a Visualized Appendicitis? Music Fest Medical Care Recap

By SAM KIM, MDCONNOR FITZPATRICK, A-EMT and MATT S. FRIEDMAN, MD

The challenges of treating the ill and injured at a 30,000 person festival.

When staffing music festivals, be prepared to treat an interesting mix of pathology. While much of the pathology is predictable based on the specific type of festival and a historical analysis of the previous medical care provided, patient presentations are quite variable between different types of music festivals featuring different music and mood.

Crowd mood, a term frequently discussed in the mass gathering medicine literature, is an important descriptor to determine crowd behavior and should be utilized as a tool to predict the patient presentation rate (PPR). Other major factors contributing to the PPR and the transport to hospital rate (TTHR) are the heat index and the amount and type of recreational drug use.  For every ten-degree increase in the heat index, the medical team can anticipate three more patients per 10,000 attendees.

Some festivals have stringent security procedures utilizing canine units at venue entrances and undercover law enforcement actively looking to arrest drug sellers while other festivals have relatively lax security measures. As emergency physicians, we always prepare for the worst and we recommend multiple resuscitation areas set up for rapid sequence intubations as well as premade ice-baths and unobstructed egress off the site for critical patients.

Severely hyperthermic patients present to on-site medical teams frequently and we should be prepared to treat significant rhabdomyolysis causing acute renal failure, which in turn can cause critical hyperkalemia and acidemia. Below are some interesting cases and lessons learned from the festival which included a range of pathology such as toxicological emergencies, status epilepticus, orthopedic injuries, major trauma, crotalid envenomations, and Point Of Care Ultrasound for the win!

Read more about the cases in EP Monthly here!

The Benefit of Mobile ER Trailers

At big events they can help avert needs for transport and burdening local hospitals

Nearly every city has its own rendition of a marathon, triathlon, extreme obstacle course or swim competition. It is prudent to treat these events, based on their anticipated size, number of participants, and viewing capacity, as predetermined MCIs, each requiring its own disaster plan and risk-mitigation procedures.

Not every mass gathering will becomean actual MCI. Fortunately, at fixed venues that host professional sports teams and collegiate sporting events, the patient presentation rate is rela- tively predictable and usually low com- pared to nonfixed venues where events like music festivals typically take place. While there is always a concern that a mass gathering will become an MCI andproper disaster preparedness principlesshould be employed at every one, it is thankfully rare at fixed venues hosting sporting events.

For EMS these events may require enhanced resources and more inten- sive preparations. Preventive measures may include multidisciplinary and inter- agency briefings, increased numbers of medical staff, and potentially a mobile trailer capable of providing emergencycare. The mobile emergency room trailercan have unique benefits at an MCI or mass gathering.

Controlled Environment

We frequently use the term controlled envi- ronment in EMS and emergency medicine. That patient with epiglottitis needs to be intubated in a controlled environment, so they should be taken to the OR. To performprocedural sedation to reduce the dislocated shoulder, we need a controlled environment.Essentially a controlled environment is aclean, relatively sterile workspace where youhave the room, maneuverability, and equip- ment to handle the worst-case scenario.

If you anticipate a range of patient pre-sentations from asthma to contusions, lacerations, and dislocated extremities, there is a medical advantage to having a controlled environment on site. It pro-vides room to treat all these patients in a humane environment, with each afforded the dignity, privacy, and appropriate care they deserve.

The real mortality benefit arises when you begin treating the critically ill, whichis not infrequent at large mass gather-ings. Life threats can include hyponatre-mia leading to seizures, hyperthermia resulting in multiorgan failure, severe asthma exacerbation requiring ventila- tory support, excited delirium owing to drug-induced toxicity, cardiac arrhyth- mias, and, if not interrupted promptly, cardiac arrest.

A mobile ER trailer allows multiple providers to access a patient in extremis. An EMS provider can obtain intravenousaccess in the upper extremities while another places the patient on a cardiacmonitor and obtains vital signs, while yet another is at the head, managing the air-way and comforting the patient.

The mobile trailer typically features well-organized supply cabinets offering ready access to supplies. Additionally, they typically have proper licensing credentials to run point-of-care serum andurine analyses. Knowing the serum pH andpartial pressure of carbon dioxide will be useful in determining the criticality of the patient and responsiveness to therapy.

Having cordoned-off private areas toexamine patients and obtain rectal tem- peratures will be important to determinewho has mild hyperthermia and who is severely hyperthermic, requiring a dunk in an ice-cold bath. In short, mobile ERtrailers provide a dignified, humane envi-ronment to treat every patient, but their biggest impact is seen with critically ill patients at an MCI.

Mobile emergency room trailers shouldbe completely self-sustaining for the first 72 hours and equipped and staffed to manage minor to severe emergency medical conditions. Generally they can be operational quickly after arriving on site and can accommodate expandabletents to significantly enhance their surgecapacity. When infrastructure is dam- aged or capacity diminished, the needfor surge relief is immediate and may lastfor weeks.

Logistical Advantages

There are other positive aspects to staging medical crews at a mobile ER. Using trailers helps avoid overburdening other local healthcare resources not dedicated to the mass gathering. EMS (as well as police and fire), while having to deal with extra traffic and road closures, will have its same resources to respond and hopefully not have to divert units.

The host community does not have to worry that its local hospitalwill be overrun and struggle to provide care. Some communities have experienced problems with local ERs that were ill-equipped to handle the excessive patients they saw from a mass gathering.Mobile ER trailers can dramatically cut down on the number of those transported to hospitals.

Finally, mobile ER trailers give medical staff a place to congre- gate and escape from the elements and enjoy an opportunity to recharge. Whether they need to warm up, cool down, hydrate, or change clothes, on-scene medical providers are given a place to do it with dignity and respect, thus keeping them ready to handle any scenario that may arise.

ABOUT THE AUTHORS

Matt S. Friedman, MD, FACEP, DABEMS, is associate medical director of prehospital care and director of the EMS clerkship at Maimonides Medical Center, Brooklyn, N.Y., and national medical director of CrowdRx Inc., New York, N.Y.

Connor B. Fitzpatrick, AEMT, is an AEMT instructor, ALS supervisor, volunteer pilot for Airlift Services, and Chief Operating Officer at CrowdRx Inc.

EVENT SAFETY: 10 FRESH TIPS FOR KEEPING EVENTS SECURE IN A BRAVE NEW WORLD

By Kait Shea for Event Marketer

In this era of routine terrorist attacks, devastating natural disasters and political unrest, it’s the million-dollar question plaguing the industry: How could this threat have been avoided? From eliminating foreseeable risks to being prepared for the worst, there’s never been a more critical time for event marketers to arm themselves with the intelligence and resources necessary to maintain safe and secure events.

1Document everything. 

You’ll hear it over and over again. In the event of an emergency, especially a medical crisis, documenting the incident is vital to keeping insurance premiums in check and staff informed.

“You want to document everything to make sure your insurance is covered, your event is covered and everyone knows what happened,” says Connor Fitzpatrick, coo at event medical services company
CrowdRX. “It’s key to remember in medicine, if it’s not documented, it did not happen.” The reports can be as simple as a first aid log noting that you’re giving away Tylenol or Band-Aids. Remember to include the name, date of birth, phone number and what the attendee requested or needed. More advanced medical situations call for a detailed patient care report with an indemnity statement. “This is key to make sure your insurance premiums can be reduced as a result,” Fitzpatrick adds.

2. Find a Venue That Prioritizes Attendee Safety.

When it comes to selecting a location for your event, make sure the venue is willing to do its part to communicate key messaging to attendees. Remember: if an incident occurs, cooperation will be key.

“I’ve been to events lately, and you will see at many of these major venues, the venue itself is taking time to express to people, ‘Here’s what you do in the event of a need to clear the facility,’” says Scott Carroll, executive vp at Take1 Insurance and secretary of the Event Safety Alliance. “At outdoor events now, announcements are being made ahead of time that if there is an event that requires clearance, here is where you go. In some places, like an open-air field, if a weather event were to come through, the shelter might be—and this is what the venue would announce—go to your cars. That may be where the safest place is. At most venues, you’re told that now.”

3. Establish a Chain of Command. 

Might sound like a no-brainer, but establishing exactly who is in charge of what and when can save precious minutes in an emergency. From brand ambassadors to event managers, everyone should be crystal clear about what their role entails.

“The key thing here is when it comes to decision-making, who is in charge?” says Shannon Jones, vp at Civic Entertainment Group. “The chain of command at an event needs to filter to the overall broader chain of command in an emergency situation as it relates to the company or brand.”

4. Be Prepared for Anything and Everything.

The uptick in terrorist attacks, including the Las Vegas shooting, which was executed from a hotel room and stands as the deadliest mass shooting in modern U.S. history, has many event marketers on edge. And while planning for these types of crises is essential, don’t assume that past tactics will be used at future events.

“If the bad guy’s weapon of choice is a box truck, or a knife on London Bridge, or some other place where pedestrians are congregating, should there be a plan for that?” says Steven Adelman, partner at Adelman Law Group and vp of the Event Safety Alliance.

Not exactly, says the attorney. “With the current shiny object—AR15s mounted on tripods on the 32nd story of a hotel—we can’t assume that the next bad guy is going to use the same means of carnage as the last one. The weapon of choice may be very different next time.”

5. Implement an Attendee Screening Strategy.

The approach may vary depending on your budget, but implementing an attendee screening process is a highly effective security measure that can be executed before the event even begins.

“Many events these days, particularly the corporate activation events, are free,” says Anthony Davis, president at AD Entertainment Services. “So, you have an audience that has not paid an admission or whatever format you use to access them. They’re showing up and we don’t know who they are; they haven’t been pre-screened in terms of their backgrounds. I suggest [using] magnetometers wherever applicable. Sometimes that’s a challenge due to power. Then, you go to a hand-held metal detector wand. And then lastly, if none of those things are available, you do a bag check.”

6. Enlist an Approachable Medical Team. 

Medical emergencies can, and do, occur at events of every variety, so having medical personnel on-site is crucial. Just as important is ensuring that the team is friendly enough for attendees to approach in the case of an emergency. Remember that uniformed first responders can be intimidating, especially in regards to drug-related incidents.

“The [medical] team should be approachable,” says Fitzpatrick. “There’s a fine balance here of being in a professional uniform where people can trust you and you immediately garner trust and rapport with your attendees, but also, being available and showing that you’re here to help them. Our standard EMT uniform is a red shirt; it’s very non-police-like. The previous way of thinking was very security focused, very police focused. But it’s important to maintain that ‘we’re here to help you’ and ‘your secret is safe with us.’ It’s important that your attendees understand that medical is a judgment-free zone.”

7. Keep Security Personnel Informed. 

Hiring security staff is a great start when it comes to maintaining a safe event, but communicating your event’s layout, including areas of concern, is absolutely essential to getting the most bang for your security buck.

“Security personnel should be provided a two-sided information sheet with a site map with the locations of all restrooms; medical tents or areas; stages and activations you’re providing and the schedule of those activities; concession stands and directions to areas where emergency exits are,” says Davis. “Also, you should equip people in sensitive areas with a two-way radio that connects to your designated security manager—you should have someone on your team who is directly responsible for managing security operations.”

8. Let the Pros Do the Talking. 

Bad news travels fast, so you have to be clear about who has the authority to develop crisis communications. (Hint: It’s not the guy handing out samples.)

“The people on the ground that are running the event that have that visibility with your audience are your first line of defense in communicating information on a one-on-one or group basis,” says Jones. “It’s important to explain to them and cascade information very quickly with approved language. You don’t want a brand ambassador or event staff taking it upon themselves to communicate what’s going on if there is some sort of emergency information. The cascade of information in that scenario is really critical as is deciding what the key points are and the information you want them to disseminate.”

9. Implement an Emergency Action Plan. 

When it comes to event safety and security, there is probably no more important document than your on-site emergency action plan. It’s an essential guide to navigating and preparing for foreseeable risks, informing event staffers of the appropriate safety protocol and ensuring insurance premiums don’t skyrocket.

“If you ask me to try and insure an event for you, one of the things I’m going to ask you about is a site safety plan,” says Carroll. “And I’m going to be looking for [whether or not] you’ve given some thought to it. Do you understand the details of the site and what are the plans associated with what events might happen? Where is your egress, where is your ingress, where are you going to stage security?”

10Triage Your Risks.

Every live experience is unique, so it’s important to establish priorities for taking action in a variety of emergency scenarios. If you fail to do so, you may find yourself in hot water with your employer, your insurance agency or the law.

“Everyone has a common law duty to behave as a reasonable person under the same or similar circumstances,” says Adelman. “That means context matters. Your circumstances will determine what is reasonable and that’s why you have to consider and triage the risks. Every event, every show isn’t the same… An emergency action plan that exists shows that someone knew what was reasonable. A plan that exists that wasn’t implemented establishes the duty of care and also establishes a breach of that duty of care. And that adds up to negligence.”

In an industry that prides itself on producing unforgettable experiences, the last thing you want burning in your attendees’ minds is how poorly your staff handled an emergency. So, be informed, be attentive and be prepared—but don’t let the process get you down.

As Davis puts it, “For years we’ve taken it for granted that it’s a fun day, it’s a nice special event, let’s just get out and have fun. And we should still have that mentality. We shouldn’t let recent terrorist acts or potential acts deter us from producing special events. The onus is now on us to be more creative in terms of our staffing.”

NYC’s critical emergency services worker shortage highlights need for on-site medical providers

Read the NY Post Article Here

According to a recent report, New York City’s ability to respond to medical emergencies has reached a critical point, highlighting the importance of on-site medical services.

Over the past year, official data show, the average time to reach people in cardiac arrest or choking rose by 24 seconds — an increase that can mean life or death.

“Every second counts — every second is lost brain cells,” a veteran paramedic explained. “Brain death starts to occur in four to six minutes.”

The overall EMS response time for other life-threatening emergencies rose by 19 seconds, the city data show.

And for all medical emergencies, the response time jumped an alarming one minute and three seconds.

What’s more, 60 percent of current EMS personnel have less than three years on the job because so many veterans have left to become firefighters.

Emergency2017 Time2018 TimeIncrease
Cardia Arrest/Choking7:197:4324 sec.
Other Life Threatening Emergency8:569:1519 sec.
All Medical Emergencies10:4211:4563 sec.

The paramedic added, “Because the call volumes are so high, they’re pulling ambulances from different areas, so you’re traveling longer distances.” 

The response data tell only how long it takes for an ambulance to arrive at a street address — not the added time it takes to find and reach the patient.

The EMS shortage means that people who call 911 for help have to wait longer for an ambulance than they should. Firefighters can administer CPR, but paramedics bring life-saving medications, intubation to secure the airway, and transportation to a hospital — crucial in trauma cases.

“On several occasions, especially during peak periods, like weekends and evenings, they’ve run out of ambulances,” an FDNY dispatcher said.

Manhattan had the worst average response time for all medical emergencies over the last 12 months (12:34), followed by the Bronx (12:30), Brooklyn (11:34), Queens (10:28) and Staten Island (9:46).

“The numbers are shameful. They’re indicative of an underfunded EMS system,” the veteran paramedic said.

CrowdRx provides expertise in identifying and hiring local, reliable, and dependable ambulance transport companies for your event.  Under the direction of an attending physician, crew members are cross-trained to provide specialty care in crowds. 

Basic and Advanced Life Support is delivered on site and in transit by our teams of Emergency Medical Technicians and Paramedics.  From first responders to last-out standby, our medical teams are trained extensively with current certifications in emergency care and public safety.

Festival Organizers Focused On Safety Ahead Of 2-Day Event

BALTIMORE (WJZ) — Baltimore’s largest outdoor concert kicks off this weekend.

For two days, artists from across the world will entertain guests at the fifth annual Moonrise Festival being held at Pimlico’s Infield.

A big focus will be on safety. Organizers tell WJZ they’ve made improvements from their past festivals and have a medical team on site to ensure everyone enjoys the event.

More than 60,000 people are expected to attend this two-day dance party, and organizers want them to have fun and be safe.

“Our water stations are better, they can serve more people over an amount of time, and have better medical planning and better safety planning,” said Moonrise event director Evan Weinstein.

In 2016, close to 50 Moonrise festivalgoers were hospitalized. Many needed treatment for dehydration, prompting organizers to make major safety enhancements so this doesn’t happen again…

“We specialize in event medicine,” said Connor Fitzpatrick, CrowdRx chief operating officer. “We are the largest event medical company in the country. There are doctors on site, you are safer in this event than you are across the street.”

CrowdRx provides emergency care and serves as an on-site hospital to ensure concertgoers have a safe experience.

Music will hit you from every angle at the festival. There are four stages, along with live pyrotechnics and more than 80 artists.

While visitors focus on the entertainment, organizers will focus on everything else.

“Keeping an eye on things and engaging with the crowd and making sure everyone is being safe and smart,” Weinstein said. “Make sure you know where you are, make sure you understand the map and have a plan for parking and Uber.”

A reminder for concertgoers to also be responsible to make this electronic dance music festival an enjoyable experience for everyone. More here.