Abstract
Objective
The Pennsic War is an annual 2-week event involving >10,000 participants of all ages who gather in western Pennsylvania to camp and to recreate medieval events, including full-scale battles with medieval weaponry. There is 24-hour, 7 days a week emergency medical services coverage, with a physician present during daylight hours. The closest community hospital is 30 minutes by ambulance. The objective of this study is to examine the epidemiology of an outdoor mass gathering event to as a lesson for future preparedness and response to medical emergencies at similar events.
Methods
This is a retrospective cross-sectional chart review of patients who registered at the first aid tent during the 2007–2013 Pennsic Wars. Inclusion criteria included any patient who had data recorded into the triage log. Missing data from incomplete entries were categorized as unknown. Variables included age, sex, chief complaint, interventions and medications provided, and disposition. Data were abstracted from these triage logs by a single researcher for statistical analysis.
Results
There were 1141 recorded visits during the 7-year study period. Dermatologic complaints were the most frequent (35%) and commonly reported as rash, insect bite, or soft-tissue wound. Musculoskeletal (16.9%), neurologic (10%), and gastrointestinal (7.3%) complaints were the next most common. The most common interventions recorded were bandaging/splinting, cardiac monitoring/electrocardiogram, and wound closure. The most common medications dispensed included normal saline (n = 131), Zofran (n = 66), and Benadryl (n = 57). Most patients, 86.2%, were treated and released, whereas 4.2% were evacuated to an emergency department (9% missing data).
Conclusions
Most presentations were not life-threatening and required only basic wound care or therapeutic measures. However, there were cases of long-bone fracture, spine injury, and overdose that required intubation. The wilderness medical provider should have a definitive stabilization and evacuation plan for the infrequent but true emergencies. Understanding the incidence and distribution of medical emergencies also aids future planning and preparation of wilderness endeavors.