INTRODUCTION: Heat-related illness is reported to be a significant cause of morbidity at outdoor mass gatherings during warm weather. Paramedics are traditionally present at mass gatherings to provide prehospital care for people in need. OBJECTIVES: To describe a paramedic-staffed medical rehydration unit and a new role for paramedics at a mass gathering attended by more than 450,000 people. METHODS: A 48-bed medical rehydration unit was deployed adjacent to the main field hospital. Paramedics admitted patients to the unit if they met predetermined criteria for mild to moderate heat-related illness. Each paramedic was responsible for four beds. Paramedics initiated oral and intravenous rehydration therapy by following medical directives. Emergency medical services (EMS) physicians reviewed patients before discharge. RESULTS: The medical rehydration unit managed 143 patients (3/10,000 attendees). The mean number of patients admitted per hour was nine. The average age was 24 years; 103 (72%) were female. The main presenting complaint was syncope, presyncope, or dizziness in 43 (30%). Forty-four (31%) patients received parenteral and oral fluids; the remainder received oral fluids alone. The average length of stay was 94 minutes (95% CI 82-106). One hundred seven (75%) patients were discharged, 17 (12%) were transferred to the main field hospital, four (3%) left against medical advice, and two (1%) required transfer to a hospital off site. In 13 (9%) cases, records of patient disposition were incomplete. CONCLUSIONS: This article defines a new role for paramedics and describes the operation of a medical rehydration unit at a large, single-day mass gathering in summer.
INTRODUCTION: Heat-related illness is reported to be a significant cause of morbidity at outdoor mass gatherings during warm weather. Paramedics are traditionally present at mass gatherings to provide prehospital care for people in need. OBJECTIVES: To describe a paramedic-staffed medical rehydration unit and a new role for paramedics at a mass gathering attended by more than 450,000 people. METHODS: A 48-bed medical rehydration unit was deployed adjacent to the main field hospital. Paramedics admitted patients to the unit if they met predetermined criteria for mild to moderate heat-related illness. Each paramedic was responsible for four beds. Paramedics initiated oral and intravenous rehydration therapy by following medical directives. Emergency medical services (EMS) physicians reviewed patients before discharge. RESULTS: The medical rehydration unit managed 143 patients (3/10,000 attendees). The mean number of patients admitted per hour was nine. The average age was 24 years; 103 (72%) were female. The main presenting complaint was syncope, presyncope, or dizziness in 43 (30%). Forty-four (31%) patients received parenteral and oral fluids; the remainder received oral fluids alone. The average length of stay was 94 minutes (95% CI 82-106). One hundred seven (75%) patients were discharged, 17 (12%) were transferred to the main field hospital, four (3%) left against medical advice, and two (1%) required transfer to a hospital off site. In 13 (9%) cases, records of patient disposition were incomplete. CONCLUSIONS: This article defines a new role for paramedics and describes the operation of a medical rehydration unit at a large, single-day mass gathering in summer.