Human Stampedes: An Updated Review of Current Literature.

Human stampedes are a major cause of mortality in mass gatherings, but they have received limited scientific attention. While the number of publications has increased, there is no recent review of new study results. This study compiles and reviews available literature on stampedes, their prevention, preparedness, and response.A search for peer-reviewed and grey literature in PubMed (National Center for Biotechnology Information, National Institutes of Health; Bethesda, Maryland USA), Google Scholar (Google Inc.; Mountain View, California USA), Web of Science (Thomson Reuters; New York, New York USA), the World Health Organization Library Database (WHOLIS; World Health Organization; Geneva, Switzerland), and ReliefWeb (UN Office for the Coordination of Humanitarian Affairs; Geneva, Switzerland) was conducted, and papers were selected according to pre-defined eligibility criteria. Included items were read and results were compiled and summarized. A total of 64 publications were included, of which, 34 were published between 2013-2016. The most studied events were Germany's Love Parade stampede in 2010 (Duisburg, Germany; n = 6) and the United Kingdom (UK) Hillsborough Stadium stampede in 1989 (Sheffield, England; n = 4). Conflicting definitions of human stampedes were found. The common belief that they result from an irrational and panicking crowd has progressively been replaced by studies suggesting that successive systemic failures are main underlying causes. There is a lack of systematic reporting, making news reports often the only source available. Prevention measures are mainly related to crowd management and venue design, but their effectiveness has not been studied. Drills are recommended in the preparedness phase to improve coordination and communication. Delay in decisions, poor triage, or loss of medical records are common problems in the response, which may worsen the outcome.Stampedes are complex phenomenon that remain incompletely understood, hampering formulation of evidence-based strategies for their prevention and management. Documentation comes mostly from high-profile events and findings are difficult to extrapolate to other settings. More research from different disciplines is warranted to address these gaps in order to prevent and mitigate future events. A start would be to decide on a common definition of stampedes. Moitinho de AlmeidaM, von SchreebJ. Human stampedes: an updated review of current literature. Prehosp Disaster Med. 2019;34(1):82-88.