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Clinical Practice

The theory of event medicine: a literature review

02 February 2025
Research
02 February 2025
Volume 17 · Issue 2

Abstract

Background:

Event medicine is a field of medicine that encompasses the provision of healthcare to spectators/attendees at sports stadiums, music events, and festivals. This article explores existing theory to understand the evidence base currently afforded to operational practice.

Aim:

The study aim is to explore the current literature on event medicine to identify collective themes and areas for future research, prompt clinician reflective practice, and inform future standards of professional practice.

Methods:

A six-stage thematic-analysis-based literature review was conducted. The electronic databases of Google Scholar, Medline and PubMed were searched between January and April 2024. The search terms used were ‘event medicine’, ‘mass gathering medicine’, stadium medicine’, and crowd medicine’. Articles prior to January 2004 were excluded. The search included English language full-text articles.

Findings:

A total of 32 articles were selected. They originated from Europe, Northern America, Southern Africa, and Asia, across a variety of sporting, outdoor festival, and music events. From their analysis, five main themes were identified: patient presentations; medical resource skill mix; predictive modelling; transfer to hospital rates; and acute cardiac events.

Conclusion:

Event medicine operational practice is under-researched, and essentially affords a large theory-practice gap in event medical service planning, provision, and application. Event-medicine clinicians should aim to deliver prehospital medical care that reflects the complexity of the five identified themes, as well as critically analyse existing event medical data, challenge their conceptual roles, and seek to develop future improved core standards of event medicine with a view to developing safer models of care for event spectators/attendees.

Event medicine is an all-encompassing term that embraces the provision of medical care across all derivatives of similar practice. This includes mass gatherings at sporting events, large crowds at festivals, outdoor entertainment events, and within stadiums accommodating either sport or music events. Therefore, it was used as such in the current article.

Such large-scale events, are considered as being heterogenous in the context of their size, duration, type of event, crowd-behaviour-linked recreational substance use and environmental factors (Schwartz et al, 2015). Therefore, they pose complex challenges in medical provision. In these prehospital environments, medical services are generally provided by a broad range of clinicians, including paramedics, doctors, nurses, and first responders (Alinier et al, 2022).

Event medicine was brought into the spotlight in the UK back in 1989, with the tragic incident of the Hillsborough Stadium Disaster. The following year, the Taylor Report was published by The Rt Hon Lord Justice Taylor (1990) who, among his recommendations, advocated for baseline figures for future medical staffing at sports events, which continue to inform and influence current event safety documents in which event medicine guidelines are published.

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Event medicine
Patient presentation rates
Medical resource skill mix
Predictive modelling
Transfer to hospital rates
Prehospital cardiac arrest