Chain of survival at mass gatherings: A case series of resuscitation events

Background: At a large public event, or mass gathering, various factors influence patient presentations, which bring challenges to patient care. The chain of survival has been investigated in the prehospital setting; however this has not explicitly included the mass-gathering environment.

Objective: This study sought to determine the facilitators and barriers to the chain of survival at mass gatherings.

Methods: This case series research was exploratory and descriptive, using the analysis of personal experiences of resuscitation. Participants were members of St John Ambulance Australia who had participated actively in a resuscitation event in 2007. Telephone interviews were used as a means of data collection. Participant narrative was recorded electronically, transcribed verbatim, and analyzed thematically using a well established human science approach.

Results: The thematic analysis revealed five main themes and a number of sub-themes. Four of the main themes were aligned easily with the four chain of survival links. The remaining main theme outlined a new link in the chain of survival of specific importance to mass gatherings, ‘early planning’. Additionally, a number of sub-themes were identified, which exemplified various facilitators and barriers to the chain of survival in this environment.

Conclusions: This research highlights various barriers and facilitators to the chain of survival in the mass-gathering environment. Additionally, the unique “early planning” link in the chain of survival as described in this research highlights the importance of a preparatory phase for responders at mass gatherings.

Reference: Ranse J, Zeitz K: Chain of survival at mass gatherings: A case series of resuscitation events. Prehospital Disaster Medicine. 2010;25(5):465–471.