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When fire chiefs support fire codes at mass gatherings, they save lives

Pre-planning and code enforcement are essential to EMS accessing, treating and extricating patients from political rallies and other mass gatherings

By Arthur Hsieh

The recent controversy over room capacity at presidential candidate Donald Trump’s political rallies point out very real issues surrounding such high-profile events. From operational concerns to public relations nightmares, this level of scrutiny nevertheless provides lessons for EMS and fire service personnel.

Many of us have worked special events and mass gatherings in the past and can speak from first-hand experience how large crowds are not just simply inconvenient, but potentially life-threatening for victims whose accessibility by EMS personnel is severely hampered. Heat, noise and confined space make an accurate patient assessment difficult. Face-to-face and radio communications with crews and dispatch are challenging. Removing a patient via gurney or litter may be impossible.

Meanwhile, citizen journalists — event attendees with their smartphones — are able to broadcast every EMS action. The musician, celebrity or politician may even pause their performance as EMS responds to the emergency — drawing additional attention and scrutiny.

Building codes, including occupancy limits, designated emergency exits and emergency responder ingress routes, exist because of historical losses of life in nightclubs, restaurants, arenas and businesses. Regulators and code-enforcement officials are smart to ask ‘what if’ questions about potential risks, not only to determine how likely a loss of life is, but how catastrophic that loss might be.

No one anticipates worst-case scenarios like a wall or stage collapse, bleacher failure, explosion or deadly fire. Too often, it’s only after damages have occurred that we realize saying ‘what if’ is much better than saying ‘if only.’

This year’s political rallies are marked with a great risk of violence. Departments must over prepare to manage mass gatherings at political events. Interagency cooperation is an absolute must and ground coordination is essential for success. These types of rallies pop up quickly, often in just a few days, and agencies must be agile in their response.

For field providers, scene safety concerns are continuous. Close working relationships with law enforcement and event security will help create safer working spaces, such as in cases where a victim must be extracted from a crowded area to a safer location.

Several fire marshals have been publicly taken to task over their code enforcement duties. These codes, written by experts and supported by evidence, are designed for the safety and protection of the people who are attending events in high-occupancy, public buildings. Fire marshals are simply required by law to enforce these life safety regulations.

Nevertheless, as the recent rhetoric has shown, politics have a way of complicating matters. Agencies should be prepared to respond to public scrutiny of policies and procedures, because long after this controversy blows over, the same agencies will continue to serve and protect the public’s safety.

About the author

EMS1 Editorial Advisor Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Art is a member of the EMS1 Editorial Advisory Board. Contact Art at Art.Hsieh@ems1.com.

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