Special event medical care: the 1984 Los Angeles Summer Olympics experience

We conducted a study to review the organization of medical care for the 1984 Los Angeles Summer Olympics, to review the spectrum of illnesses encountered by health care providers, to determine the usage patterns of available services, and to assess the role that physicians and other providers play in special event mass medical care. Recorded medical care provided at Olympic venues with a spectator capacity of more than 10,000 (nine of 28 competitive sites) was reviewed retrospectively. Total attendance at these sites during the 15 days of competition was 3,447,807. Of this population, 5,516 (0.16%) were evaluated on site by RNs or MDs. Only 29% required physician evaluation. Common diagnoses (recorded using International Classification of Diseases code) encountered by physicians were minor musculoskeletal and dermal injuries (25%), heat-related illness (12%), and minor gastrointestinal complaints (8%). Two percent of patients presented with symptoms of cardiac disease, and only eight people required physician care for alcohol or drug ingestion. Ninety-one individuals were transferred to hospitals for further evaluation/care; of these, 22 were transferred for musculoskeletal injury and 18 were transferred for suspected cardiac disease. Usage rates (number of patient visits per 1,000 in attendance at each site) ranged from 0.68 to 6.8, with a mean of 1.6, and were higher at venues with multiple daily sessions, outdoor events, and events at which spectators could move about. We found that the majority of medical problems encountered at major athletic events are musculoskeletal, cutaneous, or of an "environmental" nature. The majority of medical problems encountered in our study were managed by appropriately trained and experienced nonphysician health care providers.(ABSTRACT TRUNCATED AT 250 WORDS)