Three Years of Medical Response at the Milan Pride: Brief Report

Mass gathering events represent complex operational environments that challenge emergency preparedness and prehospital medical response systems. Milano Pride, Italy's largest LGBTQIA+ event, attracts over 300,000 attendees annually and combines a dynamic parade with a high-density static concert. This study reports a 3-year experience (2022-2024) of prehospital organization, operational deployment, and patient presentation patterns during the event.

A retrospective observational study was conducted using data from medical action plans, mission reports, and patient records collected during the final day of Milano Pride from 2022 to 2024. The integrated response system included 6 Basic Life Support ambulances, one Advanced Life Support unit, foot and bicycle rescue teams, a field hospital, and a centralized command center.

A total of 165 missions were recorded across the 3 editions. Most cases were minor and managed on site; 8-20% required field hospital care and ≤7% hospital transport. Substance- and alcohol-related presentations accounted for approximately one quarter of cases annually. Trauma-related cases decreased over time. The mean patient age was 32 years, and the medical incident rate (0.17-0.20 per 1,000 participants) was lower than rates reported for comparable international events.

A structured, multidisciplinary prehospital system ensured effective on-site care while minimizing hospital impact, highlighting the importance of proactive planning and coordinated response in large urban mass gatherings.