Medical Support for International Sports Events国际体育赛事的医疗支持 - an experience of the 2002 FIFA World Cup Games in Korea 2002年韩国世界杯的经验 Joon Pil Cho, MD, PhD Department of Emergency Medicine Ajou University School of Medicine, Suwon, Korea 韩国AJOU大学医学院急救医学部 jpcho@ajou.ac.kr

Contents内容 Experience of 2002 FIFA World Cup Games in Korea 韩国2002年世界杯的经验 Issues of Medical Planning for International Sports Events国际赛事医疗计划问题 Mass Casualty Preparation 应对大众意外伤亡的准备工作

2002 FIFA World Cup In Korea 韩国2002年世界杯 Type of events: Football games 赛事类别：足球 Venues: 10, Teams: 16, Matches: 32 赛场：10个，参赛队16个，比赛场次：32场 Duration of events: one month 赛事时间：一个月 Size of crowds观众规模 Each stadium: 45-65 thousands 每个体育场馆：45000-65000 Total expected spectators: 160 millions plus 预计观众总数：1亿6千万 Local medical facilities: 当地医疗机构： Designated hospital within 30 minutes在30分钟内到达的指定医院 Affiliated hospitals附属医院 Wide regional emergency medical center广泛的地区性医疗急救中心 As we know well. It is football games, which peoples living all over the world will watch. It will held 10 cities all of the country in Korea. There will be 32 matches of 16 teams from all continents of the world. It will last one month. We can estimate the size of the crowds according to sold tickets in advance. Each stadium can host 45 to 65 thousands of spectators. So we can expected spectators over 160 millions in total. Except Seoul, there is one designated hospital at each venue and more than one affiliated hospitals. Most of the designated hospital has Wide regional emergency center designated by Ministry of Health.

Spectators and Patients 观众和病人 N=977,028 (7 Stadium, 23games) 7个体育馆，23场赛事

Patients 病人 Total number of Pts : 1,305 pts (23games) 病人总数：1，305人次（23场赛事） Number of pts / games : 56.7 pts 病人数/场：56.7人次 Number of pts / 1,000 spectators : 1.34 pts 病人数/1，000名观众：56.7人次 man 725(55.6%) : woman 580(54.5%) 男725(55.6%) : 女580(54.5%) average age : 30.8 (1~78) 平均年龄： 30.8 (1~78) foreigner : 81(6.2%) ； 外国人： 81(6.2%)

The patients病人 N=1,305 1000 1200

Age Distribution of Patients病人的年龄分布

CardioVascular Problems Causes of visit 就医原因 etc 5.6% 79 pts GI Problems injury 25.7% 336 pts 19.3% 251 pts CardioVascular Problems 0.7%, 9pts 13.4% 175 pts OB-Gyn Problems 2.1%, 28 pts 33.2% 433 pts Headache Respiratory Problems N=1,305

Severity 严重性 moderate 1.1% 14 pts severe 0.2% 3 pts mild 98.7% Hospital Transportation 来自医院的数据：中、重症患者（0.74/场, 0.017/1,000 观众）一人由于从体育馆跌落造成头部损伤而死亡。 moderate, severe (0.74/game, 0.017/1,000 spectators) (one mortality due to head injury due to fall at stadium) moderate 1.1% 14 pts severe 0.2% 3 pts mild 98.7% 1,288 pts N=1,305

Summary小结 Patients 病人: Severity严重程度： mild 轻为主 (98.7%) 56.7 / game场, 1.34 / 1,000 spectator观众 Severity严重程度： mild 轻为主 (98.7%)

2008 Beijing Olympic Games 2008北京奥林匹克大赛

Information for Medical Planning 医疗计划所需要的信息 Type of events 赛事类型 Duration of the events赛事持续时间 Structure of the venue比赛地点的建筑结构 Size of crowds 人群的规模 Local medical facilities当地医疗设施

Type of Event 赛事类型 A total of 28 sports will feature on the program for the Beijing Games. 北京奥运会总计将有28种运动列入计划 These 28 sports are made up of 302 events, comprising 165 men’s events, 127 women’s events and 10 mixed events. 这28种运动由302场赛事组成，包括165个男子比赛项目，127个女子比赛项目和10个混合比赛项目

Duration of Events 赛事持续时间 Opening date: 8 August 2008 开始日期：2008年8月8日 Closing date: 24 August 2008 结束日期：2008年8月24日

The Venue 比赛地点 Host City : Beijing 举办城市：北京 Co-host city 合办城市 Qingdao青岛: Sailing 水上航行项目 Hong Kong 香港: Equestrian 骑马项目 Tianjing 天津: Football 足球 Shanghai上海: Football 足球 Shenyang沈阳: Football 足球 Qinhuangdao秦皇岛: Football 足球

Structure of Venue 比赛地点建筑结构 This slide shows schematic picture of the stadium. The grandstand is divided into five sectors including one for VIPs. The spectators will not be expected to move freely to each other sector. Each sector has one first aid room staffed two physicians and two nurses. Four paramedics or nurses will be staffed at each sector. Outside of the stadium, one first aid both will be located for peoples gathering to buy tickets or to enter the stadium. Entrance Ticketing

Chronology of Major Crowd-Related sports events 造成大规模人群聚集的主要运动赛事年表 Year Location Event Cause Deaths Injuries 1964 1971 1985 1989 1994 Lima, Peru Glasgow, U.K. Bradford, U.K. Brussels, Belgium Birmingham, U.K. Hillsborough, U.K. Baytown, U.S.A Football Game Sports Event Riot and Panic Crowd Pressure Crowd Crush Stadium Fire Crowd Panic Riot Crowd Craze Grandstand collapse 300 66 56 39 1 95 500 ‘100s’ Unknown 200 375 250 400 17

Mass Casualty Incidents 人群意外伤亡事件 Definition 定义 Situations overwhelming the capacity of medical care by the medical personnel staffed inside of the stadium 大幅超出运动场内医疗人员进行医疗救助的能力范围。 Medical help needed 医疗救助需求 From local medical facilities 来自当地医疗设施 Mutual aids from adjacent cities 邻近城市相互援助

Mass Casualties Incidents 人群意外伤亡事件 Hooliganism/Crowd violence 流氓/人群暴力 Crowd surge/panic 人群猛增/恐慌 Structural collapse/Fire 建筑的倒塌/火 Terror attacks 恐怖袭击 Bomb blast, biological, chemical 炸弹爆炸，生物性的，化学性的 Protestor 抗议者 Transportation accidents 交通事故

Immediate post event phase 赛事后续事件处理 Main sectors involved 有关的主要部分 Police 警察 Fire/Rescue 火灾/营救 Medical 医疗 Main Issues 主要问题 Scene control 场面控制 Triage and Victim care 治疗类选法和照料伤员 Dispatch and Transportation 分派和交通

Police department 公安部门 Scene control 场面控制 Criminal evidence collection 犯罪证据收集 Evacuation of crowds 人群的撤退 Traffic control 交通管制 The police department must keep the scene safe. 경찰이 현장이 안전하다고 확인해 주기 전에는 의료 종사자들이 현장에 들어 가서는 안 된다. 특히 테러로 인한 경우 현장에 위험 물질이 유포 되어 있을 수도 있고 시간 차를 두고 2차 테러를 감행할 수도 있기 때문이다. 또한 범죄와 연관되어 있을 경우 범인 체포와 향후 수사를 위하여 증거를 확보할 수 있도록 조치를 취하는 것도 경찰의 주된 임무 중의 하나이다. Crowds panic or crowds surge는 최초의 event에 더 하여 이 자체만으로도 많은 사상자를 낼 수 있으므로 관중들이 동요하지 않고 질서 있게 현장을 빠져 나갈 수 있도록 유도하여야 한다. 효율적인 대피를 위하여 재난 상황을 가상하여 사전 시나리오를 만들어 놓아야 한다. 재난 현장에서의 교통 통제는 EMS 관계자들이 현장에 진입할 수 있도록 관중 대피로와 별도로 설정해 놓아야 하며 현장에서 구조된 사상자들의 병원으로의 원활한 이송을 위해서 일방통행의 도로가 확보되는 것이 좋다.

Fire/Rescue 火灾/营救 Fire fighting 灭火 Elimination of hazardous material 消除有害材料 Search and rescue 搜索和营救 Scene triage 现场治疗类选 Decontamination of the victims at scene现场受难者消毒 Transportation of the victims 受难者运输 소방은 화재가 났을 경우 진화의 책임이 있으며 생화학적 테러 시 현장의 chemical or biological hazard material을 제거 하여야 한다. Stadium의 붕괴나 광범위한 재해 상황일 경우 search and rescue를 담당하여야 한다. 소방의 또 하나의 주된 임무는 현장에서의 일차적인 triage이다. 이는 greatest good for greatest number라는 재해 의료서비스의 목표를 달성하기위한 매우 중요한 임무 중의 하나이다. Decontamination of the victims at scene 과 transportation도 소방의 중요한 임무 중의 하나이다.

Medical sector 医疗部分 Life support at the victims collection point 受伤人员聚集点的生命救助 Secondary triage 次要伤员鉴别分类 Dispatch to appropriate medical facilities 分派适当的医疗设施 Transportation of victims 运输受伤人员 Definitive care at hospital 医院治疗

Public Health concerns公共卫生影响 Drinking water 饮用水 Sanitary facilities卫生设施 Shade or Shelter in adverse weather conditions 恶劣气候时的避难场所

Summary 小结 Issues for Medical Planning 医疗计划的问题 Type of events 赛事类型 Duration of the events 赛事持续时间 Structure of the venue 比赛地点的建筑结构 Size of crowds 人群的规模 Local medical facilities 当地医疗设施