While 65,000 people are warming up for the Göteborgsvarvet – also known as the Gothenburg half marathon, Amir Khorram-Manesh and his colleagues are gathered in the staff room of the Prehospital and Disaster Medicine Centre in Olskroken. At the Centre, medical emergency preparedness is coordinated for all of Gothenburg’s major events. A tool to be used to support medical readiness at international events and disasters is also being developed here.
At the Gothenburg half marathon in 2013, 70 people had to be transported by ambulance. It was far more than what Amir Khorram-Manesh and his colleagues at the Prehospital and Centre for Disaster Medicine Centre had anticipated.
Miscalculation is hardly unique. events are constantly occurring in the world which illustrate in a merciless way how difficult it is to plan and allocate the response resources in the event of a potential or ongoing disaster.
An example is the Hajj, the Muslim holy pilgrimage to Mecca that gathers over two million individuals. In the huge throng that occur, hundreds die of disease or after being trampled.
The collective medical readiness: nine ambulances.
“In recent decades, major accidents, natural disasters and global terrorism has intensified the need for research into emergency medical response. With a response to a disaster, various parties often make completely different risk assessments. Decisions are made without any scientific basis, which has major implications for emergency response efforts,” comments Amir Khorram-Manesh.
As a researcher at PKMC and the Sahlgrenska Academy, Amir Khorram-Manesh and his colleague Erik Carlström are now attempting to develop a completely new standard tool for disaster medicine, which will be able to calculate in a scientific way and project the medical emergency efforts and thus bring different parties assessments closer together to each other.
In this work, the Gothenburg half marathon plays a special role.
“When we reviewed the 70 incidents of ambulance calls that resulted in pickups that were made in 2013, we saw that these are largely made in clusters, at certain sections of the track. This led us to think about what particularly distinguishes these sections. Is track gradient or slope stronger? Is the temperature higher, the surface harder? Is the crowding too congested?” explains Erik Carlström.
“Our hope is to be able to conduct a scientific study of the Göteborgsvarvet, because we believe that there is something to learn here of a more general value with regard to risk factors and medical emergency preparedness,” says Amir Khorram-Manesh.
Every year, 90 major events are organized in Västra Götaland, of which 30 are considered to be of particular high risk. During these events, Amir Khorram-Manesh and his preparedness colleagues have the assignment with heavy responsibility to be the strategic medical adviser – an assignment where Amir makes use of both his many years of experience as a physician and director of the region’s trauma surgery, and of his research.
Both Amir Khorram-Manesh and Erik Carlström are among the country’s most accomplished researchers within the field of disaster medicine and emergency preparedness. They have also participated in the development of MACSIM: a unique Swedish system for disaster simulation which Amir is now introducing beyond Sweden to various places in the world.
“I have been to Thailand several times, including working with the flooding that occurred in Bangkok, and have also arranged training in Croatia, Holland, Italy, Slovakia and Portugal. There is a very significant international interest in our model,” he remarks.
Next year, Erik Carlström will publish a 470-page book describing practice models for what the researchers call the “blue-light activity”:
“Every day we read in the newspapers that there is a shortage of ambulances. But there actually is plenty of data to immerse oneself in, where we, in a scientific manner, could be able to achieve major improvements.”
“On the international scale, we have a graduate student who comes from Saudi Arabia, and who is currently interested in emergency preparedness around the pilgrimage. We also work with researchers in Iran and in Thailand to develop the prehospital care. It may be that it is internationally where our research has the greatest benefit,” says Amir Khorram-Manesh.
FACTS ABOUT PKMC
The Prehospital and Disaster Medicine Centre, PKMC, is the Region Västra Götaland unit for crisis and disaster preparedness. The strategic, medical efforts made during disasters and serious events are managed from here, partly via preventive efforts as well as during the progression of the emergency, and where subsequent follow-up analyses are conducted.
PKMC was formed in the aftermath of one of Sweden’s largest disasters: the discotheque fire at Backaplan in 1998, in which 63 people died and more than 200 were injured – most of them young people. The Centre is now one of Sweden’s five training centers in disaster medicine and gathers together students, researchers, doctors and nurses.
At PKMC, research and development in disaster medicine is ongoing continually, focusing on such areas as trauma surgery, infectious diseases, triage and hospitals evacuation.
Picture Caption – bicycles: The Göteborgsvarvet attracts large crowds to Gothenburg which increases the need for additional medical care resources. One such enhancement is a cycling medical team.
