Medical Support At Public Events: Why “Being There” Isn’t Enough

“As an emergency physician, I have learned one hard truth over years of practice: emergencies do not announce themselves, and survival depends on preparation not intention. Public events whether marathons,

religious gatherings, festivals, concerts, or political rallies are meant to bring people together. Yet, behind the crowds and celebrations, medical preparedness at many such events remains seriously inadequate,” shares Dr Shameem K. U., Clinical Director, Group Coordinator & Consultant, Department of Emergency Medicine, KIMSHEALTH, Thiruvananthapuram

“In my experience as an emergency medicine specialist, intent without preparation simply doesn’t save lives,” says Dr. Shameem K. U. “Large public gatherings expose people to physical strain, emotional stress, and delayed access to care, but medical planning is often treated as an afterthought.”

A recent public event in India illustrated this failure clearly. Despite large participation and obvious physical stressors, medical arrangements were minimal. When an individual collapsed and suffered a cardiac arrest, there was no organised emergency response. Instead, the person was transported to a hospital by a bystander in a private vehicle.

“This was not bad luck,” Dr. Shameem K. U. emphasises. “It was a failure of planning.”

When Presence Is Mistaken for Preparedness

From an emergency medicine perspective, any mass gathering is a high-risk environment, explains Dr Shameem K. U. Heat, dehydration, crowd density, physical exertion, emotional stress, alcohol use, and delayed access to care all increase the likelihood of medical emergencies ranging from minor injuries to life-threatening conditions such as heat stroke, trauma, stroke, and sudden cardiac arrest.

“Too often, medical cover at public events is reduced to a symbolic gesture,” says Dr. Shameem K. U. “A single ambulance, a basic first-aid desk, or a few volunteers may offer comfort, but they do not provide capability. Medical presence does not equal medical readiness.”

Why This Matters in Cardiac Arrest

“In cases of cardiac arrest, every minute without CPR and defibrillation reduces survival by 7–10 per cent,” notes Dr. Shameem K. U. Survival depends on rapid recognition, immediate high-quality CPR, early defibrillation, and swift transport with advanced life support.

“When trained teams, essential equipment, and clear response protocols are missing, outcomes are left to chance,” he adds. “In emergency rooms across the country, we see patients arriving too late, with severe brain injury or irreversible organ damage outcomes that could have been prevented with timely on-site care.”

Minimal Cover Is a Dangerous Illusion

From a public health standpoint, minimal medical arrangements at large public events amount to a calculated risk, says Dr Shameem K. U. Multiple medical emergencies can occur simultaneously across large venues, and without distributed medical teams and rapid response systems, delays are inevitable and delays cost lives.

“Globally accepted standards for mass gatherings already exist,” he points out. “They include adequate ambulances with basic and advanced life support, trained medical and paramedical staff across venues, accessible AEDs, and clear triage and evacuation plans. These are not excessive demands they are minimum safety standards.”

From Responsibility to Regulation

According to Dr. Shameem K. U., public safety cannot rely on goodwill alone. “The moment organisers invite people to gather, they assume a duty of care,” he says. “That duty must be enforced through regulation.”

He calls for mandatory national norms covering medical risk assessments, defined staffing and equipment ratios, compulsory AED availability, certification of medical readiness before permissions are granted, and accountability when standards are violated.

A Call to Act

“A person collapsing at a public event should be met by a trained medical team not by fellow citizens improvising care in desperation,” Dr. Shameem K. U. asserts.

“From the emergency room, we see the cost of inadequate planning every day,” he concludes. “Being present is not enough. Being prepared must become mandatory. Lives depend on it.”