Dublin EDs struggling to find extra medical staff to cope with expected papal mass influx

The Irish Association of Emergency Medicine (IAEM) has voiced concerns on the potential influx of between 250 and 750 people attending the Papal Mass in the Phoenix Park on Sunday August 26 into the six Dublin emergency departments (EDs).

Some planning has occurred but it has been too late starting, according to the Association, and the necessary extra funding to hospitals is as yet unconfirmed. The assumptions about workload also appear to have been unduly conservative believes the Association.

An on site medical facility is planned with the aim of resuscitating and stabilising the most critically ill before transport to an ED but it is not yet adequately staffed. Because of ongoing staff shortages, Dublin EDs are struggling to bring in the extra medical and nursing staff that will be needed to cope with the extra arrivals to the receiving hospitals.

The medical literature on mass gatherings describes the numbers likely to require medical care on site and the numbers that will need transport to hospital. From the literature, the IAEM says it is clear that papal masses carry additional specific risks such as a significant number of older attendees, many with pre-existing illnesses; a mobile unseated crowd; a prolonged length of time on site and exposure to the elements.

For the expected 500,000 people in the Phoenix Park, this equates to 1,000–3,000 requiring medical assistance, mostly first aid on site, but between 250 and 750 needing transport to one of the six Dublin EDs.

The Association said it is well known that the public hospital system is struggling to cope with increasing patient numbers and needs. The pressure on acute care is most evident in EDs with long waits to see a doctor, and unacceptably long waits for a quarter of attendances needing hospital admission on an ED trolley waiting for a hospital bed now being the norm.

While the volunteer first aid services and the ambulance services will be on site to provide care, these services will not have medical support.

Last Monday morning (August 13), there were 47 admitted patients without hospital beds in the Dublin hospitals, 41 of them on ED trolleys.

By the following morning, that number had increased to 87, including five children. “We expect that scheduled care will be cancelled to provide some extra bed capacity but this is unlikely to be sufficient. Some people may defer attending for care until the Monday or Tuesday after the Papal Mass.

“This will bring its own risks to individuals and is likely to cause a continuing surge in ED attendances. These days will also need to be staffed and resourced appropriately,” the Association added.

valerie.ryan@imt.ie