Mobile computed tomography at the Munich Oktoberfest : From idea to implementation.

Abstract

Background: The Munich Oktoberfest, the largest folk festival in the world, attracts around 6.2 million visitors over 16-18 days. Some of the visitors exhibit certain risky behaviors, leading to a significantly increased number of medical emergencies during the festival. During Oktoberfest, the prehospital and clinical emergency services of the city are heavily strained, as one-third more ambulances are needed, and over 7000 patients must be treated on-site each year. Until 2022, there was no option for guideline-compliant radiological assessment on-site for patients with head or facial trauma and suspected serious trauma-related injuries. This required a large number of emergency service admissions to hospitals, mostly for outpatient assessments. To relieve the overburdened medical system, a mobile computed tomography (CT) scanner was set up on the Oktoberfest grounds in 2022 for the first time.

Methods: A mobile CT scanner at the Munich Oktoberfest was utilized for diagnosing injuries to the face, cranium, and cervical spine. For an indication of cranial CT, we used a combination of the Canadian CT Head Rule and NEXUS criteria. Despite the complex structural conditions, this integration seamlessly fit into the structured processes of the on-site medical service. Since this deployment was, to our knowledge, the first of its kind globally, we had to develop and implement new clinical concepts and procedures tailored to the unique conditions of a folk festival.

Results: We demonstrated that a CT scanner could be effectively integrated into the preclinical processes of a medical service without direct hospital connection. On-site CT diagnostics proved to be a highly effective means of avoiding unnecessary transportation to the hospital. Consequently, a reduction in emergency medical service provision and stabilization of clinical emergency medicine during the Oktoberfest became feasible.

Conclusion: From the authors' perspective, establishing a mobile CT scanner at events with high or very high demands on preclinical and clinical emergency medicine is feasible and provides significant relief for the system. The primary goal of stabilizing prehospital and clinical emergency structures, as well as improving the detection and treatment of potentially life-threatening patients on-site, was successfully achieved. Careful integration into the overall process flow is essential.