Spontaneous and Unplanned Mass Gathering Events: A Scoping Review of Health Considerations for Riots, Civil Unrest, and Protest.

Objective: To identify the health planning, health provision, and health lessons learned from unplanned or spontaneous mass gathering events.

Methods: This research used a scoping review design. Data was collected from 4 databases, using search terms relating to "mass gathering events," "spontaneous events," and "health services." Data was extracted relating to the event characteristics, health usage, and patient outcomes. Extracted data were deductively coded against the surge capacity domains of staff, stuff/supplies, space, and systems.

Results: Ten papers were included in this review. Most spontaneous mass gathering events were related to riots, civil unrest, or unplanned large parties, which required a response from the health care system. Health staff were predominantly from an ambulance, pre-\hospital, or emergency medical services. Additional personal protective equipment, such as ballistic equipment and respiratory protection, was required.

Conclusions: The planning for a health care response to a spontaneous mass gathering event requires a risk-based approach. Such an approach should be applied in local disaster and mass casualty plans as a hazard-specific response. Preparation and response should include interagency collaboration. Enhancing the reporting of spontaneous mass gathering events will provide insights for future planning and response.