How to Design an Emergency Medical Services System for Mass Gathering Swimming Activity in Crossing Sun Moon Lake in Taiwan

Summary: Once a year, during the Festival of Sun-Moon Lake in Nan-Tou County, Taiwan, a long-distance swimming mass gathering event (LDSMG) takes place. It’s about 3 km from the launch to the landing area. The number of participants was 22,606 in 2024. This study aimed to collect patient data from the medical stations (launching and landing areas) and analyze the differences between them. In 2024, the number of patients requiring treatment was determined from on-site data. A total of 152 patients presented at on-site medical stations (MSs). The medical utility rate is 0.67%, where 35 patients presented to launching MSs and 91 to landing MSs. The ages ranged from eight to 80 years. Eighty-four patients (55%) were male. Fifty-six patients were treated with medication (2.74 per 1,000 attendees). Four patients were taken to the hospital (0.04 per 1,000 attendees); two were from a landing MS. The injuries included trauma (47.3% vs 20.0%), such as abrasion, laceration, contusion, and hypothermia (8.7% vs 6.6%), eye problems (9.9% vs 0%), etc. The patients got specific problems like hypothermia, abrasions, and eye problems more often in landing MS. The medical utilization rate was 0.84%, reached a high of 0.88%, then fell to 0.67% in 2024. The patient presentation rate (PPR) was quite the same from the data gathered on-site. The PPR of LDSMG was related to factors including the seating or standing, the outdoors or indoors, the mobility of the crowd, whether the activity was contained within a boundary, attendance figures, and humidity and temperature. It’s especially related to the water temperature, visualization of the lifeguard, the capacity of the space in swimming, and the crowdedness of swimmers. The medical stations, including staff, supplies, and facilities, should be tailored to the medical needs of the swimmers accordingly.