Emergency Medical Services
London 2012 Olympic and Paralympic GamesDr Pamela Venning DSC PhD RN
November 3rd 2017

Health Bid Commitments• Free Hospital Care during Games time
• Release of volunteers from the NHS• Ambulance services for all venues and athlete care

LOCOG’s Medical Responsibilities
LOCOG was responsible for:• Medical and health care planning for all client groups
associated with the Games• Coordination of delivery of medical care inside all
Olympic and Paralympic venues and sites• Ensure there is appropriate medical care outside
Olympic and Paralympic venues
The aim of the service was to:“ to provide an accessible, high quality andcomprehensive medical service to all Games clientgroups “3The London Games – Some Information

Sports and Competition Venues
Wembley• Football• Badminton• Gymnastics

Central Zone
Wimbledon• Tennis•••••Archery
Triathlon
Beach Volleyball
Volleyball
Marathon , Road Cycling

Lord’s Cricket Ground
Hyde Park
Horse Guard’s Parade
Earl’s Court
London Streets

Olympic Park•
••
•
•
•
•
•
•

Athletics - Olympic Stadium
Aquatics Centre
Water Polo
Cycling - Velodrome
BMX Circuit
Hockey Centre
Basketball ArenaHandball Arena
Wheelchair Tennis

River Zone

• Boxing, Judo, Fencing, Taekwondo, Table Tennis,
Weightlifting, Wrestling, Boccia ExCeL• Equestrian, Modern Pentathlon Greenwich Park
• Shooting, Paralympic Archery Royal Artillery Barracks• Basketball (Finals), Gymnastics North Greenwich Arena

Venues outside London

Coventry
Hadleigh
Hadleigh
Farm
Farm

Eton Dorney

Weymouth &Portland

LondonOlympic Park
Competition Venues• Olympic Stadium (80,000)• Hockey centre (20,000)• Basketball Arena (12,000)• Handball Arena (7,000)• Aquatics Centre (17,500)• Water Polo Arena (5,000)• VeloPark (6000)• BMX (6000)• Eton Manor (10,500)
Non Competition Venues• Athlete Village• International Broadcast Centre• Park Common Domain

London Olympic Medical Data
27th July – 12th August
Encounters per Medical Provider - EMS
8000
7109

7000

NUMBER OF ENCOUNTER

6000
5000
4000

3391

3000

2019
2000
555

1000

730

718

0
04 Doctor Crowd

06 Doctor Field of Play

09 Doctor Sports

10 First
Responder

11 Nurse

NULL

Planning EMS Services

A Games Planning Structure
Commercial
Commercial Negotiations
Merchandising
Client Services
Ticketing
Procurement
Commercial Business Management

TechnologyBusiness Technology Services
Internet Technology Services

Games Operations
SportGames Services

CultureSport Competition

Accommodation

Opening and Closing Ceremonies

Sport Policy & Operations

Catering & Food Services

Torch Relay

Sports Presentation

Cleaning & Waste Management

Medal Ceremonies

Test Events

Arrivals & Departures

Team Welcome Ceremonies

NOC and NPC Services

Transport

Education Programme

MedicalLogistics

Youth Camp

Anti-Doping

City Operations

Livesites

Sport Management & Support

Games Services Management

Animating Venue Experience
CCE Team Management

Security

Results Technology Services
Telecommunications Services
Technology Programme Office
Technology Service Delivery
Technology Operational Readiness
Venue Technology Services

CCE

Venues & Infrastructure
Venue Development & Overlay

Security

Villages
Village Management

LegalVenue Management
Spectator Services

Broadcast
Broadcast Services

HR

Paralympic Integration

HR Operations

Paralympic Planning & Delivery

Uniforms

Look, Way Finding and Signage

SSP

LegalVenue Department Management

Planning&Programme Management

Volunteering

Stakeholder Relations

Communications and Public Affairs

Finance

Accreditation

IKM

Website & New Media

Finance (Planning, Control & Payments)

Workforce Training

Editorial Services

Risk Assurance

Workforce Planning

Community Relations

Rate Card

Diversity and Inclusion

Corporate EventsMedia and PR

Facilities

Nations and Regions

Government Relations

Health and Safety

Sustainability

Press Operations

C3Contact Centre

International Relations

CPA Management

HR Management

Brand and Marketing
Brand and Marketing

Executive OfficeMedical Services - Key milestones
DateDescription

G-65

Appoint Head of Medical Services

G-60

Polyclinic design agreed

G-60

Define workforce requirements

G-60

High level draft list of equipment, consumables and pharmacy products

G-54

Commence public health planning

G-54

Commence policy and procedure development

G-40

Identify clinical experts

G-36 – G-15

Appoint first medical coordinator

G-30

Outline clinical service requirements

G-30

Identify procurement streams and commence procurement process

G-24 – G-0

Volunteer recruitment starts

G-18

Polyclinic facilities finalised

G-18

Clinical services agree prior to test events

G-12 – G-0

Volunteer training commences

G-12

Review equipment, consumables and pharmacy post test events

G-6

Final clinical services finalised post test events

G-3

Licences for pharmacies and venue drug storage

Event Literature

Multi Sport Games Time Medical Organisation
International Olympic
Committee MedicalCommission

Medical HQ

Procurement Manager

Director of Sport

Procurement Assistant

Head of Medical Services

Chief Medical Officer

Workforce Co-ordinator

Clinical experts

Workforce AssistantTeam Coordinator
Emergency Medical Services
ImagingPharmacyManager- Polyclinics, Official
Hotel Services &Technical Officials

Medical Group Leader

Medical Group Leader

Central and River ZoneVenues

Olympic Park

Medical Group Leader

Physical Therapies
Polyclinic

Outer London Venues
Sport Medicine

Venue Medical Managers

Volunteers

EMS

ImagingPharmacy

Polyclinic

SportRadiologist

Nurse

Radiographer

First
Responder
Team Leader

Radiographic
Team
MemberFirst
Responder
Team
MemberSport
Pharmacists

Primary
Care Nurse

GP

DentalNurse

Dentist.

Osteopath

DentistHygienist

Dental Lab
TechnicianSports
Massage
PractitionerOptometrist

Dispensing
Optician

Podiatrist

MedicalDispatcher

Chiropractor

PhysiotherapistPolyclinic
Nurse

Medical FOP
Team Leader

MedicalFOP Team
MemberSports
Medicine

Polyclinic and Venues

Polyclinic and Venues
Crowd
DoctorPhysical
Therapies

MedicalDriverEmergency

Medicine
DoctorMedicalAdmin

Emergency
Nurse

Sport
Medicine
DoctorAims of London 2012 EMS• Use of Dynamic Risk Assessment methods• Mobile Services “treat in the seat”• Compliant with UK standards for sport and non sport
events• Unified services for all client groups• Standardized methods• Standardized equipment• Integrated working within the organising committee• Partnership working with national health andemergency services• Reduce pressure on “business as usual” for theHealth Service

Stakeholder and Partnership WorkingGovernment Organisations• Department of Health; central and local• Other Government departments (Security and Policing)• Wales, Scotland and NI• Local Authorities
Clinical Delivery Partners• Ambulance Services• Designated Hospitals• Other non designates hospitals• Primary care organisations

Other Agencies• Public Health England• Medicines authorities• Clinical professional councils• Water and air quality specialists

Public Health Planning• Major risk to the Games - planning started early• Public Health England - Mass Gathering Unit
• Team dedicated to planning with a single point of contact for:• Communicable diseases• Food, air and water quality & safety issues• Detailed policy on operations including exception reporting• Senior PH team based in Polyclinic in Athletes village• PH team had daily conference with UK wide leads daily and reported
back to• Exception reporting• PH team had a daily conference call with UK wide PH leads for signposting on any issues
17Designated Games HospitalsLondon• Athlete• Olympic/Paralympic Family• TraumaRegional• One in each town/city (7)Develop a service level agreement with each hospital• Roles and responsibilities
Each hospital needed to enhance the following:
HOPLO - a single point of contact officer
Security

PrivacyCommunications

Facilitated Admission

Drugs in Sport• Operational Hand Book18

Ambulance Services• London Ambulance Service (LAS)• Lead service for the UK• Dedicated senior lead at Ambulance HQ• Operational lead embedded in LOC• Managers aligned to venue clusters• Service level agreements with 8 services• Operational handbook developed• Daily calls with HoM and Ambulance HQ lead
• Mutual aid to LAS from ambulance services in England andWales

Medical Risk Assessment
London 2012 Olympic Games and Paralympic Games
Olympic Park

Systematic Approach to Risk Asessment• Sport rules for Olympic and Paralympic Games• Length of sessions• Seating capacity for each venue• Health and Safety Matters from Green Guide• Ingress and egress flows (The last mile)• Local regulations, rules and legislation• Current licenses for existing venues• Operations of other organising committee functions• Polyclinic service levels

Risk assessment methods

Consequence

Likelihood

Insignificant

Minor

Moderate

Major

Catastrophic

12345Rare

1

1234

5

Unlikely

22468

10Possible

33

6

9

1215

Likely

44812

16

20

Almostcertain

55

1015

20

25

Each hazard is identified in the assessment table below and the risk scored using the matrix. Any mitigating
factors and additional risk treatments are then added and a further assessment is made.
•Any risks that remain in the red or orange section (Scores between 8 and 25) after the residual risk iscompleted will need to be reassessed and additional mitigation/ controls put in place to reduce the risk
further.

•Any risks that are yellow (Scores between 4 and 6) should be highlighted to ensure that all persons areaware of the controls for that risk and if possible further controls employed.

•Risks that are green are low risk but they must still be considered by all personnel and additional
controls put in place if possible.

Who isaffectedCL

IssuesRisk

Potential Hazard

Further actions / CompletionDate and by who

Residual
Risk Score
CL

Risk

InitialRisk Score

236313414

Medical team to develop
plans for casualty
evacuation from seats.
Seating, stairwells andangle of rake

Staff/spectators

The upper tier is a temporary build; the designmeans there is no concourse or usable lifts fromthis level.
4312

Patients have to be carried down two levels withover 150 steps.

All casualty evacuationfrom the stand will be afour man lift.
Carry chairs with theability to be wheeled
down stairs will beavailable.
A second team will beavailable to take overwhen the initial teamneed to rest.

Audience profile
causing specificissues.

Staff/spectat
ors

3

1

3

Mixed family groups.

Risk of staff not fully understanding their roles.
Inadequate briefing of
medical teams

Staff/Spectat
ors/Athletes

4

2

8

Staff may not be aware of any dynamic risks
identified from the venue brief.

N/A

Ensure adequate briefing
to all medical staff before
each shift and provide
summary hand-out brief.
Ensure all medical staff
are aware of the venue
Operational Plan.

Olympic Stadium - Planning
Athletics & Ceremonies

80,000 Capacity

Minimum No Required Provided by Additional Athlete Total ambulanceby ‘Safety at Sports
Type of Medic
Minimum Qualification
LOCOG
medical provision vehicles providedgrounds’
Certificate of first aid H&S regs
First Aiders
4540
1981
Trained & experienced in
Crowd doctor
14
immediate care
Venue Medical Manager
2
Paramedics
IHCD qualified
44
2
NHS Ambulance
IHCD, MIMMS, Silver
2
1managers
commander qualified.
Communications officer MPDS qualified
1
1
Medical team
RGN nurses,
216Sport doctors
2Total535418Vehicles
Paramedic units
2213
Major incident vehicle
1Control Vehicle
1Total4213Additional sport
requirement

Bmx Arena

Water Polo
Basketball
2 ambulances

2 ambulances

Velodrome

Common Domain

Aquatics Centre

Common Domain

Common Domain

2 ambulances

1 ambulance

1 ambulance

2 ambulances

Handball Arena
Hockey Arena

3 ambulances

Olympic StadiumLondon Organising Committee of the
Olympic Games and Paralympic Games
Eton Dorney
Medical Plan
Version 2
November 2011

Emergency Medical Services
Equipment• Three types of bags
• Personal (600)• Medical (200)• Advanced (80)Personal Medical Bag

Medical Bag

Emergency Medical Services

RSI BagEmergency Medical Services

Emergency Medical Services• Additional Equipment• Sam splint• Kendrick splint• EZ Intraosseous• CAT Tourniquet• Celox Gauze• Scoop stretcher• Basket stretcher• Carry Chair

Emergency Medical Services

Numbers of Volunteer for Emergency Medical Services

Olympics

Paralympics

Both

FOP Team Leader

98

29

20

FOP Team Member

271

98

71

Crowd Doctor

92

38

28

Crowd Nurse

114

44

29

First Responder 2412

174

128

First Responder 1402

184

140Total

1389

567

416

All Medical26331140734

Medical Workforce Training
Venue SpecificRole SpecificOrientation

CommonRole

Test Event
Training

CommonVenue

Functional
Area SpecificRole

MedicalSpecificVenue

Specific Role

Daily
Scenario
Training

Test Event - Schedule
Cluster One

Cluster Two

Basketball
Cycling – BMX

Aug 2011
Aug 2011

Equestrian Eventing
Modern Pentathlon

July 2011
July 2011

Marathon & Race Walk
May 2011
TennisJune 2011
Volleyball
July 2011
Canoe Slalom
July 2011
Cycling – Mountain Bike
July 2011
Sailing
Aug 2011
Triathlon
Aug 2011
RowingAug 2011
Badminton
Aug 2011
Volleyball – BeachAug 2011
Aquatics Marathon Swim Aug 2011
Cycling – RoadAug 2011

HandballGoalballCycling – Track
Aquatics – Diving
Aquatics – Swimming

Nov 2011
Dec 2011
Feb 2012
Feb 2012
Mar 2012

Table Tennis
BoxingFencing
JudoTaekwondo
Wrestling
Weightlifting
Gymnastics

Nov 2011
Nov 2011
Nov 2011
Dec 2011
Dec 2011
Dec 2011
Dec 2011
Jan 2012

Canoe Sprint
Archery37

Cluster Three

Sep 2011
Oct 2011

BocciaApril 2012
Aquatics – Synchro. Swim April 2012
HockeyMay 2012
Wheelchair Tennis
May 2012
Aquatics – Water PoloMay 2012
Wheelchair Rugby
May 2012
Athletics
May 2012

Shooting
Paralympic Archery

April 2012
May 2012

FootballApril 2012

Co-ordinated Testing• Table top exercises• Venue based• All functions and partners• Games wide exercises• A day in the life of the Games• Different scenarios often including a communicable disease• All functions and external partners• City wide exercises• Nation wide exercises• External team ”injecting” events• Lasting more than one day• Repeated 2-3 times

Operations

Control Room Suite

SCREEN

Venue Control Room

VENUE SECURITY CONTROL CENTREECR Coordinator
Administrate the EventControl Room and theother spaces within thearea

Security VenueManagerProvides the link in tothe VSCC and venue

CCTV
Monitor feeds from thestadium and crowd
Management
1800mm desk

CCTV
Monitor feeds from thestadium, crowd
Management & VSCC
1800mm Desk

Fire Brigade

VGM

Safety Officer

PoliceCommander

Ambulance
Services
Commander

Radio Logist
Will record in-coming
and outgoing calls
made by the Safety
Officer/VGM

EVS Group Leader
Radio sat on EVS
stewarding Chan

PoliceAmbulance
Services
Comms Officer

Hot Desk

LOCOG Fire
Officer

LOCOG Medical
Dispatcher
Managing Medical
deployment &response with theStadium & Field of Play

Transport
Not required inall venues

Last MileNot required inall venues

BMS Engineer
Building SystemsManager

If space unavailable due
to venue constraints
these positions do notneed to be in the EventControl RoomNot required in Olympic
Park as will be present in
the Park Operations
CentreVenue Communication
Manager

VENUE NORMAL OPERATIONS AND COMMUNICATIONS

Required spaces in all
Event Control Rooms

Preferably separation or
screens

EVENT CONTROL ROOMVENUE COMMUNICATION CENTRE

NORMAL SECURITY OPERATIONS AND COMMUNICATIONS

Preferably separation or
screens

SCREEN

Communication Plan for Venue Medical Services
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICALMEDICALMEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL
MEDICAL

Medical Fleet Map
Medical Channel Ops 1 Channel
Role
Call Sign✔
✔
Venue Medical Manager
MEDLEAD✔
Dispatcher
Dispatcher✔
Crowd Doctor
Crowd Dr 1✔
Crowd Doctor
Crowd Dr 2✔
Crowd Doctor
Crowd Dr 3✔
Crowd Nurse
Crowd Nurse 1✔
Crowd Nurse
Crowd Nurse 2✔
Crowd Nurse
Crowd Nurse 3✔
Sports Medicine Doctor
Sport Dr 1✔
Sports Medicine Doctor
Sport Dr 2✔
Physiotherapy Lead
Physio Lead✔
First Responder
First Aid 1✔
First Responder
First Aid 2✔
First Responder
First Aid 3✔
First Responder
First Aid 4✔
First Responder
First Aid 5✔
First Responder
First Aid 6✔
First Responder
First Aid 7✔
First Responder
Frst Aid 8✔
First Responder
First Aid 9✔
First Responder
First Aid 10✔
First Responder
Frist Aid 11✔
First Responder
First Aid 12✔
First Responder
First Aid 13✔
First Responder
First Aid 14✔
First Responder
First Aid 15✔
FOP Team Leader
FoP 1✔
FOP Team Leader
FoP2✔
FOP Team Leader
FoP 3✔
Ambulance
Ambulance 1✔
Ambulance
Ambulance 241

Games Time Medical Communication Routes
International Olympic
Committee MedicalCommission

Partner organisations
DoH
Public Health England
Ambulance Service
Senior Security Forces
Met Police

Director of Sport

Medical HQ

Head of Medical Services

Chief Medical Officer

Procurement Manager
Procurement AssistantClinical experts
Team Coordinator

Workforce Co-ordinator

Emergency Medical Services

Workforce AssistantImagingPharmacy

Designated Hospitals

HOPLO

Manager

Medical Group Leader

Medical Group Leader- Polyclinics, Official
Hotel Services &Technical Officials

Central and River Zone
VenuesOlympic Park

Medical Group LeaderPhysical Therapies
Polyclinic

Outer London Venues
Sport Medicine

Venue Medical Managers

Volunteers

Venue ManagementTeam

Monitoring Activity• Medical Encounter System• All encounters logged• Daily reports• Daily reports from the encounter system of activity• Syndromic surveillance reports given to Public Health for review• Activity numbers sent to the IOC/IPC, DoH and Sport Director• Operational reports in venue• Intelligence from Public Health Authorities• Exception reporting• All partners

Conclusions• Emergency Medical Planning is integrated in the Medical function andthis function is working closely with other OCOG departments• Early engagement and close working arrangements with external
health care partners is essential• Games plans are absorbed into the national major incident tried andtested plans – reviewing any gaps

• Attention to detail in planning is key to a dynamic system that enables adeep understanding of medical operations – Flexibility• Investment of time, resources and commitment to training the medical
workforce is key to success of the program• Testing and review post test is essential for refining operational
planning