{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T12:04:15Z","timestamp":1790597055382,"version":"4.1.0"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Background<\/jats:title>\n Mass gatherings can generate concentrated, time-dependent demand across in-event health services, municipal emergency medical services (EMS), emergency departments, and inpatient services. Evidence relevant to preparedness is heterogeneous and is often reported with inconsistent denominators, limiting direct comparison.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This structured narrative review synthesizes published evidence on EMS and hospital surge-capacity integration across the four surge domains of staff, stuff\/supplies, space, and systems. The review retained the original structured search of MEDLINE\/PubMed, Embase, Scopus, Web of Science, and the Cochrane Library for 2010-February 2026 and incorporated a focused PubMed and citation update through September 2026. Because the purpose is interpretive synthesis rather than exhaustive effect estimation, no\n de novo<\/jats:italic>\n meta-analysis or pooled estimates were produced; quantitative findings are reported with the denominators and analytic context used by the source publications.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A 2025 scoping review of 41 papers reported medical-doctor presence in 34\/41 papers (82.9%), medication interventions in 23\/41 (56.1%), procedural interventions in 23\/41 (56.1%), health-support systems in 18\/41 (43.9%), mobile treatment spaces in 23\/41 (56.1%), and temporary structures in 21\/41 (51.2%). That review reported median calculated patient-presentation and transport-to-hospital rates of 6.2 and 0.35 per 1,000 attendees, respectively, whereas a separate 22-article stadium review reported much lower medians when standardized per 10,000 spectators. Hospital effects were directionally heterogeneous: a 14-study systematic review found event-associated emergency-department changes ranging from 7.5%\u201337% decreases to increases as high as 83% in specific settings. Digital integration has shown promising simulated gains, but clinical effectiveness remains insufficiently validated.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Preparedness is best treated as an integrated continuum rather than as separate event-site and hospital plans. Standardized denominators, linked patient-level data, context-specific resource design, and prospective evaluation are priorities.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2026.1861093","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T11:43:46Z","timestamp":1790595826000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrating emergency medical services and hospital surge capacity for mass-gathering preparedness: a structured narrative review"],"prefix":"10.3389","volume":"13","author":[{"given":"Abdullah","family":"Basnawi","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Department of internal medicine, University of Tabuk","place":["Tabuk, Saudi 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