EMSA Policy 7010 — Emergency Medical Services at Special Events[1]
Summary
Applies to any gathering with an expected peak crowd size of more than 1,000 people at any one time, and to events with more than 100 swimmers. Ambulances are required where peak crowd size exceeds 2,500. Crowds larger than 20,000 fall within Levels 1 to 3, and distance runs over 10k within Levels 3 to 4. Establishes a five-tier resource ladder from most to least resourced: Level 1 requires multiple ALS and BLS units greater than four; Level 2 multiple ALS and BLS units of three or greater; Level 3 one to two ALS ambulances; Level 4 a minimum of one BLS ambulance; Level 5 event EMTs with the ability to readily access further resources. Effective 1 April 2025.
So what
Supersedes the 2006 San Francisco rule that Meites & Brown studied, and the direction of travel is the interesting part. The 2006 policy triggered a standby ambulance at 15,500 attendees; that study found mass-gathering transport ran at roughly one-seventh the city's own community baseline with 46% of mandated ambulances unused. San Francisco's response was not to relax the trigger but to lower it six-fold to 2,500, while replacing the binary with a graduated ladder. Whether that is a considered rejection of the finding or a policy drift that never revisited it cannot be determined from the documents alone, but a city whose own published evidence and current regulation point in opposite directions is a case worth putting in the manuscript.