For more than three months prior to Pope Benedict XVI's April visit to Yonkers, NY, Empress Emergency Medical Services planned a medical response for the more than 25,000 people expected to attend his public appearance. The city was asked to plan for any type of event, from normal medical calls to a complete decontamination of the crowd. In preparation, Empress officials held meetings with the Archdiocese of New York, the Yonkers police and fire departments, and the U.S. Secret Service.

     Empress' Special Operations Division, along with its sister company, Emergacare EMS, planned to field 16 units for the event, as well as three more crews inside the site to deal with the medical needs of the crowd and event staff. At one count approximately 35,000 people were at the event, plus personnel from Yonkers police and fire, Westchester County police, New York State police and the Secret Service.

     Empress has had a Special Operations Division for six years. It presently consists of 30 EMTs and paramedics specially trained in hazmat and MCI response. While the fire department remains in charge of any hazmat scene, Empress makes sure anyone needing treatment during the decontamination process gets it, from the BLS level to full ALS response.

     The event marked Empress' first deployment of its new Special Medical Response Team (SMRT) mobile command truck, which is outfitted with MCI and decon equipment, as well as a full working dispatch center. To assist Empress in treatment and decon processes, the truck carries an inflatable Zumro decontamination tent. It also carries 12 60-minute SCBA bottles and six SCBA racks. To further assist a decon line, Empress has an air cart with two 60-minute SCBA bottles capable of keeping four people on air. Empress also has two 50-patient MCI trailers, which it deployed to its staging location, where they were ready to be moved where needed.

     In the event of a contamination incident, Empress had seven of its 16 units trained and ready to deploy to assist the Yonkers FD in decontaminating everyone on site.

     Between 0900 and 0000 on the day of the papal visit, Empress transported 30 people. Working with St. Joseph's Medical Center, which staffed two medical tents with nurses and doctors, we saw approximately 100 people. Empress EMTs and medics also paired with Yonkers firefighters to drive around the event in golf carts and John Deere Gators, responding directly to medical incidents and transporting patients back to medical tents for evaluation by hospital staff.

     Empress had two fully dedicated units for the Pope on site, one at the chapel of St. Joseph's Seminary, where he met handicapped children and seminarians, and another behind the stage to be used should the Pope need transport to a hospital or awaiting helicopter.

     Calls for the day were mostly due to the heat. Though it was around 70 degrees all day, there was little shade to be found. Water was available for purchase, and the New York Archdiocese distributed bottles in care packages as people entered. Reasons behind people's complaints included simply the excitement of seeing the Pope; many just wanted to be quickly rehabbed in the tents and then allowed to go back to the crowd.

     Lessons learned from this event included assuming that more people will come than expected—medical staff should be ready for this. Better coordination with the volunteers to get to people should also be a major point, but in our case, most people were there to see the Pope, including the volunteers, so communications among emergency personnel were of special importance.

Marcel Cekuta is an operations captain with Empress EMS in Yonkers, NY.