The IPL Stampede Underscores the Importance of Medical SOPs

The ecstasy of the Royal Challengers Bengaluru winning this year's Indian Premier League lasted less than 24 hours before it turned out to be agony for cricket fans in our country. A victory celebration led to the death of 11 cricket fans, with scores battling for life in hospitals.

Reports reveal that those who had organised the celebrations believed that the show must go on. Inside the 35,000-capacity stadium, the celebrations of a cricket cup won was in full swing while outside its gates, a stampede was going on. Those who could not get inside the stadium were busy trying CPR to revive the dead or transfer the injured to nearby hospitals – to the horror of television viewers across the country.

One also saw how politicians tried to take advantage of the tragedy by accusing the state government of mismanagement of the event.

Meanwhile, the chief minister, Siddaramaiah, in his press conference, said that the event was not organised by the government – it only gave permission to the Karnataka Cricket Association to hold the event, at its request.

The question arises as to whether the government, while granting permission to organise the event, ensured that the organisers follow the Standard Operating Procedure (SOP) on crowd control. In this case, the SOP would include arrangements of an optimum medical support system, along with that of people and material required for disaster management. The district collector and local police authorities have to ensure that adequate safety arrangements are in place wherever a crowd assembles before giving permission to the organisers of such events. From the reports which are coming in, there is a lapse on the part of the KCA and also the government in ensuring the safety of the crowd which was expected to attend the IPL victory celebrations. As per reports, there were two lakhs outside the stadium trying to get in and participate in the celebrations. 

First-aid and its importance

The SOP for conducting mass scale sports meets include establishing multiple first-aid posts exclusively for spectators in addition to the medical post set up separately for players inside the stadium. First-aid posts for spectators are required to be put up in the gallery enclosures and at the entry gates of the stadium. Each first-aid post should have a nurse and a four-member stretcher-bearer team along with stretchers and first-aid kit. Depending on the size of the stadium, one or more life-supporting ambulances should be deployed. All this should be under the supervision of a sports medicine- or emergency medicine-trained doctor. The medical infrastructure should have an effective communication network. Casualties, if any, among spectators should be attended to by the first-aid teams which should transfer cases to hospitals when the need arises.

Stampedes and riots are not uncommon in sports. Football stadiums in Europe and Latin America are notorious for these tragedies where dozens of spectators lose their lives. The IPL tragedy in Bengaluru is perhaps the worst in the country's cricket history. It is also not known whether the KCA had insured the event so that the victims are adequately compensated for their losses.

Organising medical cover for sports events is a challenging task. Sports administrators are generally not inclined to consider medical cover a top priority. As such, one will hardly find an adequate number of first-aid personnel and ambulances at sports meets.

In a stampede, most people die of suffocation, dehydration and cardiac arrest. Timely first aid and ambulance services can prevent death. Provision of drinking water also comes under the umbrella first-aid. Will the KCA and the district administration disclose   what they had done to ensure the safety of those who were eventually trampled to death?

The deaths and injuries of IPL fans at the Chinnaswamy stadium do not require fact-finding committees. People have witnessed enough in the telecast of the event. Only the culpability of those who were negligent on medical requirements needs to be fixed.    

Dr P.S.M. Chandran is president of the Indian Federation of Sports Medicine. He is a former director (sports medicine), of the Sports Authority of India. He had worked with the IPL as medical officer and also as a doping control officer.

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