This quick guide will help you make sure you have the right level of first aid and medical services at an event.
Who should read this guidance?
This guidance is for any PCBU (person conducting a business or undertaking) that organises events. It might also be useful for:
- PCBUs that own or manage venues where events are held
- PCBUs that provide first aid and health services for events.
There is existing WorkSafe guidance which may be useful alongside this guide:
PCBU duties
PCBUs have duties under the Health and Safety at Work Act 2015 (HSWA).
PCBUs have a primary duty of care to ensure the health and safety of their workers so far as is reasonably practicable.
PCBUs must also look after people that could be put at risk by their work (that is, the event), so far as is reasonably practicable. This includes customers, visitors and the public.
Another duty PCBUs have is that they must make sure there is adequate first aid for their workers by:
- making sure there are enough workers trained to administer first aid, or
- making sure the workers have access to people who are trained to administer first aid.
Something to note
As a PCBU, your duty to provide first aid to workers does not automatically extend to visitors.
But you also have the duty to make sure that any event you organise is without risks to the health and safety of visitors, so far as is reasonably practicable.
If you organise an event you should consider whether it would be reasonably practicable to provide a health service at the event to minimise the risk of serious harm.
Planning to manage health risks
If you choose to provide medical services for events, plan early and involve your event health service provider at the beginning. Ensure everyone involved has all the information needed to decide what coverage is needed for your event.
Health New Zealand | Te Whatu Ora's has event guidance to help you work out your risk assessment, health risk controls and emergency coordination with health services.
For more, see Public health guidance for festival and event organisers(external link)
Planning to provide medical cover
If you are providing medical services for events, they should be:
- staffed by qualified and capable workers who can treat the injuries and health problems that might happen
- coordinated with emergency response plans. For information on what information should be included in your area, check with your local council. Links to templates are provided as examples.
Event health service providers can help you identify what level of coverage is needed for your event, including:
- appropriate medical coverage for different size events
- expectations for first-aid capability
- organiser options (volunteer first aiders versus a contracted event medic)
- service standards including the clinical governance model.
For more information from Hato Hone St John, see Event Health Services(external link)
For more information from Wellington Free Ambulance, see Event Medical Services(external link)
For information on clinical standard of care for injury or management of illness, that First Aiders should follow, see First aid and Resuscitation guidelines(external link)
Working out what level of onsite medical cover you might need at an event – a two-step model
This is a sample tool to help you plan. It is only an example. Final cover should reflect your own documented risk assessment and any input and information you might get from your event medical service provider and local authorities.
1. Work out your relative risk
For each of the risk factors in the first column, look across the row and choose the option that applies to your event. Note the score and then add the scores together. In any risk factor, choose the highest level that applies.
| Risk factors | Relative risk score | Risk score | |||
|---|---|---|---|---|---|
| 0 | 1 | 2 | 3 | ||
| Attendance (peak) | < 500 | 500 to 5,000 | 5,001–20,000 | More than 20,000 | |
| Crowd dynamics | seated/low mobility | mixed/family | active/dense | mosh/rushing risk | |
| Alcohol/other drugs | none | licensed low-risk | licensed + high consumption history | festival-style/high usage expected | |
| Ambulance access/egress | excellent | good | difficult | very difficult/remote | |
| Event duration | ≤ 4 hrs | 4–10 hrs | > 10 hrs or multi-day | ||
| Environment | indoor/controlled | outdoor mild | outdoor with heat/cold/wind | ||
| Participant activity | sedentary | moderate | strenuous/competitive | ||
| Anticipated audience clinical profile | general population | mixed incl vulnerable | large vulnerable cohorts | ||
| Total | |||||
Add +2 if your event (or similar New Zealand events) has a history of elevated medical incidents.
Table 1: Relative risk calculator for onsite medical cover at an event
2. Work out what medical cover you should consider
Use your total score to help you plan what minimum medical cover tier may look like at your event.
Note: Escalate or adjust upwards if there are specific hazards or risk factors.
| Tier | Score | Minimum onsite medical cover | Notes/triggers |
|---|---|---|---|
| Tier 1: Low | 0–3 |
|
Suitable for small, low-risk gatherings. Keep a clear ambulance route. Escalate if the event is outdoor and weather risk rises. |
| Tier 2: Moderate | 4–7 |
|
Consider medical event service cover where alcohol/crowding present. See Health New Zealand guidance for heat/dehydration, crowded-space risks. |
| Tier 3: Elevated | 8–11 |
|
For larger/longer events or sites where access/egress is difficult. Confirm escalation and transfer-to-ambulance procedures. |
| Tier 4: High | 12+ |
|
Large festivals or high-risk sport. Implement multi-agency emergency plan (see council templates and Health New Zealand guidance). |
Table 2: Considerations for onsite medical cover
Control measures to put in place (for all tiers)
- First aid arrangements
- named coordinator – ensure there is a single, known, point of contact who can coordinate first aid efforts and any escalation actions
- staffed and signposted first-aid/treatment post(s) with adequately stocked kits
- AED where crowds are greater than 500 people or response delays possible.
- Communications
- radio network and 111 capability
- agreed ambulance rendezvous/handover point
- site map shared with provider and emergency services.
- Access/egress
- keep emergency routes clear, your traffic plan should prioritise ambulance flow during times of peak attendance.
- Crowd care
- provide drinking water, shade/warmth as needed
- intoxication and drug management strategy
- lost and found persons and family/child safety processes.
- Overlapping duties
- coordinate with venue, security, stallholders, medical event providers, and others
- agree who does what, when, and how to escalate.
Before, during, after – sample checklists
Before
- Complete your risk assessment and choose a tier.
- Engage a suitable medical provider (for Tiers 3–4).
- Finalise Emergency Management Plan and First-aid/Health and Safety Plan; circulate site maps and contact lists.
During
- Brief teams (roles, radio channels, rendezvous point).
- Monitor heat/crowd/alcohol/drug risks; adjust resourcing for peak attendance.
- Log incidents and near-misses.
After
- Debrief with your medical event provider and key PCBUs;
- Review incident data to inform what to improve next time.
Example: Two-day inner-city weekend street festival
This annual two-day street festival attracts approximately 100,000 people across a single inner-city suburb over one summer weekend.
- Multiple city blocks are closed to traffic and converted into pedestrian zones
- There are music stages, roving street performances, market and food stalls, pop-up installations
- There are multiple licensed premises and several permanent venues operating under temporary extensions to their alcohol licences (midday–midnight)
- The surrounding area includes residential apartments, bars, retail spaces, and dense footpaths, creating complex crowd-movement patterns.
- The suburb sits within minutes of a major hospital, police station, and fire service hub.
- Drug and alcohol use is common, though crowd behaviour in previous years has generally been positive.
Risk profile
The risks stem primarily from:
- Very high crowd volumes, alcohol consumption, hot summer conditions, densely packed streets, temporary structures, moving performers, food preparation areas, and multiple intersecting activities.
- Hazards include dehydration, slips and falls, intoxication-related injuries, burns from food stalls, heat stress, crowd crush points, and minor trauma from trip hazards or uneven road surfaces.
- Street closures create complex access issues for ambulances during peak times. Under HSWA, PCBUs involved in the event (council, venue operators, event management contractors, stallholder PCBUs, security providers, and health service providers) must work together to ensure, so far as is reasonably practicable, the health and safety of both workers and the large volume of visitors.
Although emergency services are close, congestion and street closures can significantly delay ambulance access, making onsite health capacity reasonably practicable to reduce the risk of serious harm.
The event organiser should plan for:
Given the scale, multi-venue layout, and moderate-to-high alcohol and drug use, a multi-site event health service is reasonably practicable. A model consistent with WorkSafe guidance may include:
- one Event Health Operations Lead (senior paramedic or RN with large-event experience) overseeing coordination across the suburb
- two Satellite Medical Posts positioned near major stages and high-volume pedestrian areas. (increase resources towards evening/night)
- one Paramedic or RN in charge of each medical post, with supporting staff
- 4–6 First Responders (NZQA Level 3 or equivalent) rotating across posts and foot patrols
- alcohol and Other Drug (AOD) monitoring/support personnel embedded in high-risk licensed areas or chill-out spaces.
This staffing level ensures timely response despite congestion and enables early intervention to prevent escalation of medical issues.
Where to go for more information and templates
Health New Zealand
Public health guidance for festival and event organisers(external link)
ANZCOR/NZ Resuscitation Council
First aid and Resuscitation guidelines (external link)
Dunedin City Council
Health and safety at events (external link)
New Plymouth District Council
Event Health and Safety Guidelines(external link)
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