• Adelaide Pratt, Trina Sale, Elizabeth Sanau, Jacinta Ramo, and Georgina Phillips.
• Emergency Department, Orange Base Hospital, Orange, New South Wales, Australia.
• Emerg Med Australas. 2025 Feb 1; 37 (1): e14548e14548.

BackgroundThe XVII Pacific Games was held in Honiara, Solomon Islands in 2023 and was attended by competitors from 24 Pacific nations. The National Referral Hospital (NRH) is the sole tertiary hospital and largest emergency department (ED) in the Solomon Islands, located in the capital city, Honiara, and was the designated referral hospital for the Pacific Games.ObjectiveThis report documents the lessons learnt from supporting a large international sporting event within a resource-limited health setting, and may help other EDs prepare for similar planned mass gatherings.MethodSenior staff members at NRH ED collaborated to document their experiences during the Pacific Games, with a focus on the impact of the games on the ED and utilizing a strengths based approach.ResultsNRH ED responded to challenges in preparing for and responding to the demands of the Pacific Games, including strains on staff and physical resources, and logistical, procedural, and governance challenges, whilst capitalising on opportunities for capacity building, cross-sectoral collaboration, and disaster preparedness.ConclusionPlanned mass gathering events can provide opportunities for EDs to increase workforce capacity and strengthen systems, but proper preparedness is required to minimise additional strain on already busy departments.© 2024 Australasian College for Emergency Medicine.

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