Skip to main content
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 5
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Busceti, Carla Letizia Pietro, Paola Di Riozzi, Barbara Traficante, Anna Biagioni, Francesca Nisticò, Robert Fornai, Francesco Battaglia, Giuseppe Nicoletti, Ferdinando and Bruno, Valeria 2015. 5-HT2C serotonin receptor blockade prevents tau protein hyperphosphorylation and corrects the defect in hippocampal synaptic plasticity caused by a combination of environmental stressors in mice. Pharmacological Research, Vol. 99, p. 258.

    Koziel, Jeannette R. Meckler, Garth Brown, Linda Acker, David Torino, Michael Walsh, Barbara and Cicero, Mark X. 2015. Barriers to Pediatric Disaster Triage: A Qualitative Investigation. Prehospital Emergency Care, Vol. 19, Issue. 2, p. 279.

    Lund, Adam and Turris, Sheila A. 2015. Mass-gathering Medicine: Risks and Patient Presentations at a 2-Day Electronic Dance Music Event. Prehospital and Disaster Medicine, Vol. 30, Issue. 03, p. 271.

    Ranse, Jamie Hutton, Alison Turris, Sheila A. and Lund, Adam 2014. Enhancing the Minimum Data Set for Mass-Gathering Research and Evaluation: An Integrative Literature Review. Prehospital and Disaster Medicine, Vol. 29, Issue. 03, p. 280.

    Krul, Jan Girbes, Armand RJ and Sanou, Björn T 2012. Increase in serious ecstasy-related incidents in the Netherlands. The Lancet, Vol. 380, Issue. 9851, p. 1385.


Medical Care at Mass Gatherings: Emergency Medical Services at Large-Scale Rave Events

  • Jan Krul (a1), Björn Sanou (a2), Eleonara L Swart (a3) and Armand R J Girbes (a4)
  • DOI:
  • Published online: 17 April 2012

Objective: The objective of this study was to develop comprehensive guidelines for medical care during mass gatherings based on the experience of providing medical support during rave parties.

Methods: Study design was a prospective, observational study of self-referred patients who reported to First Aid Stations (FASs) during Dutch rave parties. All users of medical care were registered on an existing standard questionnaire. Health problems were categorized as medical, trauma, psychological, or miscellaneous. Severity was assessed based on the Emergency Severity Index. Qualified nurses, paramedics, and doctors conducted the study after training in the use of the study questionnaire. Total number of visitors was reported by type of event.

Results: During the 2006–2010 study period, 7,089 persons presented to FASs for medical aid during rave parties. Most of the problems (91.1%) were categorized as medical or trauma, and classified as mild. The most common medical complaints were general unwell-being, nausea, dizziness, and vomiting. Contusions, strains and sprains, wounds, lacerations, and blisters were the most common traumas. A small portion (2.4%) of the emergency aid was classified as moderate (professional medical care required), including two cases (0.03%) that were considered life-threatening. Hospital admission occurred in 2.2% of the patients. Fewer than half of all patients presenting for aid were transported by ambulance. More than a quarter of all cases (27.4%) were related to recreational drugs.

Conclusions: During a five-year field research period at rave dance parties, most presentations on-site for medical evaluation were for mild conditions. A medical team of six healthcare workers for every 10,000 rave party visitors is recommended. On-site medical staff should consist primarily of first aid providers, along with nurses who have event-specific training on advanced life support, event-specific injuries and incidents, health education related to self-care deficits, interventions for psychological distress, infection control, and disaster medicine. Protocols should be available for treating common injuries and other minor medical problems, and for registration, triage, environmental surveillance and catastrophe management and response.

Corresponding author
Correspondence: Jan Krul, RN, MSc, Educare Groningen, P.O. Box 1305, 9701 BH Groningen, The Netherlands, E-mail:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

P Arbon , FHG Bridgewater , C. Smith Mass gathering medicine: a predictive model for patient presentation and transport rates. Prehosp Disaster Med. 2001;16(3):109116.

LM Bachmann , E Kolb , MT Koller , J Steurer , G. ter Riet Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review. BMJ. 2003;326(7386):417.

M Jalili ,. H. Gharebaghi Validation of the Ottawa Knee Rule in Iran: a prospective study. Emerg Med J. 2010;27(11):849851.

J Krul , A. Girbes Gamma-hydroxybutyrate: experience of 9 years of gamma- hydroxybutyrate (GHB)-related incidents during rave parties in The Netherlands. Clin.Toxicol.(Phila). 2011;49(4):311315.

I Aramendi ,. W. Manzanares Hyponatremic encephalopathy and brain death in Ecstasy (3,4-methylenedioxymethamphetamine) intoxication [in Spanish]. Med Intensiva. 2010;34(9):634635.

YJ Hsu , JS Chiu , KC Lu , T Chau , SH. Lin Biochemical and etiological characteristics of acute hyponatremia in the emergency department. J Emerg Med 2005;29(4):369374.

J Rosenson , C Smollin , KA Sporer , P Blanc , KR. Olson Patterns of ecstasy-associated hyponatremia in California. Ann Emerg Med. 2007;49(2):164171.

AB Sanders , E Criss , P Steckl , HW Meislin , J Raife , D. Allen An analysis of medical care at mass gatherings. Ann Emerg Med. 1986;15(5):515519.

P. Arbon Planning medical coverage for mass gatherings in Australia: what we currently know. J Emerg Nurs. 2005;31:346350.

GF van de Wijngaart , R Braam , D de Bruin , M Fris , NJM Maalste , HT. Verbraeck Ecstasy use at large-scale dance events in the Netherlands. J Drug Issues. 1999;29(3):679702.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
  • URL: /core/journals/prehospital-and-disaster-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *