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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)
Abstract
Abstract

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.

Copyright
Corresponding author
Correspondence: Jan Krul, RN, MSc, Educare Groningen, P.O. Box 1305, 9701 BH Groningen, The Netherlands, E-mail: educare@home.nl
References
Hide All
Arbon P, Bridgewater FHG, Smith C.Mass gathering medicine: a predictive model for patient presentation and transport rates. Prehosp Disaster Med. 2001;16(3):109116.
De Lorenzo RA.Mass gathering medicine: a review. Prehosp Disaster Med. 1997;12(1):6872.
Gram H, Jongedijk S, Olthof S, Reinders A, van Schubert D.Dance in Nederland. De betekenis en impact van dance op de Nederlandse economie en maatschappij: Een verkenning. Amstelveen: KPMG; 2002.
Milsten AM, Maguire BJ, Bissel RA, Seaman KG.Mass-gathering medical care: a review of the literature. Prehosp Disaster Med. 2002;17(3):151162.
Milsten AM, Seaman KG, Liu P, Bissel RA, Maguire BJ.Variables influencing medical usage rates, injury patterns, and levels of care for mass gatherings. Prehosp Disaster Med. 2003;18(4):334346.
Krul J, Girbes ARJ.Experience of health-related problems during house parties in the Netherlands: nine years of experience and three million visitors. Prehosp Disaster Med. 2009;24(2):133139.
Krul J, van Litsenburg R.Medische zorg tijdens dance-events. Critical Care. 2010. 2010:2226.
de Boer J. Rampengeneeskunde. Een samenvattend overzicht. Spoedeisende en rampengeneeskunde. Amsterdam: VU Uitgeverij; 2001:179191.
Christ M, Grossmann F, Winter D, Bingisser R, Platz E.Modern triage in the emergency department [in German]. Dtsch.Arztebl.Int. 2010;107(50):892898.
van dW I, Rullmann HA, Leenen LP, van Stel HF.Associations of the Emergency Severity Index triage categories with patients' vital signs at triage: a prospective observational study. Emerg Med J. 2010:28(12):10321035.
Carpenito LJ.Handbook of Nursing Diagnosis. Philadelphia: J B Lippencott Company; 1991.
Bachmann LM, Kolb E, Koller MT, Steurer J, ter Riet G.Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review. BMJ. 2003;326(7386):417.
Jalili M,. Gharebaghi H.Validation of the Ottawa Knee Rule in Iran: a prospective study. Emerg Med J. 2010;27(11):849851.
Robb G, Reid D, Arroll B, Jackson RT, Goodyear-Smith F.General practitioner diagnosis and management of acute knee injuries: summary of an evidence-based guideline. N Z.Med J. 2007;120(1249):U2419.
Krul J, Girbes A.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.
Aramendi I,. Manzanares W.Hyponatremic encephalopathy and brain death in Ecstasy (3,4-methylenedioxymethamphetamine) intoxication [in Spanish]. Med Intensiva. 2010;34(9):634635.
Hsu YJ, Chiu JS, Lu KC, Chau T, Lin SH.Biochemical and etiological characteristics of acute hyponatremia in the emergency department. J Emerg Med 2005;29(4):369374.
Rosenson J, Smollin C, Sporer KA, Blanc P, Olson KR.Patterns of ecstasy-associated hyponatremia in California. Ann Emerg Med. 2007;49(2):164171.
Sanders AB, Criss E, Steckl P, Meislin HW, Raife J, Allen D.An analysis of medical care at mass gatherings. Ann Emerg Med. 1986;15(5):515519.
Arbon P.Planning medical coverage for mass gatherings in Australia: what we currently know. J Emerg Nurs. 2005;31:346350.
de Bruin D, Maalste NJM, van de Wijngaart GF.Goed fout gaa;. Eerste hulp op grote dansevenementen. Utrecht: CVO; 1998.
van de Wijngaart GF, Braam R, de Bruin D et al. . Ecstacy in het uitgaanscircuit. Utrecht: CVO; 1997.
van de Wijngaart GF, Braam R, de Bruin D, Fris M, Maalste NJM, Verbraeck HT.Ecstasy use at large-scale dance events in the Netherlands. J Drug Issues. 1999;29(3):679702.
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Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
  • URL: /core/journals/prehospital-and-disaster-medicine
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