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

Published online by Cambridge University Press:  17 April 2012

Jan Krul ,
Björn Sanou ,
Eleonara L Swart  and
Armand R J Girbes
Jan Krul*
Affiliation:
Educare Groningen, Groningen, The Netherlands
Björn Sanou
Affiliation:
Department of Anesthesiology, Academic Medical Center, University of Amsterdam Amsterdam, The Netherlands
Eleonara L Swart
Affiliation:
Department of Clinical Pharmacology and Pharmacy, University Hospital VU Medical Centre, Amsterdam, The Netherlands
Armand R J Girbes
Affiliation:
Department of Intensive Care, University Hospital VU Medical Centre, Amsterdam, The Netherlands
*
Correspondence: Jan Krul, RN, MSc, Educare Groningen, P.O. Box 1305, 9701 BH Groningen, The Netherlands, E-mail: [email protected]
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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.

Keywords

event medicinemass gathering medicinerave
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 27 , Issue 1 , February 2012 , pp. 71 - 74
Copyright
Copyright Krul © World Association for Disaster and Emergency Medicine 2012

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References

Arbon, P, Bridgewater, FHG, Smith, C.Mass gathering medicine: a predictive model for patient presentation and transport rates. Prehosp Disaster Med. 2001;16(3):109–116.CrossRefGoogle ScholarPubMed
De Lorenzo, RA.Mass gathering medicine: a review. Prehosp Disaster Med. 1997;12(1):68–72.CrossRefGoogle ScholarPubMed
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.Google Scholar
Milsten, AM, Maguire, BJ, Bissel, RA, Seaman, KG.Mass-gathering medical care: a review of the literature. Prehosp Disaster Med. 2002;17(3):151–162.CrossRefGoogle ScholarPubMed
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):334–346.CrossRefGoogle ScholarPubMed
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):133–139.CrossRefGoogle ScholarPubMed
Krul, J, van Litsenburg, R.Medische zorg tijdens dance-events. Critical Care. 2010. 2010:22–26.Google Scholar
de Boer, J. Rampengeneeskunde. Een samenvattend overzicht. Spoedeisende en rampengeneeskunde. Amsterdam: VU Uitgeverij; 2001:179–191.Google Scholar
Christ, M, Grossmann, F, Winter, D, Bingisser, R, Platz, E.Modern triage in the emergency department [in German]. Dtsch.Arztebl.Int. 2010;107(50):892–898.Google ScholarPubMed
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):1032–1035.Google Scholar
Carpenito, LJ.Handbook of Nursing Diagnosis. Philadelphia: J B Lippencott Company; 1991.Google Scholar
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.CrossRefGoogle ScholarPubMed
Jalili, M,. Gharebaghi, H.Validation of the Ottawa Knee Rule in Iran: a prospective study. Emerg Med J. 2010;27(11):849–851.CrossRefGoogle ScholarPubMed
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.Google ScholarPubMed
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):311–315.CrossRefGoogle ScholarPubMed
Aramendi, I,. Manzanares, W.Hyponatremic encephalopathy and brain death in Ecstasy (3,4-methylenedioxymethamphetamine) intoxication [in Spanish]. Med Intensiva. 2010;34(9):634–635.CrossRefGoogle ScholarPubMed
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):369–374.CrossRefGoogle ScholarPubMed
Rosenson, J, Smollin, C, Sporer, KA, Blanc, P, Olson, KR.Patterns of ecstasy-associated hyponatremia in California. Ann Emerg Med. 2007;49(2):164–171.CrossRefGoogle ScholarPubMed
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):515–519.CrossRefGoogle ScholarPubMed
Arbon, P.Planning medical coverage for mass gatherings in Australia: what we currently know. J Emerg Nurs. 2005;31:346–350.CrossRefGoogle ScholarPubMed
de Bruin, D, Maalste, NJM, van de Wijngaart, GF.Goed fout gaa;. Eerste hulp op grote dansevenementen. Utrecht: CVO; 1998.Google Scholar
van de Wijngaart, GF, Braam, R, de Bruin, D et al. . Ecstacy in het uitgaanscircuit. Utrecht: CVO; 1997.Google Scholar
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):679–702.CrossRefGoogle Scholar