Mass-Gathering Medical Care in Electronic Dance Music Festivals

FitzGibbon, Kathleen M; Nable, Jose V.; Ayd, Benjamin; Lawner, Benjamin J.; Comer, Angela C.; Lichenstein, Richard; Levy, Matthew J.; Seaman, Kevin G.; Bussey, Ian

doi:10.1017/s1049023x1700663x

Cited by 17 publications

(25 citation statements)

References 25 publications

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“…First, since a substantial proportion of cannabis-related visits on April 20 seem to involve inexperienced cannabis users, high-potency cannabis, or edible products with limited dosing information, policy makers should continue to develop regulatory regimes that address these safety gaps 14. Second, since the increase in demand for local ED services is similar to that occuring during music festivals, the chain-of-survival framework adapted for these contexts should be applied to 4/20 festivals 22. Accordingly, stakeholders such as event organisers, event security, police, on-site medical services, ambulance services and local EDs should coordinate efforts well in advance of the festival to clarify responsibilities, identify gaps in care and reduce service duplication 23.…”

Section: Resultsmentioning

confidence: 99%

Emergency department visits during the 4/20 cannabis celebration

et al. 2019

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BackgroundAnnual ‘4/20’ cannabis festivals occur around the world on April 20 and often feature synchronised consumption of cannabis at 4:20 pm. The relationship between these events and demand for emergency medical services has not been systematically studied.MethodsWe conducted a population-based retrospective cohort study in Vancouver, Canada, using 10 consecutive years of data (2009–2018) from six regional hospitals. The number of emergency department (ED) visits between 4:20 pm and 11:59 pm on April 20 were compared with the number of visits during identical time intervals on control days 1 week earlier and 1 week later (ie, April 13 and April 27) using negative binomial regression.ResultsA total of 3468 ED visits occurred on April 20 and 6524 ED visits occurred on control days. A non-significant increase in all-cause ED visits was observed on April 20 (adjusted relative risk: 1.06; 95% CI 1.00 to 1.12). April 20 was associated with a significant increase in ED visits among prespecified subgroups including a 5-fold increase in visits for substance misuse and a 10-fold increase in visits for intoxication. The hospital closest to the festival site experienced a clinically and statistically significant 17% (95% CI 5.1% to 29.6%) relative increase in ED visits on April 20 compared with control days.InterpretationSubstance use at annual ‘4/20’ festivals may be associated with an increase in ED visits among key subgroups and at nearby hospitals. These findings may inform harm reduction initiatives and festival medical care service planning.

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Section: Resultsmentioning

confidence: 99%

Emergency department visits during the 4/20 cannabis celebration

et al. 2019

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“…As the results of this study are consistent regarding the incidence of medical emergencies during MGs, the high number of potentially life-threatening conditions at EDMFs is striking. It is common knowledge that EDMF-festivalgoers engage more in alcohol and illicit drug use, 6,8,12,18 but the results above (75.7% of all life-threatening conditions) do raise concern. Future research should focus on PPR at EDMEs and the organization of in-event medical care at these events.…”

Section: Discussionmentioning

confidence: 96%

“…18 There is wide agreement that the availability of alcohol and illicit drugs leads to higher PPRs, and most notably music MGs. 5,6,13,14 Especially in Belgium, the consumption of alcohol (mostly beer) is commonplace. More worrying is the level of combined drug and alcohol consumption.…”

Section: Discussionmentioning

confidence: 99%

Validation of a Belgian Prediction Model for Patient Encounters at Music Mass Gatherings

Spaepen

Haenen

Kaufman

et al. 2020

Prehosp. Disaster med.

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Introduction: A Belgian predictive medical resource tool, Plan Risk Manifestations (PRIMA), for the prediction of the number of patient encounters at mass gatherings (MGs) has recently been developed, in addition to the existing models of Arbon and Hartman. This study presents the results of the validation process for the PRIMA model for music MGs. Methods: A retrospective study was conducted using data gathered from music MGs in the province of Antwerp (Belgium) during the period of 2012-2016. Data from 87 music MGs were used for the study. The forecast of medical resources for these events was determined by entering the characteristics of individual events into the Arbon, Hartman, and PRIMA models. In order to determine if the PRIMA model is under- or over-predictive, the data gathered were retrospectively compared to the predicted number of resources needed using the aforementioned models. Statistical analysis included means, medians, and interquartile ranges (IQRs). Nonparametric related samples test (Wilcoxon Samples Signed Rank Test) for comparison of the median in deviations in predictions of patient presentation rates (PPRs) was performed using SPSS version 23 (IBM Corp.; Armonk, New York USA). Confidence interval levels were set at 95% and results were deemed statistically significant at P <.05. This triple comparison was used to determine the overall performance of all three models. Results: All three models had an acceptable rate of over-prediction of number of patient encounters ([Arbon 25.29%; 95% CI, 30.91-43.74]; [Hartman 29.89%; 95% CI, 57.10-68.90]; and [PRIMA 19.54%; 95% CI, 57.80-76.20]). But all models also had a high rate of under-prediction of number of patient encounters ([Arbon 74.71%; 95% CI, 453.31-752.52]; [Hartman 70.11%; 95% CI, 546.90-873.77]; and [PRIMA 78.16%; 95% CI, 288.91-464.89]). Only the PRIMA model succeeded in the correct prediction of the number of patient encounters on two occasions (2.3%). Conclusion: Results of this study are in-line with existing literature. When comparing the predicted patient encounters, all three models had high rates of under-prediction and moderate rates of over-prediction. When comparing mean deviations, the PRIMA model had the lowest mean deviation of all predicted PPRs. Belgian events of the types included in the presented data may use the PRIMA model with confidence to predict PPRs and estimate the in-event health services (IEHS) requirements.

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“…Traditionally, patients from a MGE who require care beyond first aid care would be transported by ambulance to a local ED. [16][17][18] Increased crowding and congestion in the ED results in negative patient outcomes, such as increased morbidity and mortality, increased adverse events, delays in time-critical care, 19,20 and increased cost per admission. 21 As such, the exploration of strategies to decrease crowding and congestion should be explored in relation to the MGE context.…”

Section: Discussionmentioning

confidence: 99%

Impacts on in‐event, ambulance and emergency department services from patients presenting from a mass gathering event: A retrospective analysis

Ranse

Lenson

Keene³

et al. 2018

Emerg Medicine Australasia

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Objective The aim of this study was to describe the in‐event, ambulance and ED impacts of patient presentations from an Australian mass gathering event (MGE) including patient demographics, provision of care, length of stay and discharge disposition. Methods This research was set at one MGE in Australia. The MGE had one first aid post and one in‐event health team staffed by doctors, nurses and paramedics. A retrospective analysis of patient care records from providers of in‐event, ambulance and ED services was undertaken. Data analysis included descriptive and inferential statistics. Results Of the 20 000 MGE participants, 197 (0.99% [95% CI 0.86–1.13], 9.85/1000) presented for in‐event first aid care, with 24/197 (12.2% [95% CI 8.33–17.49], 1.2/1000) referred to in‐event health professionals. Fifteen of the referred patients (62.5% [95% CI 42.71–78.84]) returned to the MGE following administration of intravenous fluids (n = 13) and/or anti‐emetics (n = 11). Seven (29.2% [95% CI 14.92–49.17], 0.35/1000) were referred to ambulance paramedic care, requiring endotracheal intubation (n = 1) and airway adjuncts (n = 3) prior to transportation to ED; these patients had an ED median length of stay of 7 h (5.5–12.5) receiving imaging and ventilator support. Five were discharged from ED, one required an operation and another required intensive care unit admission. Conclusions There was an impact on in‐event, ambulance and ED services from this MGE but the in‐event model of care may have limited ambulance usage and ED visits. The ED length of stay was greater than the national median, perhaps reflecting the appropriateness of transport and nature of care requirements while in the ED.

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Mass-Gathering Medical Care in Electronic Dance Music Festivals

Cited by 17 publications

References 25 publications

Emergency department visits during the 4/20 cannabis celebration

Emergency department visits during the 4/20 cannabis celebration

Validation of a Belgian Prediction Model for Patient Encounters at Music Mass Gatherings

Impacts on in‐event, ambulance and emergency department services from patients presenting from a mass gathering event: A retrospective analysis

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