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

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 eventspecific 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.

Preparedness for Mass Gatherings: Factors to Consider According to the Rescue Authorities

“…Sufficient first-aid capability and the quality of security emerged from the results along with other needed services, such as taking care of water supply. Previous studies indicated that on-site medical staff should include health professionals along with first-aid providers [15,18,19,23,40]. According to Locoh-Donou et al [26], absence of free drinking water is strongly associated with patient presentations.…”

“…Different factors were shown to have an impact on the need of transport to hospital, the number of patients, and the injury patterns. These include weather [13,14], the level of the on-site medical care [15][16][17][18][19][20][21][22][23], audience profile [24], event type [25][26][27], duration [28], and geographical location [29]. Alcohol and drug use, attendance, and the age and mood of the crowd can also have an effect on the level and the need of medical response [28].…”

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

“…If a similar scenario also occurs in rave attendants in spite of the rewarding properties of the environment, hippocampal dysfunction might contribute to the increasing number of psychological and traumatic medical events, including car accidents, and may significantly compromise working activity and school/academic performance for a few days after rave [55,56]. A prolonged 5-HT depletion in response to environmental stressors might produce tolerance to the detrimental effects of a subsequent exposure, but, on the other hand, might alter the mechanisms of resilience to stress [57][58][59][60] resulting into mood disorders or other stress-related disorders in predisposed individuals.…”

Management of Waste Collection from Yachts and Tall Ships from the Perspective of Sustainable Water Tourism

“…Meanwhile, it is worth considering how waste collection affects the functioning of the city area in which the mass event is organized, especially when there is a large accumulation of vessels that are disposing of waste. Mass events require extraordinary measures to ensure the safety of participants [30,31], transport accessibility of the venue, and supplies [32]. However, issues related to reverse logistics are also equally important.…”