Hospital in the field: prehospital management of GHB intoxication by medical assistance teams.
BACKGROUND
Recreational use of gamma-hydroxybutyrate (GHB) is increasingly common at mass-gathering dance events in Australia. Overdose often occurs in clusters, and places a significant burden on the surrounding health care infrastructure.


OBJECTIVE
To describe the clinical presentation, required interventions and disposition of patrons with GHB intoxication at dance events, when managed by dedicated medical assistance teams.


METHODS
Retrospective analysis of all patrons attending St. John Ambulance medical assistance teams at dance events in the state of Victoria (Australia), from January 2010 through May 2011. Main outcome measures Clinical presentation, medical interventions and discharge destination.


RESULTS
Sixty-one patients with GHB intoxication attended medical teams during the study period. The median age was 22 years, and 64% were male. Altered conscious state was present in 89% of attendances, and a GCS <9 in 44%. Hypotension, bradycardia and hypothermia were commonly encountered. Endotracheal intubation was required in three percent of patrons. Median length of stay onsite was 90 minutes. Ambulance transport to hospital was avoided in 65% of presentations.


CONCLUSIONS
The deployment of medical teams at dance events and music festivals successfully managed the majority of GHB intoxications onsite and avoided acute care ambulance transfer and emergency department attendance.
St. John Ambulance Australia, Melbourne, Australia. mdutch@stjohnvic.com.au
Martin J
MJ
Dutch
Kristy B
KB
Austin
D000759:Adjuvants, Anesthesia / Q000506:poisoning; D000552:Ambulances / Q000706:statistics & numerical data; D003615:Dancing; D062787:Drug Overdose / Q000628:therapy*; D004632:Emergency Medical Services / Q000379:methods / Q000458:organization & administration* / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008399:Mass Behavior; D008952:Mobile Health Units / Q000458:organization & administration* / Q000706:statistics & numerical data; D009146:Music; D063487:Prescription Drug Misuse; D012189:Retrospective Studies; D012919:Social Behavior; D012978:Sodium Oxybate / Q000506:poisoning*; D019966:Substance-Related Disorders / Q000150:complications; D014739:Victoria; D055815:Young Adult
D000759:Adjuvants, Anesthesia; D012978:Sodium Oxybate