title: A Prospective Analysis of Patients Presenting for Medical Attention at a Large Electronic Dance Music Festival.
abstract: Mass-Gathering Medicine studies have identified variables that predict greater patient presentation rates (PPRs) and transport to hospital rates (TTHRs). This is a descriptive report of patients who presented for medical attention at an annual electronic dance music festival (EDMF). At this large, single EDMF in New York City (NYC; New York, USA), the frequency of patient presentation, the range of presentations, and interventions performed were identified. This descriptive report examined consecutive patients who presented to the medical tent of a summertime EDMF held at an outdoor venue with an active, mobile, bounded crowd. Alcohol was available for sale. Entry was restricted to persons 18 years and older. The festival occurred on three consecutive days with a total cumulative attendance of 58,000. Medical staffing included two Emergency Medicine physicians, four registered nurses, and 86 Emergency Medical Services (EMS) providers. Data collected included demographics, past medical history, vital signs, physical exam, drug and alcohol use, interventions performed, and transport decisions. Eighty-four patients were enrolled over 2.5 days. Six were transported and zero died. The ages of the subjects ranged from 17 to 61 years. Forty-three (51%) were male. Thirty-eight (45%) initially presented with abnormal vital signs; four (5%) were hyperthermic. Of these latter patients, 34 (90%) reported ingestions with 3,4-methylenedioxymethamphetamine (MDMA) or other drugs. Eleven (65%) patients were diaphoretic or mydriatic. The most common prehospital interventions were intravenous normal saline (8/84; 10%), ondansetron (6/84; 7%), and midazolam (3/84; 4%). Electronic dance music festivals are a growing trend and a new challenge for Mass-Gathering Medicine as new strategies must be employed to decrease TTHR and mortality. Addressing common and expected medical emergencies at mass-gathering events through awareness, preparation, and early, focused medical interventions may decrease PPR, TTHR, and overall mortality. Friedman MS , Plocki A , Likourezos A , Pushkar I , Bazos AN , Fromm C , Friedman BW . A prospective analysis of patients presenting for medical attention at a large electronic dance music festival. Prehosp Disaster Med. 2017; 32(1):78-82.
authors.affiliation: 1Department of Emergency Medicine,Maimonides Medical Center,Brooklyn,New YorkUSA.
authors.forename: Matt S
authors.initials: MS
authors.lastname: Friedman
authors.affiliation: 1Department of Emergency Medicine,Maimonides Medical Center,Brooklyn,New YorkUSA.
authors.forename: Alex
authors.initials: A
authors.lastname: Plocki
authors.affiliation: 1Department of Emergency Medicine,Maimonides Medical Center,Brooklyn,New YorkUSA.
authors.forename: Antonios
authors.initials: A
authors.lastname: Likourezos
authors.affiliation: 1Department of Emergency Medicine,Maimonides Medical Center,Brooklyn,New YorkUSA.
authors.forename: Illya
authors.initials: I
authors.lastname: Pushkar
authors.affiliation: 2Department of Orthopedic Surgery,New York University Langone Medical Center,New York,New YorkUSA.
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Bazos
authors.affiliation: 1Department of Emergency Medicine,Maimonides Medical Center,Brooklyn,New YorkUSA.
authors.forename: Christian
authors.initials: C
authors.lastname: Fromm
authors.affiliation: 3Department of Emergency Medicine,Montefiore Medical Center,Bronx,New YorkUSA.
authors.forename: Benjamin W
authors.initials: BW
authors.lastname: Friedman
mesh_terms: D000293:Adolescent; D000328:Adult; D003441:Crowding; D003615:Dancing; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009146:Music; D009519:New York City / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies; D014187:Transportation of Patients / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000628:therapy; D055815:Young Adult
keywords:  DOHMH Department of Health and Mental Hygiene;  ED emergency department;  EDMF electronic dance music festival;  EMS Emergency Medical Services;  IAP incident action plan;  MDMA 3;  NYC New York City;  PMA para-methoxyamphetamine;  PPR patient presentation rate;  TTHR transport to hospital rate; 4-methylenedioxymethamphetamine; EMS; mass gatherings; toxicology