Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-22T11:09:15.875Z Has data issue: false hasContentIssue false
  • English
  • Français

Prehospital Severity Scoring at Major Rock Concert Events

Published online by Cambridge University Press:  28 June 2012

Timothy B. Erickson ,
Max Koenigsberg ,
E. Bradshaw Bunney ,
Brian Schurgin ,
Paul Levy ,
Jacob Willens  and
Logan Tanner
Timothy B. Erickson*
Affiliation:
Department of Emergency Medicine, University of Illinois at Chicago, Chicago, Illinois, USA Toxikon Consortium, Cook County Hospital/University of Illinois, Chicago, Illinois, USA
Max Koenigsberg
Affiliation:
Department of Emergency Medicine, University of Illinois at Chicago, Chicago, Illinois, USA Department of Emergency Medicine, Chicago North EMS System, Illinois Masonic Medical Center, Chicago, Illinois, USA
E. Bradshaw Bunney
Affiliation:
Department of Emergency Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
Brian Schurgin
Affiliation:
Department of Emergency Medicine, MacNeal Hospital, Berwyn, Illinois, USA
Paul Levy
Affiliation:
University of Illinois at Chicago, The School of Public Heath, Chicago, Illinois, USA
Jacob Willens
Affiliation:
Medical and Safety Engineering (MASE), Chicago, Illinois, USA
Logan Tanner
Affiliation:
Medical and Safety Engineering (MASE), Chicago, Illinois, USA
*
University of IllinoisDepartment of Emergency Medicine CMW Rm 618 (M/C 724) 1819 Polk Street Chicago, IL 60612USA
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Rock and contemporary music concerts are popular, recurrent events requiring on-site medical staffing.

Study objective:

To describe a novel severity score used to stratify the level of acuity of patients presenting to first-aid stations at these events.

Methods:

Retrospective review of charts generated at the first-aid stations of five major rock concerts within a 60,000 spectator capacity, outdoor, professional sports stadium. Participants included all concert patrons presenting to the stadiums first-aid stations as patients. Data were collected on patient demographics, history of drug or ethanol usage while at the concert event, first-aid station time, treatment rendered, diagnosis, and disposition. All patients evaluated were retrospectively assigned a “DRUG-ROCK” Injury Severity Score (DRISS) to stratify their level of acuity. Individual concert events and patient dispositions were compared statistically using chi-square, Fisher's exact, and the ANOVA Mean tests.

Results:

Approximately 250,000 spectators attended the five concert events. First-aid stations evaluated 308 patients (utilization rate of 1.2 per 1,000 patrons). The most common diagnosis was minor trauma (130; 42%), followed in frequency by ethanol/illicit drug intoxication (98; 32%). The average time in the first-aid station was 23.5±22.5 minutes (± standard deviation; range: 5–150 minutes). Disposition of patients included 100 (32.5%) who were treated and released; 98 (32%) were transported by paramedics to emergency departments (EDs); and 110 (35.5%) signed-out against medical advise (AMA), refusing transport. The mean DRISS was 4.1 (±2.65). Two-thirds (67%) of the study population were ranked as mild by DRISS criteria (score = 1–4), with 27% rated as moderate (score = 5–9), and 6% severe (score >10). The average of severity scores was highest (6.5) for patients transported to hospitals, and statistically different from the scores of the average of the treated and released and AMA groups (p <0.005).

Conclusion:

The DRISS was useful in stratifying the acuity level of this patient population. This severity score may serve as a potential triage mechanism for future mass gatherings such as rock concerts.

Keywords

acuityfirst-aidintoxicationmass gatheringsmedical staffprehospitalrefusal of carerefusal of transportrock concertsseverity score
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 12 , Issue 3 , September 1997 , pp. 22 - 26
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Sanders, AB, Criss, E, Steckl, P, et al: An analysis of medical care at mass gatherings. Ann Emerg Med 1986;15:515–519.Google Scholar
2. Thompson, JM, Savoia, G, Powell, G, et al: Level of medical care required for mass gatherings: The XV Winter Olympic Games in Calgary, Canada. Ann Emerg Med 1991;20:385–390.CrossRefGoogle ScholarPubMed
3. Baker, WM, Simone, BM, Niemann, JT, et al: Special event medical care: The 1984 Los Angeles Summer Olympics experience. Ann Emerg Med 1986;15:185–190.Google Scholar
4. Bullock, C: Spectator medicine: A discipline in throes of evolution. Emergency Medicine News 1994;16:10–14.Google Scholar
5. Meislin, HW, Rosen, P, Sternbach, GW: Concepts, components and configurations: Life-support system: Emergency medical care for conventions. JACEP 1976;5:351–354.CrossRefGoogle Scholar
6. De Lorenzo, RA, Gray, BC, Bennett, PC, et al: Effect of crowd size on patient volume at a large, multipurpose, indoor stadium. J Emerg Med 1989;7:379–384.CrossRefGoogle Scholar
7. Whipkey, RR, Paris, PM, Steward, RD: Emergency care for mass gatherings, proper planning to improve outcome. Postgrad Med 1976;1984:47–51.Google Scholar
8. Feldstein, BD, Gallery, ME, Sanner, PH, et al: Disaster training for emergency physicians in the US: A systems approach. Ann Emerg Med 1985;14:36–40.CrossRefGoogle Scholar
9. De Lorenzo, RA, Boyle, MF, Garrison, R: A proposed model for a residency experience in mass gathering medicine: The United States Air Show. Ann Emerg Med 1993;22:1711–1714.CrossRefGoogle ScholarPubMed
10. McDonald, CC, Koenigsberg, MD, Ward, S: Medical control of mass gatherings: Can paramedics perform without physicians on-site?. Prehospital and Disaster Medicine 1993;8:327–331.CrossRefGoogle ScholarPubMed
11. Levens, LK, Durham, JE: Pop-music festivals: Some medical aspects. BMJ 1971;1:218–220.CrossRefGoogle ScholarPubMed
12. Chapman, KR, Carmichael, FJ, Goode, JE: Medical services for outdoor rock music festivals. CMAJ 1982;126:935–938.Google Scholar
13. James, SH, Calendrillo, B, Schnoll, SH: Medical and toxicological aspects of the Watkins Glen Rock Concert. J Forensic Sci 1974;1:71–82.Google Scholar
14. Hayman, CR, Standard, RL, Meek, HS, et al: Provision of emergency health care at a rock festival. Med Ann District of Columbia 1973;42:229–235.Google Scholar
15. Osier, DC, Shapiro, S: Medical services at outdoor festivals: Risks and recommendations. Clin Pediatr 1975;14:390–395.Google Scholar
16. Schlict, J, Mitcheson, M, Henry, M: Medical aspects of large outdoor festivals. Lancet 1972;1:948–952.Google Scholar
17. Farrow, RJ: Pop music festivals: A special medical problem. The Practitioner 1972;208:381–386.Google Scholar
18. Fulde, GWO, Forster, LS, Preisz, P: Open air rock concert: An organized disaster. Med J Australia 1992;157:820–822.Google Scholar
19. Ybarra, MJ: Mosh pit medicine: “Dr. Dave” treats bloodied rock fans. Wall Street Journal, Dow Jones & Company, Inc 1994; September 9:1.Google Scholar
20. Ounanian, LL, Salinas, C, Shear, CL, et al: Medical care at the 1982 US festival. Ann Emerg Med 1986;15:520–527.CrossRefGoogle ScholarPubMed
21. Anonymous: 1994 Boxoffice Summary: Pollstar Year-End Special Edition. 1994; Dec 31:58–64.Google Scholar
22. Jennett, B, Teasdale, G: Aspect of coma after severe head injury. Lancet 1977;1:878–881.Google Scholar
23. Champion, HR, Sacco, WJ: Measurement of injury seventy and its practical application. Trauma Quart 1984;1:25–36.Google Scholar
24. Baxt, WG, Berry, CC, Epperson, MD, et al: The failure of prehospital trauma prediction rules to classify trauma patients accurately. Ann Emerg Med 1989;18:1–8.Google Scholar
25. Knudson, P, Frecceri, CA, DeLateur, SA: Improving the field triage of major trauma victims. J Trauma 1988;28:602–606.CrossRefGoogle ScholarPubMed
26. Graves, HB, Smith, EE, Braen, GR, et al: Clinical policy for the initial approach to patients presenting with acute toxic ingestion or dermal or inhalation exposure. Ann Emerg Med 1995;25:570–585.Google Scholar
27. Waeckerle, JF: Disaster planning and response. N Engl J Med 1991;324:815–821.Google ScholarPubMed