Date sent: Mon, 27 May 1996 23:59:13 -0400 Send reply to: RWHartung@AOL.COM From: RWHartung@AOL.COM Subject: Rock Concerts To: Multiple recipients of list EMED-L For anyone who is interested, this is a summary of the information I have been able to come up with so far from the abstracts (and a couple of full text articles) from a search our library did for me. What do your think? The following are figures for patients needing medical care at various music festivals and rock concerts. 1. An outdoor rock concert in Sydney, Australia attracted 93,000 people. Of these, 450 sought treatment the various first aid teams (0.4% of the total). Of these, 36 were thought serious enough to need "admission" to the main medical area (8% of the 450 patients seen, or .04 % of the total). Seven required transport to the hospital (1.5% of the patients seen or 0.01% of the total). 2. A music festival in 1989 in Cornwall, England attracted around 45,000 people. This resulted in 1% of the total number of attendees requiring some sort of aid. Of these, 15 patients required hospital admission (3.2 % of the patients, or 0.03% of the total). 3. A 3-day outdoor music fest in New Zealand attracted 20,000 attendees. There were a total of about 2000 visits to the medical area (about 10% of the total). The numbers requiring hospital transport and/or admission was not given. The five most common complaints were sunburn, headaches, minor foot trauma, gastroenteritis and lacerations. These made up 75% of the total encounters. 4. The 1982 US Festival, a three-day outdoor rock music festival, attracted close to 410,000 people. Ambulatory care was provided by a multitiered approach using EMTs, RNs, "Medical Health Counselors" (?), and MDs. A total of 2,623 encounters were logged (0.64% of the total). Of these, 38% involved minor surgical trauma. Very high temperatures, high winds and high dust conditions acounted, in part, for the 14% with reactive airway disease and 7% with heat exhaustion. There were 91 transports (3.4% of patients, or 0.02% of total), of which 12 were classified as major casualties. 5. The Arizona chapter of ACEP studied the medical care given at 15 facilities in Phoenix and Tucson. The events studied included street fairs, concerts, professional sporting events and state fairs. Of the 490 medical encounters reviewed, 46% were felt to be within the realm of Basic EMTs, 52% were felt to be within realm of Paramedics. They found that the most common injuries/illnesses encountered were lacerations, sprains, headaches and syncope. Other diagnoses included heat exhaustion (8%), alcohol and drug related problems (4%), bruises (4%), shortness of breath (4%), epigastric distress (4%), chest pain (4%), nosebleeds (4%), and burns (4%). All other diagnoses (assaults, head injury, asthma, seizures, old injury/new dressing, insect stings, flank pain, earache, blisters, diarrhea and ob/gyn problems) accounted for less than 2% each. They quoted information from the 1984 Summer Olympic Games in Los Angeles which found that medical care was used by 1.6 persons per 1,000 spectators (0.16%). This varied between site and event and ranged from 0.07% to 0.7%. Utilization was increased for outdoor events. 6. An article in the Canadian Medical Association Journal suggests that between 0.5% and 1.5% of concertgoers could be expected to use medical services. Most of these were minor problems. 7. An emergency facility was provided at the midtfyn Rock Music Festival (Sweden) in 1990. The total number of people there was about 67,000. Over the course of the 4 1/2 day festival, 329 patients were treated at the facility (0.5% of the total). In 74% of the cases, treatment was completed at the emergency facility (26% transported to the hospital or 0.1%). They felt that this was a cost effective way to provide care, partly based on the savings in staff (?efficiency) and transport costs. ------------------------------------- In summary, based on these studies, we can expect anywhere from 0.1% to 1.0% of the total attendees to require medical care of some type. (One paper suggested the range might be as high as 1.5%. One paper was clearly outside the average in reporting nearly 10% needing medical care. This would seem extremely high). The hospital transport rate was anywhere from 0.01% to 1% of the total attendees. Most of the encounters were felt to be treatable at the scene. Given an expected attendance, then, of 30,000 people for the Phish concert, we can expect from 30 to 300 people (450 at the outside) to require some type of medical intervention at the scene. From 3 to 30 may require transport to the emergency department. It should be noted that these figures are only for the care given at, or patients transported from the AFB. It does not necessarily include the increased demand on the hospital and the ED from the increased number of people staying in town and going into town to shop, etc. The Emergency Medicine Residency at Loma Linda University Medical Center works with MedEvent Corporation to provide medical care at concerts at several large venues in southern California. I have reviewed the data from the last 5 years (over 400 concerts) and have found certain trends. The number of patients, number of transports, type of medical need varies considerably with the type of music. For instance the average number of patients per concert varies as follows: rock/classic rock-6; alternative rock-11; heavy metal-17; easy listening-2; country-3; jazz-5; world-4; classical-2; latin-2; R&B-2; and psychedelic (i.e. Grateful Dead, Jerry Garcia) 9. Also, the average number of patients requiring transport varied from 0-2 for all categories of music. The most transported at any one concert was 8 at a Metallica concert. Remember, however,(except for the psychedelic category which lasted longer) the concerts were generally from 3 to 5 hours in length. I have never actually worked a Phish concert but if it is similar to the Grateful Dead the following may be helpful. We have worked 7 Grateful Dead concerts and a Jerry Garcia concert. (6/1/91, 12/8/93, 12/9/93, 12/10/93, 12/15/94, 12/16/94, 12/18/94, and 5/13/94). The number of patients seen at first aid at each concert ranged from 3 to 18. One concert required 1 transport to local ED, one concert required 2 transports and the other concerts required no transports. At these concerts we saw a total of 70 patients. The chief complaints were as follows (Dermal injury-14, eye injury-2, head injury-7, musculoskeletal-9, other trauma-3, abdominal pain-1, alcohol/drug ingestion-8, dizziness-3, headache-3, heat/cold related-1, other medical-4, respiratory distress-3, seizure-1, syncope-6 and ALOC-5). Remember, however, this is only their chief complaint and that most of the patients seen had drug/etoh also. LSD was by far the most common of the drugs. The attendance at these concerts was 5867 at Jerry Garcia, 12500, 14366, 14371, 14373, 14322, 14644 and unknown. All of these concerts were held at the Los Angeles Sports Arena. If you could use any other information please let me know. Jeff T. Grange, MD (PGY-2) Special Event Medicine Coordinator Dept. Emergency Medicine Loma Linda University Medical Center