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Avoid 'tunnel vision' at large-scale events

Editor's note: This article is in response to the story "Some ER doctors call for end to LA Coliseum raves." More than 100 people were taken to hospitals during a weekend rave. Read the full story and tell us what you think in the member comments below.

Raves have been popular for some time. Initially these events had the philosophy of people getting together to dance all night. Of course where large groups of teens and young adults come together, alcohol and drugs follow. Raves have become large events, attended by thousands.

Recent events like this one and one that recently occurred in San Francisco points out the ongoing need to have MCI plans dusted off and ready to go at any time. Recall that these events may require significant numbers of resources for an extended period of time.

Communications may be a challenge, and for large spaces access may become a challenge as you try to locate the patient. Preplanning may help alleviate some of the issues; system planners can try to initiate discussions with event planners prior to the event. Many cities in fact have ordinances that require organizations to have EMS standbys at mid to large scale events.

Working at an event like this one has its challenges. It can become quite warm and humid inside rave sites. Dehydration and heat exhaustion can set in, often unnoticed by otherwise healthy young adults until well into the progression of the illness. Food and water is often not available, compounding the problem.

"Rave" drugs such as MDMA or ecstasy can have unpredictable effects, especially mixed with alcohol or illicit drugs. Airway management and evaluating patients with altered mental status become a priority. Don't be lulled into tunnel vision and assume that every patient is an overdose.

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