At this particular event, recreational drug abuse necessitated on-site medical treatment in one out of 350 attendants and a hospital transfer in one out of 1,000. Ethanol remains the most frequently abused (legal) drug, yet classical illicit recreational drugs are also frequently (co-) ingested. The most worrying observation was high-risk poly-drug use, especially among MDMA users. Regarding NPS, the number of cases was low and the clinical presentations were rather mild. It should be stressed that these observations only apply to this particular event and cannot be generalized to other EDM events. Calle P , Sundahl N , Maudens K , Wille SMR , Van Sassenbroeck D , De Graeve K , Gogaert S , De Paepe P , Devriese D , Arno G , Blanckaert P . Medical emergencies related to ethanol and illicit drugs at an annual, nocturnal, indoor, electronic dance music event. Prehosp Disaster Med. 2018;33(1):71-76.

First aid (FA) services are provisioned on-site as a preventive measure at most public events. In Flanders, Belgium, the Belgian Red Cross-Flanders (BRCF) is the major provider of these FA services with volunteers being deployed at approximately 10,000 public events annually. The BRCF has systematically registered information on the patients being treated in FA posts at major events and mass gatherings during the last 10 years. This information has been collected in a web-based client server system called "MedTRIS" (Medical Triage and Registration Informatics System). MedTRIS contains data on more than 200,000 patients at 335 mass events. This report describes the MedTRIS architecture, the data collected, and how the system operates in the field. This database consolidates different types of information with regards to FA interventions in a standardized way for a variety of public events. MedTRIS allows close monitoring in "real time" of the situation at mass gatherings and immediate intervention, when necessary; allows more accurate prediction of resources needed; allows to validate conceptual and predictive models for medical resources at (mass) public events; and can contribute to the definition of a standardized minimum data set (MDS) for mass-gathering health research and evaluation. Gogaert S , Vande veegaete A , Scholliers A , Vandekerckhove P . "MedTRIS" (Medical Triage and Registration Informatics System): a web-based client server system for the registration of patients being treated in first aid posts at public events and mass gatherings. Prehosp Disaster Med. 2016;31(5):557-562.

according to predefined eligibility criteria. Included items were read and results were compiled and summarized. Results: In a total of 64 included items, 34 were published between 2013-2016. The most studied events were Germany's Love Parade stampede in 2010 (n = 6) and the UK Hillsborough stadium stampede in 1989 (n = 4). The literature retrieved was from a wide range of different disciplines. Conflicting definitions of human stampedes were found. The common belief that they result from an irrational and panicking crowd has progressively been replaced by studies suggesting that successive systemic failures are the main underlying causes. Stampedes are not reported in global disaster databases, making unusual sources like news reports often the only information available. Prevention measures are to date mainly related to crowd management and venue design, but their effectiveness has not been studied. Best practices for preparedness and response are not consensual. Conclusion: Stampedes are a complex phenomenon that remains incompletely understood, hampering formulation of evidence-based strategies for their management. Many of the findings come from high-profile events and are difficult to extrapolate to other settings. More research from different disciplines is warranted to address these gaps in the knowledge in order to prevent and mitigate future events. A start would be to agree on a commonly accepted definition of stampedes. Study/Objective: To identify the epidemiological spread of athletes, the injuries and medical conditions they present with, to assess the level of preparedness and organization of the medical care at the event, and how the medical preparedness coped with the surge at the medical tent. Background: Marathons and ultra-marathons have become increasingly popular in Nigeria and other developing countries. Participants are more dedicated, investing time and effort to prepare and compete. As the field increases, so do the types of injuries and medical conditions that present to the medical tent on event day. As a result, a lot more goes into preparation and medical capacity for these events. Methods: A mass gathering matrix will be applied to the event demographics to assess the projected need for the event. Actual preparedness on the ground will be assessed and studied. All athletes entering the medical tent, picked up along the route, or taken directly to hospital will be triaged and a questionnaire applied to them. Results: Musculoskeletal injuries, dermatological, respiratory problems, collapse and hypotension have been shown to be common problems in marathon runners. The result should clarify, if this is so in marathons in Nigeria. Organization of medical coverage of these events needs to be well coordinated and staffed to be effective. The matrix will help organizers have a baseline or template for proper preparation. Conclusion: The epidemiology of marathon injuries may follow conventional events, but a proper understanding of this will aid proper preparation for the event and organiz...

Background: The Belgian Red Cross provides first aid at 50 events with an attendance of more than 10,000 people every year. Since 2006, every patient encounter gets logged in a database called MedTRIS. The MedTRIS database contains more than 150,000 patient encounters. Methods: The triage category of a patient is recorded upon entering the first aid post. Four categories are used: without treatment, first aid, medical condition and medical emergency. A "medical emergency" requires immediate attention of a physician, a "medical condition/case" can wait. Other patient's characteristics, such as type of injury and type of event, are also recorded. All recorded information was coded for analysis in SPSS©. Results: 162.611 patient encounters are recorded in the MedTRIS database. 16.989 (10,5%) patients needed medical attention. 1080 (0,8% of total patient encounters) of these patients presented as a medical emergency. In the "medical condition/case" triage category the most prevalent type of injury was of the miscellaneous kind. This category represents-among others-urological and gynecological problems, eye abrasions and patients with chronic conditions. It is worth noting that some of the patients in the miscellaneous category probably belong in one of the other, more specific categories. Other types of injuries such as skin lesions, traumas and intoxications were roughly equally represented. However, in the "medical emergency" category, intoxications were more than three times as common as other type of injuries. Conclusion: True medical emergencies remain infrequent. An on-site physician needs to be capable to treat a multitude of different conditions. However, it is important to note that a medical emergency often concerns an intoxicated patient. Therefore, extra training in this specific type of injury is advisable.

Introduction:Attendees at music festivals rely upon on-site medical services for their emergency and medical care needs. Patients previously cared for can re-present for services at different times over the course of an event.Aim:To identify the proportion of visits that are repeat presentations at music festivals and discuss themes in the medical care needs of these potentially resource-intensive patients.Methods:This study included a review of prospectively enrolled patients presenting for health services over five years at a number of music festivals in Belgium and Canada. Patient data were extracted from existing databases of visits as well as visit documentation, and linked by name and date of birth to identify repeat visits. Data were de-identified and visit times, triage acuity, chief complaints, treatments, and discharge instructions were extracted.Results:Re-presentations constituted approximately 5% of all on-site medical visits. The majority were for minor care (e.g., wounds, dressings, foot care). Repeat visits for major issues included chronic disease (e.g., asthma, seizures, diabetes) and serial intoxications; these were high risk for transport to hospital. Festival duration was positively correlated with the number of patients with multiple visits. Three or more visits or visits in different years were rare occurrences.Discussion:At music festivals, a small but significant proportion of attendees utilize medical services repeatedly. Most are low acuity issues that could potentially be avoided with counseling or supplies at the initial visit. However, higher acuity re-registrations, both within and between event years, are a higher risk for transport and could benefit from early identification. Having a plan to identify and potentially remove the sicker, higher risk patients from the event could be important for safety and liability.