paramedic crew and 10 St John ambulances. The organisation of on-site medical per-These were distributed around the circuit. sonnel and facilities is described for an The medical centre consisted of (1) a two open air rock concert attended by 62 000 bedded resuscitation room with a full range of people. Care of the majority of patients resuscitation drugs and fluids, ECG and dewas completed on site, avoiding an fibrillator, pulse oximeter, automatic nonincreased workload for local hospitals and invasive blood pressure monitor, intubation general practitioners. Many of the head and ventilation equipment; (2) two bays injuries could have been avoided by pre-with three examination couches; (3) a small venting the distribution of promotional operating theatre for minor procedures; (4) a items and large drinks containers which recovery room with two beds; (5) The concert was held in the infield areas of the people were referred to the medical centre for race circuit in August. Many people arrived the treatment or a second opinion and 54 required day before and left the day after, camping observation in the recovery area; 31(2-9%) overnight at a site within the confines of the were referred to hospital, of whom five were circuit.admitted and 10 required hospital or general Medical cover was provided by 12 doctors. practitioner (GP) follow up. Two patients Many of the doctors regularly attend race refused to go to hospital, both of whom had a meetings at the circuit and were therefore suspected fractured scaphoid. The five cases familiar with circuit layout and medical requiring admission were an ankle fracture, a facilities. Medical staff worked a shift system minor head injury, a fractured maxilla, a throughout the duration of the concert. Four fractured orbital floor, and a recurrence of doctors including a consultant anaesthetist, endometriosis. a consultant and registrar in accident andThe diagnoses of attenders were recorded in emergency medicine, and an orthopaedic several categories (figure). The most frequent registrar worked in the medical centre. Two diagnosis was headache, which accounted for doctors were located back-stage with first aid 22-7% of attendances.

The CCR can be applied successfully in the UK. Had the CCR been in use during the study period, a 17.4% reduction in radiography could have been achieved without compromising patient care.

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SUMMARYThe case of a fit young man who developed rhabdomyolysis after a short period of immobilization following acute alcohol intoxication is described. Rhabdomyolysis should be considered in an intoxicated patient presenting with muscle tenderness, particularly after immobilization.

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