Clinical survey assessing the appropriate management of individuals with acute recreational drug toxicity at a large outdoor festival event

Abstract

Background: The published ambulance referral criteria (ARC) for assessing individuals with acute recreational drug toxicity in the prehospital setting consist of nine domains. The ARC recommend that an ambulance is called to transfer those with a score ≥1 to hospital.Methods: Individuals presenting to a physician-led medical facility with acute drug and/or ethanol toxicity during an outdoor festival were assessed to determine whether the ARC recommended hospital transfer. Final disposition following management in the facility was compared with ARC assessment to determine if physician-led management reduced the need for hospital transfer.Results: A total of 28 patients were presented during the study period; 16 (57.1%) had an initial ARC ≥1 (range 1–5). Twelve (75%) of these were discharged after management in the facility. Four were transferred to hospital: two for severe acute recreational drug toxicity and two due to closure of the facility at the end of the event.Conclusions: Physicians present at this festival event significantly reduced the need for hospital transfer of individuals with acute recreational drug toxicity. Organisers of similar festivals should consider whether it would be appropriate to arrange for appropriate physician-level support to reduce the use of local health-care resources during the event for individuals with acute recreational drug/ethanol toxicity.