Do Physiological Variables Predict the Need for Transport to Hospital From Music Festivals? An Analysis of Australian Festival Data. (3rd March 2023)

• Record Type: Journal Article
• Authors: Douglas, Ned; Donovan, Jake; Carew, James; Brouwer, Kayla; Edwards, Ebony; Gibson, Mitchell; Leverett, Jacqueline; Paul, Joseph; Holbery-Morgan, Lachlan; Pritchard, Jessica; Bourke, Elyssia; Smith, Erin
• Is Part Of: Disaster medicine and public health preparedness. Volume 17(2023)
• Publication Date: 2023-03-03
• Subjects: Delivery of health care -- mass gathering medicine -- triage; Disaster medicine -- Periodicals; Emergency management -- Planning -- Periodicals; Public health -- Periodicals; 363.34
• DOI: 10.1017/dmp.2022.6
• Languages: English
• ISSNs: 1935-7893

Abstract

Abstract: Objective: Using physiological markers to detect patients at risk of deterioration is common. Deaths at music festivals in Australia prompted scrutiny of tools to identify critically unwell patients for transport to hospital. This study evaluated initial physiological parameters to identify patients selected for transport to hospital from a music festival. Methods: A retrospective audit of 2045 presentations at music festivals in Victoria, Australia, was performed. Presentation heart rate, systolic blood pressure, respiratory rate, oxygen saturation, temperature, and Glasgow Coma Scale were assessed using area under the receiver operating characteristic curve (AUROC) analysis, with a prespecified threshold of 0.7. Results: The only measured variable to exceed the prespecified cutpoint was initial systolic blood pressure, with an AUROC of 0.72 and optimal cutpoint of 122 mmHg. Using commonly accepted cutpoints for variables did not improve detection performance to acceptable levels, nor did using combination systems of cutpoints. Conclusions: Initial physiological variables are poor predictors of the decision to transport to hospital from music festivals. Systolic blood pressure was significant, but only at a clinically insignificant value. Decisions on which patients to transport from an event site should incorporate more information than initial physiology. Senior clinicians should lead decision-making about hospital transport from music festivals.