We are all busy this time of year with Music Festivals and other New Year’s Eve / New Year’s Day community events throughout Melbourne, Sydney, Brisbane, Adelaide, Perth, Canberra and Hobart. As always to ensure positive patient outcomes and Event Healthcare, we need to be particularly vigilant with the use of illicit substances, in particular MDMA (ecstacy) and a cheaper, more toxic substance called PMA/PMMA being sold as MDMA. Focus group work with government and stakeholder agencies have developed the “sooner than later” principle. In other words if you are suspecting illicit substance effects and abnormal vital signs (see criteria below), please obtain higher level medical assistance as soon as possible. Do not hang on to these patients. Serotonin toxicity and high temperature effects must be recognised and dealt with quickly.
There is anecdotal information that higher concentrations of MDMA are currently on the market and the user may not and often does not know what strength they are taking. Similarly a mixture of methamphetamine can have a serotonin potentiating affect.
Quick google searches with regard to serotonin syndrome and MDMA or other methamphetamine will yield much information. Do not forget other drugs such as depressants or poly-pharmacy effects with/without alcohol.
Be pedantic with your observations & documentation. Some of many web based information links below:
And much more info – do your research. Be pedantic with recording temperatures. The following advice is issued by the NSW Department of Health and will apply to all Colbrow Medics.
Stay safe. Be vigilant. Have plenty cold fluids/ice/shade/fans etc available.
Vital Sign Criteria
Vital Signs Criteria: Suggested ACTIONS
Event Healthcare: NSW Department of Health – Music Festival Guidelines
The thresholds in this document are more conservative than those applied to the general population to account for other factors such as:
Calling & Escalation Criteria
Where there is a conflict between these guidelines and the ‘between the flags’ calling criteria, the NSW Department of Health – Music Festival Guidelines shall be used.
Fever: Suggested ACTIONS
In relation to temperature, based on use of tympanic temperature: