Lehigh University, located in Northampton County, Pa., became the scene of an unexpected mass causality incident at their Rauch Field House, which sits adjacent to the Stabler Arena. The university leased the 62,000-square-foot facility through New Castle Entertainment, which advertised DayGlow Blu as an electric music, dance party and paint show. The Dec.2, event attracted approximately 4,200 college-aged attendees. Starting at 8 p.m., it lasted until the early morning hours—but not before nearly 40 people were rushed to hospitals at Lehigh Valley Cedar Crest, Lehigh Valley Hospital-Muhlenberg , Easton Hospital and St. Luke’s Hospital and St. Luke’s Hospital-Anderson.
Lehigh University Director of Media Relations Jordan Reese stated that alcohol was not served at the party; however, Northampton County Director of Emergency Management Robert Mateff reported to the Lehigh Valley News that “those who became ill exhibited signs of drug and alcohol use.”(1) Captain John Bate of Lehigh University’s contracted special event ambulance service, Dewey Fire Company No.1 Ambulance, had researched Dayglow on the Internet and decided to preplan with an established command structure from the start.
A triage officer, operations officer and three response teams were positioned around the dance floor. As attendees became ill, they were triaged by on-site staff. Dewey personnel found they needed assistance. Bethlehem Township Volunteer Fire Company; Suburban EMS Inc.; Upper Saucon Ambulance Corps; Easton EMS; Hanover Township EMS; St. Luke’s Emergency and Transport Services and Northampton County Emergency Medical Agency (EMA) trucks No. 5 and 6 were on scene to help transport patients. This put a strain on the county’s emergency management system.
Was it dehydration, drug and alcohol use, a combination or something else? Though these events can be potentially fatal, little information was provided by the incident commander, Lehigh University or Northampton County EMA as to the exact medical emergencies other than to say “alcohol intoxication, possible recreational drug use and minor musculoskeletal injuries.”
EMS Response to Raves
Electric music parties, otherwise known as raves, were once held in clandestine locations, such as open fields, barns and empty warehouses. Over the years, police crackdowns have forced them to reorganize. Today, they operate as legitimate “for-profit” entertainment businesses with producers.
Now found on university and college campus throughout the U.S., as well as nightclub scenes in most major cities and stadiums worldwide, they’re promoted as dance parties. They draw crowds anywhere from several hundred people to hundreds of thousands. Most attendees are of college age, although some have been as young as 13.
Some of the most noted illicit drugs found at rave parties include the following:
- MDMA (ecstasy);
- Ketamine (Special K) veterinary anesthetic;
- LSD (acid);
- Rophypnol (date-rape drug) sedative;
- GHB-CNS depressant;
- Cannabis; and
Other illicit drugs, such as PCP (angel dust), psilocybin (magic mushrooms) and heroin, can be found but are not as common on the rave scene. Such prescription drugs as Viagra, Prozac and cough elixirs, along with menthol inhalants, vaporizing ointments and nitrous oxide, can also be found among attendees at rave parties.(2)
The combination of drug use, high-energy dancing in crowded areas and people’s pre-existing medical conditions make EMS treatment all the more complicated. The three most common medical emergencies encountered at these events include the following:
- Hypernatremia; and
- Drug overdoses.
The partiers continue dance practically non-stop in large crowds, causing their bodies to overheat. Combined with the ingestion of some of the above-mentioned drugs, the body’s temperature regulating mechanisms are compromised, resulting in a rise in body temperature to fatal levels. EMS providers responding to a rave should be aware that certain drugs, such as ecstasy, impair the kidneys’ capacity to produce urine, possibly causing kidney failure.
Some of the ravers experience hypersensitivity or allergic reactions to the drugs. Some drugs trigger complications in pre-existing medical conditions, while many ravers have no idea what chemicals they have actually ingested. Most of the rave drugs are illegal; therefore, the quality has been cut or chemically altered. This complicates treatment by responders because they might not know which drug is actually causing the problem.(2) Fatalities at these events are minimal, however, they have occurred.
More than 200 of the 185,000 attendees to the June 2010 Electric Daisy Carnival in Los Angeles were injured, 114 of which required transport to hospitals. One 15-year-old girl died from ecstasy overdose.(3–5)
A year later in Dallas, 10 units, most from Dallas Fire-Rescue responded to treat 25–30 of the 23,000 attendees to that city’s Electric Daisy Carnival. One 19-year-old patient died of drug overdose after being transported to Baylor University Medical Center, Dallas.(6,7)
Ten units responded to the Pop2010 Concert in San Francisco in May 2010. They treated 12 of the 15,000 attendees. One patient died, and two were transported with critical injuries that included internal bleeding and kidney failure.(8) In Octobter 2010, Cow Palace hosted Subsonic Spookfest 2010 in which 17 people were hospitalized from drug and alcohol overdoses. San Mateo County sent out a mutual-aid request and were aided by San Francisco, Santa Clara and Alameda emergency crews. The patients were transported to five hospitals in San Francisco and San Mateo County.(10)
In September, a 16-year-old girl was gang raped during a rave party in Vancouver, British Columbia after being slipped a date rape drug that rendered her unconscious.(3)
Of the 5,000 in attendance at the Dayglow Blu event in Syracuse, N.Y., in September, 15 patients were transported to the hospital. According to a report in the Daily Orange, the Syracuse Police Department had been forewarned of drinking and use of PCP and ecstasy.(9)
On Oct. 31, 2010, in London, three police officers were injured in a “party turned riot” during the Scumo’ween rave, which was at an abandoned former post office. More than 500 people were in attendance.(7)
These are the latest variation of an on-going history of problems associated with youth entertainment.(2) Cities and venues have started banning these events, but first responders need to be prepared since proper diagnosis and treatment is of the essence. Responders need to be aware that ecstasy is often taken one to two hours before the event but would be unknown to the dance party hosts. As for these types of events, need to expect the unexpected.
Bates emphasizes that responders shouldn’t wait to pre-plan. Understand the event that EMS is covering; know the audience and what previous incidents have occurred; have an incident command structure in place; understand how it operates and maintain communications.
1. Malone JD. (Dec.5, 2011.), 35 taken to hospitals after Dayglow event at Lehigh University-UPDATE. In The Express Times. Retrieved Dec. 5, 2011, from www.lehighvalleylive.com/bethlehem/index.ssf/2011/12/six_arrested_dozens_taken_to_h.html.
2. Scott MS. (March 7, 2002.) Rave parties-problem-oriented guides for police series, No. 14. In Community Oriented Policing Services. Retrieved Dec. 5, 2011, from www.cops.usdoj.gov/pdf/e12011406.pdf.
3. Goldstein & Basher, PC. (Dec. 6, 2011.) Where is your child at night? Rave parties are dangerous but popular on Long Island and New York City. In Goldstein & Basher. Retrieved Dec. 6, 2011, from www.eglaw.com/library/dangerous-rave-parties-are-held-around-long-island-and-new-york-city.cfm.
4. Daily Mail Reporter. (Nov. 1, 2010.) Spooked riot police forced to retreat as 600 Halloween youths cause chaos at an illegal rave in central London. In Daily Mail. Retrieved Dec. 12, 2011, from www.dailymail.co.uk/news/article-1325282/Holborn-Halloween-rave-Riot-police-forced-retreat-600-youths-cause-chaos.html.
5. LAFD Media and Public Relations. (June 27, 2010.) LAFD responds to 200+emergencies at 2010 Electric Daisy Carnival in Los Angelos. In Los Angeles Fire Department News & Information. Retrieved Dec 18, 2011, from http://lafd.blogspot.com/2010/06/lafd-responds-to-200-emergencies-at.html.
6. CNN Wire Staff. (June 19, 2011.) Texas rave leaves one dead, dozens in hospital. In CNN US. Retrieved Dec. 5, 2011, from http://articles.cnn.com/2011-06-19/us/texas.rave_1_electric-daisy-carnival-drug-overdose-fire-marshal?_s=PM:US.
7. Betz J (June 19, 2011.) Arglye teen dies at Fair Park music festival. In WFFA. Retrieved Dec. 17, 2011, from www.wfaa.com/news/local/Death-at-Fair-Park-music-festival-124153214.html.
8. McKinley J. (May 31, 2010.) Tainted drugs are suspected in party death. In New York Times. Retrieved Dec. 6, 2011, from www.nytimes.com/2010/06/01/us/01rave.html.
9. Delaney M, McBride D. (Sept. 3, 2011.) Arrest, hospitalizations occur during Dayglow concert. In Daily Orange. Retrieved Dec. 6, 2011, from www.dailyorange.com/news/arrest-hospitalizations-occur-during-dayglow-concert-1.2573870.
10. Gordon, R. (Oct. 31, 2010). 17 hospitalized at Cow Palace concert. In SF Gate. Retrieved Dec. 22, 2011, from http://articles.sfgate.com/2010-10-31/bay-area/24799853_1_apparent-overdoses-demand-more-police-concert.