There are known higher rates of drug and alcohol consumption in music festival attendees. Patterns of MDMA use had been changing over a number of years however the festival season (Sept 2018 - May 2019) in NSW saw a dramatic rise in drug related mortality and morbidity which had not been seen in other states in Australia although similar instances had been noted overseas.

With over 70 music festivals in NSW in this period, five deaths in four months and 29 severely unwell patrons transported to NSW hospitals, the impact was significant.To support both the festival site and NSW hospitals a Health Response Team (HRT) deployment model was implemented

The planning and intervention strategies included provision of onsite specialist critical care teams to complement existing event management and paid healthcare providers. Disaster management principles, although documented, had not previously been used in the music festival setting. To deploy such a team, guidance on equipment, pharmaceutical and physical requirements were scarce. Our team developed processes and protocols for all aspects of this unique deployment.

Operational procedures included specific equipment, medications, documentation processes, and clinical protocols were developed and reviewed and refined after each festival.

The effectiveness of the teams was evidenced through the early recognition and management of severe drug toxicity seen at the five festivals to which WSLHD deployed HRTs. This management resulted in good outcomes with minimal morbidity and no deaths of the 29 festival patrons treated by the HRT noting 25 required intensive care admission.

Innovative processes and collaborative arrangements enabled effective deployment to NSW music festivals. Expert HRTs were key in preventing drug related morbidity and mortality through early recognition and management of complications. Team members gained unique and invaluable experience as a result of their deployments and patients transported to hospital were managed more effectively.