Erickson T B, Koenigsberg M, Bunney E B, Schurgin B, Levy P, Willens J, Tanner L
Department of Emergency Medicine, University of Illinois at Chicago 60612, USA.
Prehosp Disaster Med. 1997 Jul-Sep;12(3):195-9.
Rock and contemporary music concerts are popular, recurrent events requiring on-site medical staffing.
To describe a novel severity score used to stratify the level of acuity of patients presenting to first-aid stations at these events.
Retrospective review of charts generated at the first-aid stations of five major rock concerts within a 60,000 spectator capacity, outdoor, professional sports stadium. Participants included all concert patrons presenting to the stadium's first-aid stations as patients. Data were collected on patient demographics, history of drug or ethanol usage while at the concert event, first-aid station time, treatment rendered, diagnosis, and disposition. All patients evaluated were retrospectively assigned a "DRUG-ROCK" Injury Severity Score (DRISS) to stratify their level of acuity. Individual concert events and patient dispositions were compared statistically using chi-square, Fisher's exact, and the ANOVA Mean tests.
Approximately 250,000 spectators attended the five concert events. First-aid stations evaluated 308 patients (utilization rate of 1.2 per 1,000 patrons). The most common diagnosis was minor trauma (130; 42%), followed in frequency by ethanol/illicit drug intoxication (98; 32%). The average time in the first-aid station was 23.5 +/- 22.5 minutes (+/- standard deviation; range: 5-150 minutes). Disposition of patients included 100 (32.5%) who were treated and released; 98 (32%) were transported by paramedics to emergency departments (EDs); and 110 (35.5%) signed-out against medical advise (AMA), refusing transport. The mean DRISS was 4.1 (+/- 2.65). Two-thirds (67%) of the study population were ranked as mild by DRISS criteria (score = 1-4), with 27% rated as moderate (score = 5-9), and 6% severe (score > 10). The average of severity scores was highest (6.5) for patients transported to hospitals, and statistically different from the scores of the average of the treated and released and AMA groups (p < 0.005).
The DRISS was useful in stratifying the acuity level of this patient population. This severity score may serve as a potential triage mechanism for future mass gatherings such as rock concerts.
摇滚音乐会和当代音乐会很受欢迎，是需要现场配备医疗人员的经常性活动。
描述一种用于对在这些活动中前往急救站的患者的 acuity 水平进行分层的新型严重程度评分。
回顾性审查在一个可容纳60,000名观众的室外专业体育场馆内举办的五场大型摇滚音乐会的急救站生成的图表。参与者包括所有作为患者前往该体育场馆急救站的音乐会观众。收集了患者的人口统计学数据、在音乐会期间使用药物或乙醇的历史、在急救站的时间、接受的治疗、诊断和处置情况。对所有接受评估的患者进行回顾性分配“DRUG - ROCK”损伤严重程度评分（DRISS），以分层其 acuity 水平。使用卡方检验、费舍尔精确检验和方差分析均值检验对各个音乐会活动和患者处置情况进行统计学比较。
约250,000名观众参加了这五场音乐会。急救站评估了308名患者（利用率为每1000名观众中有1.2人）。最常见的诊断是轻度创伤（130例；42%），其次是乙醇/非法药物中毒（98例；32%）。在急救站的平均时间为23.5 +/- 22.5分钟（+/-标准差；范围：5 - 150分钟）。患者的处置情况包括100人（32.5%）接受治疗后出院；98人（32%）由护理人员转运至急诊科（ED）；110人（35.5%）不听从医嘱自行离开（AMA），拒绝转运。DRISS的平均值为4.1（+/- 2.65）。根据DRISS标准，三分之二（67%）的研究人群被列为轻度（评分 = 1 - 4），27%被评为中度（评分 = 5 - 9），6%为重度（评分 > 10）。被转运至医院的患者的严重程度评分平均值最高（6.5），与接受治疗后出院和AMA组的评分平均值在统计学上有差异（p < 0.005）。
DRISS有助于对该患者群体的 acuity 水平进行分层。这种严重程度评分可能作为未来如摇滚音乐会等大型集会的潜在分诊机制。
