# Massive MCI at Astroworld



## DrParasite (Nov 7, 2021)

I'm surprised this hasn't been mentioned yet









						What we know about the medical staffing and response at Travis Scott’s Astroworld Festival
					

AUSTIN (KXAN) — As Houston Police start their investigation into what caused the crowd to surge at Travis Scott’s Astroworld Festival, questions remain about how well-equipped the city and ev…




					www.kxan.com
				












						Video shows frantic CPR efforts in midst of deadly Astroworld concert
					

Footage posted online shows at least two people desperately performing CPR on fallen concertgoers at Houston’s NRG Park while Scott continues to perform.




					nypost.com
				












						Viral videos show fans jumping on emergency carts trying to reach injured Astroworld attendees
					

Numerous viral videos detail a horrifying scene that left eight people dead and hundreds injured Friday night during the Astroworld Festival.




					www.dailydot.com


----------



## CCCSD (Nov 7, 2021)

For the most part: humans acting like animals.


----------



## CbrMonster (Nov 7, 2021)

i was just about to start a thread on this,

on reddit there is supposed a firefighter that was on scene during this event and he himself screwed up treating a patient but the paradocs paramedics or emt's not sure what they staffed for the incident where way under equipped and staffed,

is paradocs owned by amr? i know they own an event medical staff company cant remember the one.

everyone is putting a lot of the blame on the medical staff on scene but sounds like they were set up for failure 

i'll start throwing up some links in a second (links copy pasted from another thread on a different forum)




The merch line 



__ https://twitter.com/i/web/status/1456704706366087182
Entrance stampede 



__ https://twitter.com/i/web/status/1456724589560598537
Stampede other angle 



__ https://twitter.com/i/web/status/1456704812456845316
People jumping over gate to escape 



__ https://twitter.com/i/web/status/1457028138140057604
Girl passed out with the crowd trying to get Travis attention 



__ https://twitter.com/i/web/status/1456986475929608201
Another angle of travis singing with girl passed out https://twitter.com/ChaudharyParvez/status/1456986475929608201?s=20

Crowd Screaming for Help https://twitter.com/tre5pix/status/1456998158152736773?s=21

Guy getting CPR https://twitter.com/chaudharyparvez/status/1456981396405166083?s=21

Golf cart & guy getting CPR https://twitter.com/sad_clown_666/status/1456999017464881154?s=21

Insta for that video above https://instagram.com/billynasser?utm_medium=copy_link

Diablo talking about the night https://twitter.com/officialshaane/status/1456898085792124936?s=21

Insta for the video above https://instagram.com/diabloxantiago?utm_medium=copy_link

People dancing on medic golf cart https://twitter.com/chaudharyparvez/status/1456883744745279491?s=21

Fans chanting stop the show https://twitter.com/camilledonita/status/1457002138454962193?s=21

Woman screaming in crowd https://mobile.twitter.com/helloitsroland/status/1457021923913781249

Girl trying to stop the show https://twitter.com/helowkeyspittin/status/1456893054384844802?s=21

Another angle of the girl trying to stop the show https://www.reddit.com/r/PublicFrea...urce=share&utm_medium=ios_app&utm_name=iossmf

Story from the girl who tried to stop the show https://www.instagram.com/p/CV7NkBiLf3L/?utm_medium=copy_link

Nurses account of how medics were not trained https://www.instagram.com/p/CV7CKqNs5f7/?utm_medium=copy_link

Reddit firefighter account of how medics were not trained https://www.reddit.com/r/travisscot...&utm_medium=ios_app&utm_name=iossmf&context=3

Ambulance in crowd https://twitter.com/onacasella/status/1456870462433148931?s=21

This video is probably the best, nurse at the show, gives full account of what happened to her, the lives she was trying to save, and the conditions of the concert.

https://youtu.be/zxjbc-oD-dY


----------



## DrParasite (Nov 7, 2021)

I worked a single concert for ParaDocs, so I have a little bit of experience with how they operate, as well as several years working large events as part of other agencies.  And for the record, I had a blast at that one concert, and would work for them again.


CbrMonster said:


> on reddit there is supposed a firefighter that was on scene during this event and he himself screwed up treating a patient but the paradocs paramedics or emt's not sure what they staffed for the incident where way under equipped and staffed,


What is this based on?  Hindsight is always 20/20.  I mean, unless he is saying there should have been 15 gators, 200 paramedics, and 3 medical tents with fully functioning surgical suites in case an MCI happened...


CbrMonster said:


> is paradocs owned by amr? i know they own an event medical staff company cant remember the one.


no, they are a private event EMS agency based out of NYC 








						Paradocs Event Medical Services
					






					www.paradocsworldwide.com
				





CbrMonster said:


> everyone is putting a lot of the blame on the medical staff on scene but sounds like they were set up for failure


I've heard the same, but I think much of the blame is unwarranted and unfairly assigned to them.

The event I worked with Paradocs was a 3 day concert, so I am going to assume the resources were similar to what happened at astroworld.  Several small BLS "first aid" stations were strategically located throughout the event (often with full BLS equipment, AED, suctions, backboard, etc), several roving BLS foot crews (with a limited BLS bag, their goal was to do a quick assessment and extricated people from the crowd and get them to the first aid station), 3-4 crews on gators, and a medical tent staffed with doctors and nurses.  1 ALS unit in the event, with others nearby.  During the event, my team encountered a variety of patients, including a dislocated knee (which was completed fixed by the medical unit, and the guy was walking around a few hours later), severe hyperthermia, head injury, plus the "routine" calls for ETOH, and everything else you would expect.

I won't lie, there were some things that were restricted by budgets (such as each team was given a radio, not each field person), but I was impressed by their operation and thought it was very well done; even if some non-critical areas were clearly disorganized and not planned out well.

There are also a few factors to consider with this situation: 

 the vast majority of medical personnel ARE NOT full time paradocs personnel.  Paradocs provides the equipment (gators, medical tents, dispatcher, etc and logistics/planning), but most of the field staff are off duty local EMS personnel who are working medical as contractors.  Ditto the docs and nurses.  if I were to make a guess, I would say there were probably less than 10 full-time paradocs employees at the event.  and the levels of experience for the field personnel can vary greatly, from people with an EMT card (and no actual 911 experience, or a FF who never worked on an ambulance, or an EMT who works FT on a dialysis transport truck, and is doing this because its extra money, or a kid who volunteers on a rescue, but that's it), to someone like me, who has worked multiple large scale events, and if you drop me in the middle of chaos, I'm going to do the best I can with the resources available.  
Many of the medical staff are working 12 or 24 hour shifts, or have been up for 18 straight hours... and we all know of the studies that say performance decline after hour 19 or so
They were running 11 cardiac arrests at the same time... following a stampede... how many EMS agencies could handle that?  So is it reasonable to expect them to?
These events DO have plans for MCIs... now, whether the plans were disseminated to the field staff, or adequately followed is another story.
These events are run by THE PROMOTERS, and the people are paying to see a show; that means the show must go on, even if someone is doing CPR.  or if a fight breaks out.  90% of the time, the goal is to treat the patient, out of public view, so the attendees can enjoy the concert which they paid for.  Was this a bad situation?  absolutely; but it's not like the medical staff didn't do their best with the resources they had.
The promoters dictate how many medical resources an event has, not the medical staff.  so if they were short-staffed, that's the fault of the promoters; paradocs was just the logistics organizer.
there were some young kids who were casualities... why did their parents take them to this event?  even if nothing bad happens, is this really a good place for a 10 year old?
Based on those videos, this looks like absolute chaos.  And while I enjoy being in the thick of things, this looked like it was out of control, and a huge failure on event security and local law enforcement.   I'll be curious to see what the investigation reveals.


----------



## DesertMedic66 (Nov 7, 2021)

I have worked the Coachella festival and Stagecoach events for the 10 years I have been involved in EMS. 

With a concert of that size if something major happens, everyone is going to be understaffed and under equipped. 

Medical at those events is designed to respond to calls for service and is not set up for a MCI. It would be physically impossible to have all the possible staff you would need.


----------



## CbrMonster (Nov 7, 2021)

DrParasite said:


> I worked a single concert for ParaDocs, so I have a little bit of experience with how they operate, as well as several years working large events as part of other agencies.  And for the record, I had a blast at that one concert, and would work for them again.
> 
> What is this based on?  Hindsight is always 20/20.  I mean, unless he is saying there should have been 15 gators, 200 paramedics, and 3 medical tents with fully functioning surgical suites in case an MCI happened...
> 
> ...



the firefighter admitted to messing up if thats what you're reffering to, but i say they were under equipped for the event if they did not have an aed or cardiac monitor, not sure on if it was staffed strickly bls or als mix, but there should be an aed/monitor per crew of 2? and only one ambubag i carry 4 adult minimum with one preset up with etco2 inline mask attached. it just seems like per the witnesses that they didnt have much equipment now maybe they're wrong im sure the truth will comeout.

i agree with most of the blame misdirected i think 99% is the event orgianizers and staff of the event itself including the performer but thats my 2 cents

copy on the ownership

1. i mean if thats how they staff doesnt seem like the greatest setup to not use active 911 personel with i guess more relatable experiences? that seems a little wonky?

2. sure totally understandable 

3. i think the staff there did what they could but i fel they should have had more equipment 

4. ive worked some very high profile events across oc and san diego county so i understand that and such

5. exactly which is why i cast most blame on them, the crowd crushing effect should have shut it down until they settled down 

6. yup understand that

7. that as a parent i do not understand, firstly a 10 year old shouldnt be listening to such music in my opinion, but to be there at that type of unsafe envirenment hell ****ing no, that was a failure of parents. 

honestly watching the videos i dont think i would have responded into the crowd unless fully escorted by lots of law enforcement because who to say once youre in if you could get out. watching that was literally horrifying to me on somany levels that we as a human race could be so wreckless towards one another.


----------



## E tank (Nov 8, 2021)

CCCSD said:


> For the most part: humans acting like animals.


Nothing new under the sun...









						The Who concert disaster - Wikipedia
					






					en.wikipedia.org
				




As far as medical standby capabilities...MCI management not part of their mission...participation, yes...management, no.


----------



## DrParasite (Nov 8, 2021)

CbrMonster said:


> 1. i mean if thats how they staff doesnt seem like the greatest setup to not use active 911 personel with i guess more relatable experiences? that seems a little wonky?


I should clarify my statement: just because you are using "active 911" personnel, doesn't mean they know what they are doing.  At the event I worked at, I worked alongside a paramedic (at a BLS first aid station) who had been doing this for 10 years, was more than competent, and had no issues at all.  and I worked with that moron on the rescue squad who didn't know his *** from a hole in the ground but thought he was hot **** and gods gift to EMS because he was part of a rescue squad.   And I'll reterate my statement, 10 years on a fire engine doing first response only doesn't mean you an experienced provider (depending on the system, some are better or worse than others).

The organizers (paradocs) definitely want experienced people, but sometimes they take what they can get, and pair them up with a more experienced provider, and hope for the best.  99% of the time, things go well, but when badness happens, it really happens.


----------



## DesertMedic66 (Nov 8, 2021)

CbrMonster said:


> 1. i mean if thats how they staff doesnt seem like the greatest setup to not use active 911 personel with i guess more relatable experiences? that seems a little wonky?.


Just because they are an event company doesn’t mean their staff doesn’t have relatable experiences. I know a lot of medics and EMTs who work in the 911 system full time and pick up events with another company on the side.


----------



## CbrMonster (Nov 8, 2021)

DrParasite said:


> I should clarify my statement: just because you are using "active 911" personnel, doesn't mean they know what they are doing.  At the event I worked at, I worked alongside a paramedic (at a BLS first aid station) who had been doing this for 10 years, was more than competent, and had no issues at all.  and I worked with that moron on the rescue squad who didn't know his *** from a hole in the ground but thought he was hot **** and gods gift to EMS because he was part of a rescue squad.   And I'll reterate my statement, 10 years on a fire engine doing first response only doesn't mean you an experienced provider (depending on the system, some are better or worse than others).
> 
> The organizers (paradocs) definitely want experienced people, but sometimes they take what they can get, and pair them up with a more experienced provider, and hope for the best.  99% of the time, things go well, but when badness happens, it really happens.


True can’t argue that 




DesertMedic66 said:


> Just because they are an event company doesn’t mean their staff doesn’t have relatable experiences. I know a lot of medics and EMTs who work in the 911 system full time and pick up events with another company on the side.


That’s not what I was meaning, I was more so asking based upon drparasites response, I know most event companies generally ask for multiple years of experience.


----------



## CentralCalEMT (Nov 8, 2021)

I think the most surprising part of the narrative coming out of this is that public statements said over 10 people were transported in cardiac arrest to the ER. I am surprised that, given it was an MCI, the black tags were not left in place and worked up in the first place. I am unfamiliar with their local MCI protocols, but it seemed strange to me. I am also surprised local protocol dictated those people be transported given what is reasonably assumed could be a prolonged downtime seeing as it takes time to identify who is in cardiac arrest, get them to a medical tent, get resources in there and transport. Perhaps this is one of the few remaining systems that transports most cardiac arrests. This leads me to believe we aren't getting the whole story and reality about what happened is probably much different that what is being said in the media. 

I have also read multiple online accounts bashing the medical staff on scene claiming they weren't doing CPR, didn't have an AED, etc. Several of them claim to be medics, nurses, etc. If the on site staff had limited resources (or even if they had a lot) they would still have to triage given the huge number of patients. If they were doing a proper START triage, then they wouldn't be doing CPR on a MCI, wouldn't bring an AED with them to do triage, etc. Security/bystanders may not understand this and may start CPR on their own, not knowing how triage works and assuming a trained medical professional failed to do their job when in reality they did. I wasn't there, but I have a hard time believing that the staff were really as incompetent as people are saying they are on line.


----------



## CCCSD (Nov 8, 2021)

Everybody that wasn’t there is an expert on what happened.
 Everyone that was a “medical” provider that was there as a partygoer is an even better expert.


----------



## CbrMonster (Nov 8, 2021)

CentralCalEMT said:


> I think the most surprising part of the narrative coming out of this is that public statements said over 10 people were transported in cardiac arrest to the ER. I am surprised that, given it was an MCI, the black tags were not left in place and worked up in the first place. I am unfamiliar with their local MCI protocols, but it seemed strange to me. I am also surprised local protocol dictated those people be transported given what is reasonably assumed could be a prolonged downtime seeing as it takes time to identify who is in cardiac arrest, get them to a medical tent, get resources in there and transport. Perhaps this is one of the few remaining systems that transports most cardiac arrests. This leads me to believe we aren't getting the whole story and reality about what happened is probably much different that what is being said in the media.
> 
> I have also read multiple online accounts bashing the medical staff on scene claiming they weren't doing CPR, didn't have an AED, etc. Several of them claim to be medics, nurses, etc. If the on site staff had limited resources (or even if they had a lot) they would still have to triage given the huge number of patients. If they were doing a proper START triage, then they wouldn't be doing CPR on a MCI, wouldn't bring an AED with them to do triage, etc. Security/bystanders may not understand this and may start CPR on their own, not knowing how triage works and assuming a trained medical professional failed to do their job when in reality they did. I wasn't there, but I have a hard time believing that the staff were really as incompetent as people are saying they are on line.



I mean I’m not sure if I would have driven into the crowd that was crowd crushing people to literal death without a full police escort

I kind of applaud them for not just black tagging these people, most of which were minors, I’d personally hate to throw in the towel on kids but I also of course understand prioritizing. I’d be sick to my stomach after having to do that myself, I’d do it, but I’d feel ****ty after without a doubt in my mind. The youngest code being what 14? That’s harsh.

I don’t mean to bash the staff by any means, but from witness statements so far just seems they were under equipped, but of course there’s always three sides to the story each sides and the truth.

I feel bad for the cops everyone is talking **** on that we’re trying to help move a patient on backboard which unfortunately got dropped, like they’re not medically trained they truly did what ever they could and should be praised.



CCCSD said:


> Everybody that wasn’t there is an expert on what happened.
> Everyone that was a “medical” provider that was there as a partygoer is an even better expert.




Drunk medics and nurses save life’s bro lol

Further proof is the firefighter I assume Emt yelling at the on site medical staff about the orientation of the backboard when they in fact had it orientated the right way. Showing proof that even bystander “professional” medically trained people were not as smart as they think they are.


----------



## DesertMedic66 (Nov 8, 2021)

I will say that while working some of the major festivals it is common to have an unofficial “no one gets pronounced at the festival” policy.


----------



## CbrMonster (Nov 8, 2021)

DesertMedic66 said:


> I will say that while working some of the major festivals it is common to have an unofficial “no one gets pronounced at the festival” policy.


Sounds like federal prisons, state doesn’t care though lol.


----------



## CCCSD (Nov 8, 2021)

DesertMedic66 said:


> I will say that while working some of the major festivals it is common to have an unofficial “no one gets pronounced at the festival” policy.


Of course. It’s bad PR. It’s a money thing.


----------



## johnrsemt (Nov 10, 2021)

This is like any other major event when the **it hits the fan;  there is not enough medical staff.

The concert in Vegas a few years ago:  people are trying to sue EMS, because there wasn't enough EMS there to handle the MCI that happened due to the Active Shooter.   Who could have fore seen an active shooter in a case like that?  How do you plan on having enough EMS and Fire and PD on scene at every concert in case a crazy person with a rifle shows up?  Are you going to charge $5,000 per ticket for the cheap tickets so that you can have 1 medical person and 1 cop for every concert goer?

The bombing at the finish line in Boston:  There weren't enough medics and ambulances there either.  Fault of the race organizers?  No

If nothing major had happened at either of these events or the concert in Houston last week, there was plenty of medical and PD staff at them.

Are all fire stations staffed, stocked and equipped for the bus load of nuns hitting the bus load of elementary children?
No we aren't and when the **it hits the fan, then we adapt and send more to help.  And it looks like a mess until more show up.
And civilians will never understand it, and always blame it on EMS and the Police:  not (in the Houston case) the concert promoters who allowed there to be standing room only attendees.


----------



## Tigger (Nov 11, 2021)

johnrsemt said:


> The bombing at the finish line in Boston:  There weren't enough medics and ambulances there either.  Fault of the race organizers?  No


Interestingly there were more than enough ambulances. The vast majority of critical patients were off the scene in the first 20 minutes. All patients including walking wounded who presented back to the area were off the site in under two hours. 

But the marathon is a “planned MCI,” and it’s been staffed that way for years as there is such high potential for a large number of patients (runners) every year. This is not a realistic goal for concerts of course and I see your point, but the marathon is not an equal comparison.


----------



## DrParasite (Nov 11, 2021)

johnrsemt said:


> The bombing at the finish line in Boston:  There weren't enough medics and ambulances there either.  Fault of the race organizers?  No
> 
> not (in the Houston case) the concert promoters who allowed there to be standing room only attendees.


Actually, you are exactly wrong.  it is the organizers/promoters/event owners responsibility to budget for enough EMS to handle any and all incidents that occur during an event.  Boston is a great example of organizers who DID have enough staff, because it was planned and staffed as an MCI, so when the bombings happened, they were able to quickly realocate resources to handle the victims

Most promoters staff for the bare minimum, to cut down on costs, because they are playing the odds that, as others would say, they just need to handle the expected "routine" issues.   Few places will staff for an MCI; however, should anything bad happen, it falls on the organizer for not providing the medical staff with enough resources to handle the MCI, not the medical agency (but the public and social media will always ignorantly say otherwise).



CbrMonster said:


> Further proof is the firefighter I assume Emt yelling at the on site medical staff about the orientation of the backboard when they in fact had it orientated the right way. Showing proof that even bystander “professional” medically trained people were not as smart as they think they are.


oh good, I thought I was the only one who was thinking that


----------



## CbrMonster (Nov 11, 2021)

DrParasite said:


> oh good, I thought I was the only one who was thinking that


I find it interesting he/she went on to publicly post that. Had that been me I would have shut my mouth and none said anything at all.


----------



## CCCSD (Nov 11, 2021)

CbrMonster said:


> I find it interesting he/she went on to publicly post that. Had that been me I would have shut my mouth and none said anything at all.


And he should be ripped apart on all forms of media. Outed as an idiot for all to see, especially his dept.


----------



## CbrMonster (Nov 11, 2021)

CCCSD said:


> And he should be ripped apart on all forms of media. Outed as an idiot for all to see, especially his dept.


I mean it in my mind does nullify a bit of his “witnessing” of lack of quality care at the event as he claims simply because he himself became more of a problem than a solution.

But I don’t think his department should pay the price or Publicly humiliated.


----------



## CCCSD (Nov 11, 2021)

CbrMonster said:


> I mean it in my mind does nullify a bit of his “witnessing” of lack of quality care at the event as he claims simply because he himself became more of a problem than a solution.
> 
> But I don’t think his department should pay the price or Publicly humiliated.


Oh no. He’s talking smack, he gets outed as does his agency, since he’s representing it.


----------



## HardKnocks (Nov 11, 2021)

What everybody's missing is the failure of the Incident Action Plan (IAP). 

Almost every large event where First Responders are assigned should have an active IAP.

The IAP address MCI's.

I'm not going to surmise what part of the IAP failed.

Here's the FEMA  ICS Templates on what should have been completed and on-site during the Event.






						Emergency Management Institute | ICS Fillable Forms
					






					training.fema.gov
				




HK


----------



## CbrMonster (Nov 11, 2021)

CCCSD said:


> Oh no. He’s talking smack, he gets outed as does his agency, since he’s representing it.


Seems he’s gone back and deleted comments on Reddit, At least from what I can tell, but plenty of nurses including ICU nurses who are literally saying paradoc medics have no experience in cardiac arrests.

But I’m also like what average nurse actually deals with an mci? Especially ICU nurses with even smaller rations. Seems a lot of jumping the gun.

Also sadly the girl that was dropped on her face by police assisting the medics passed away today so total count is 9 deaths, I feel for her parents as the last semblance of her body is that video smeared all over the internet.


----------



## HardKnocks (Nov 11, 2021)

Did any wonder why the EMS Carts had no Siren activated.

In my 25 yrs a Siren is better than Warning Lights in moving a Pedestrian/Crowd.

Thinking out Loud;  A Horn would of also gotten people to look at the Cart Operator who would be signalling to make a clear path


----------



## CbrMonster (Nov 11, 2021)

HardKnocks said:


> Did any wonder why the EMS Carts had no Siren activated.
> 
> In my 25 yrs a Siren is better than Warning Lights in moving a Pedestrian/Crowd.
> 
> Thinking out Loud;  A Horn would of also gotten people to look at the Cart Operator who would be signalling to make a clear path


They over took and started dancing on it, you think those kids would have cared if you ran the sirens on them? They probably would have lashed out with anger at them. 

I don’t think I would have even bothered entering into the mob without a police escort if people were getting crushed what’s to say they wouldn’t crush in on you. Can’t trust people to always do the right thing. Clearly they demonstrated they would kill their fellow party goer.


----------



## DesertMedic66 (Nov 11, 2021)

HardKnocks said:


> Did any wonder why the EMS Carts had no Siren activated.
> 
> In my 25 yrs a Siren is better than Warning Lights in moving a Pedestrian/Crowd.
> 
> Thinking out Loud;  A Horn would of also gotten people to look at the Cart Operator who would be signalling to make a clear path


Usually the festival directors and artist get a little pissed if someone is using their siren while there is an active performance so many of the golf carts at the events do not have a siren and some may not even have response lights.


----------



## HardKnocks (Nov 12, 2021)

DesertMedic66 said:


> Usually the festival directors and artist get a little pissed if someone is using their siren while there is an active performance so many of the golf carts at the events do not have a siren and some may not even have response lights.


I understand it was uncontrolled Kaos......Just thinking out loud;


The other idea of using audible signalling is to get the attention of the Spotter, (who is up high looking for things that can't be seen from ground level) and would then direct resources, (LEOS/Security) to assist.

Btw, The on-site security has been reported to have refused the pre-show staging of Local Fire/EMS Assets on the venue grounds. Then when the response was needed they misrouted the vehicle assets and caused unnecessary response delays.

So many levels of failure..........


----------



## DrParasite (Nov 12, 2021)

HardKnocks said:


> What everybody's missing is the failure of the Incident Action Plan (IAP).
> 
> Almost every large event where First Responders are assigned should have an active IAP.
> 
> ...


maybe because it didn't?  Based on my experience with ParaDocs, working a live nation event, I can say with a high degree of certainty that there was an IAP in place, and MCIs were covered.  If I were to guess, I would say it involved calling for mutual aid from the local 911 system, but they (HFD) still needs to drive there.  I don't know of a single MCI where you have all of your mutual aid immediately available; if so, than it's event resources, and not really mutual aid.  You are making a lot of assumptions here



CbrMonster said:


> At least from what I can tell, but plenty of nurses including ICU nurses who are literally saying paradoc medics have no experience in cardiac arrests.


I'm throwing the BS flag on this.  It's completely untrue; it's like saying the medic on the ambulance have no experience in cardiac arrests.  Does anyone believe that?  Absolutely not, because it's flat out wrong.  Now, are there some EMTs who have no experience with cardiac arrests?  sure, especially if they don't work on a 911 ambulance.  Even a paramedic who doesn't work on the ambulance might have limited experience (don't they require them to be handled in paramedic school, on field clinicals?)

and I will say there are many nurses who have no experience handling a cardiac arrest in the field, with limited equipment, all by themselves, while their coworker was doing CPR on another person 20 yards away.


CbrMonster said:


> But I’m also like what average nurse actually deals with an mci? Especially ICU nurses with even smaller rations. Seems a lot of jumping the gun.


The vast majority of nurses, outside of an ER nurse in an understaffed inner city ER, are in no position to be judging any MCI, because they have no experience working in that type of environment.



HardKnocks said:


> Did any wonder why the EMS Carts had no Siren activated.
> 
> In my 25 yrs a Siren is better than Warning Lights in moving a Pedestrian/Crowd.
> 
> Thinking out Loud;  A Horn would of also gotten people to look at the Cart Operator who would be signalling to make a clear path


1) many of the EMS carts don't have sirens
2) using a siren when you are that close to people's ears is likely to cause hearing damage to both the providers and the crowd
3) a horn might help, but I doubt it's going to be louder than the artist's sound systems or the crowd level of noise
4) a better option is to have people (like security) walking in front of the cart gently moving people out of the way so the cart can pass.


----------



## CbrMonster (Nov 12, 2021)

DrParasite said:


> maybe because it didn't?  Based on my experience with ParaDocs, working a live nation event, I can say with a high degree of certainty that there was an IAP in place, and MCIs were covered.  If I were to guess, I would say it involved calling for mutual aid from the local 911 system, but they (HFD) still needs to drive there.  I don't know of a single MCI where you have all of your mutual aid immediately available; if so, than it's event resources, and not really mutual aid.  You are making a lot of assumptions here
> 
> 
> I'm throwing the BS flag on this.  It's completely untrue; it's like saying the medic on the ambulance have no experience in cardiac arrests.  Does anyone believe that?  Absolutely not, because it's flat out wrong.  Now, are there some EMTs who have no experience with cardiac arrests?  sure, especially if they don't work on a 911 ambulance.  Even a paramedic who doesn't work on the ambulance might have limited experience (don't they require them to be handled in paramedic school, on field clinicals?)
> ...


sounds like we are in violent agreement lol


----------



## HardKnocks (Nov 16, 2021)

DrParasite said:


> 2) using a siren when you are that close to people's ears is likely to cause hearing damage to both the providers and the crowd


FYI, Average Concert Sound Levels range from 150-175+ dB.  

I doubt a 30w Cart Siren, will hurt (as a Cart has a limited electrical system).....Unless you embed an Ear in the Siren's Speaker for over a minute or so..lol

I've always been success in moving pedestrians with a Tap on of the siren/horn, People will Look and Move.


----------



## DrParasite (Nov 16, 2021)

HardKnocks said:


> FYI, Average Concert Sound Levels range from 150-175+ dB.


you might want to double-check that... as per https://www.reference.com/science/many-decibels-rock-concert-1b1e7439ec0d2158, *A loud rock concert has a sound pressure level of 115-120 decibels.*

as per https://www.alpinehearingprotection.com/music/hearing-protection-festivals-concerts/, "Do not stand too close to the speakers. The noise around the speakers can soon go up to over 110 decibels" and "The average noise volume at a concert or festival is around 100 decibels."

for comparison, a football game can generate 110 dB of noise, as per https://4f9f43c1b16d77fd5a81-7c3252...00/12448/012714oticonsuperbowlinfographic.pdf


HardKnocks said:


> I doubt a 30w Cart Siren, will hurt (as a Cart has a limited electrical system).....Unless you embed an Ear in the Siren's Speaker for over a minute or so..lol


according to https://www.amazon.com/Epsilont-Outdoor-Self-Contained-Electric-Security/dp/B01E9P0G5K, a 30w siren can go as loud as 120bB.  The https://www.covertlights.com/feniex-titan-30w-siren/ can go as high as 110db.

The biggest difference is at a concert, the loudest spot is right near the speakers, which aren't a foot away from a person (They are on the stage, elevated, and there is often a barrier that keeps the crowd 10+ ft from the actual speakers).   When you are in a cart, pushing through a crowd, you are right up against people, which is where the dB is the highest


----------



## DrParasite (Nov 17, 2021)

The CEO of Paradocs went on CNN, to explain what his staff did









						Medical staff at Astroworld responded to 11 cardiac arrests at the same time, CEO of medic company says | CNN
					

ParaDocs CEO Alex Pollak said he wants to set the record straight on what his team did and to defend how hard his staff of more than 70 people worked to save lives.




					edition.cnn.com


----------



## Summit (Nov 17, 2021)

What shocks me is that there was not a mechanism to stop the concert. There should have been an indication and a mechanism to order "flashing lights off, house lights on, kill the music, address the crowd."



CentralCalEMT said:


> If they were doing a proper START triage, then they wouldn't be doing CPR on a MCI


There are many times that START does not work.

I think a crowd crush MCI is absolutely a time where START does not apply well. Compressive asphyxia is the primary mechanism. People are gonna be apneic and maybe PEA and a little CPR can go a long way. It is probably the only intervention you could possibly do that would make a difference, followed by AED, O2 and maybe needling a trampled chest.


----------



## DesertMedic66 (Nov 17, 2021)

Summit said:


> What shocks me is that there was not a mechanism to stop the concert. There should have been an indication and a mechanism to order "flashing lights off, house lights on, kill the music, address the crowd."
> 
> 
> There are many times that START does not work.
> ...


There are usually systems built in to stop the music and turn on all the lights however there is a very strict number of people, often the number is in the low single digits, who have the authority to give that order.


----------



## Summit (Nov 18, 2021)

DesertMedic66 said:


> There are usually systems built in to stop the music and turn on all the lights however there is a very strict number of people, often the number is in the low single digits, who have the authority to give that order.


Makes sense. Those people should be on speed dial or easy radio access for the security and medical crew.

"Show boss, security 4, one dozen dead people  in section 15, multiple CPR, crowd crush. Stop the show."
"Roger. Crap. Stopping the show"

Guess what didn't happen for like 35 minutes?


----------



## CCCSD (Nov 18, 2021)

Summit said:


> Makes sense. Those people should be on speed dial or easy radio access for the security and medical crew.
> 
> "Show boss, security 4, one dozen dead people  in section 15, multiple CPR, crowd crush. Stop the show."
> "Roger. Crap. Stopping the show"
> ...


“Sorry. Not going to stop the show just yet. Gotta sell more CDs and T shirts.”


----------



## MEDicJohn (Nov 18, 2021)

interesting as one of the main points in the main stream was that a concert goer was injecting people with fentanyl, now its a head trauma. I'm sure the Houston police are so inundated with so much.  

https://www.khou.com/article/news/l...hief/285-4d61abed-176b-4c9e-81bd-5ff57e8da10f


----------

