Massive MCI at Astroworld

DrParasite

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I'm surprised this hasn't been mentioned yet



 

CbrMonster

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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
Entrance stampede
Stampede other angle
People jumping over gate to escape
Girl passed out with the crowd trying to get Travis attention
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
 
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DrParasite

DrParasite

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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.
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...
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
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:
  1. 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.
  2. 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
  3. 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?
  4. These events DO have plans for MCIs... now, whether the plans were disseminated to the field staff, or adequately followed is another story.
  5. 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.
  6. 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.
  7. 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

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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

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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...

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

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:
  1. 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.
  2. 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
  3. 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?
  4. These events DO have plans for MCIs... now, whether the plans were disseminated to the field staff, or adequately followed is another story.
  5. 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.
  6. 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.
  7. 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.

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.
 
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DrParasite

DrParasite

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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

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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

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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


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

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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

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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

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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.

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.
 
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DesertMedic66

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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.
 

johnrsemt

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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

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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.
 
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DrParasite

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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).

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
 

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