Texting shows recovery after faint

doi:10.1136/bmj.a2723

Published 17 December 2008, doi:10.1136/bmj.a2723
Cite this as: BMJ 2008;337:a2723

Filler

Christmas 2008: Music

Texting shows recovery after faint

Mike Sinclair, retired consultant anaesthetist, Festival Medical Services, Wells, Somerset, David W Pigott, consultant anaesthetist, Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford, Katherine N Carpenter, consultant clinical neuropsychologist, Russell Cairns Unit, Department of Clinical Neuropsychology, John Radcliffe Hospital

mikesinclair{at}ntlworld.com

Festival Medical Services is a charitable trust that providesmusic festivals throughout the United Kingdom with doctors,nurses, paramedics, first aiders, and other trained medicaland administrative staff. One of the authors (MS) is the coordinatorfor the Festival Medical Services "pit crew." This team providesa resuscitation facility for the audience at the two main stagesat Glastonbury and Reading festivals as well as a triage systemto sort or treat people who need medical attention. The teamfollows the advice of the Third Annual Rock Concert Safety SurveyReport published by Crowd Management Strategies in February1995 (www.crowdsafe.com/mosh.html).

Festival Medical Services has a small tent (3 m x 3 m) at theside of these stages, with resuscitation equipment as suggestedby the Resuscitation Council UK’s recommended minimumequipment for inhospital adult resuscitation.¹ A consultantanaesthetist, two nurses, an operating department practitioner,and at least two first aiders are present from when the firstband appears on stage until the last band of the day finishes.

Three years ago we noticed that most of the patients with faintor panic attack were teenagers and as soon as they could theyused their mobile phones to send an SMS (short message service)text message to their friends. SMS allows the interchange ofshort text messages between mobile phones. About 1.4 billiontext messages are sent in the UK alone every week, accordingto the Mobile Data Association (www.text.it).

The ability to text, whether or not it actually makes sense,requires a Glasgow coma scale score of 15 (fully conscious),an adequately functioning "executive system" in the frontallobes, and a high degree of manual dexterity and psychomotorcoordination. It also shows a degree of common sense not alwaysevident in teenagers.

Two years ago we decided to use this texting sign as an indicationthat patients had recovered from their faint or panic attackand were orientated and coordinated enough to be dischargedback to the festival. At times of massive influx to the medicaltent, when up to two patients a minute are triaged, this systemseems to work well.

This year at the Reading festival we managed, with only oneconsultant anaesthetist, two accident and emergency nurses,one operating department practitioner, and two to four firstaiders, to treat 142 patients in less than 60 minutes duringthe performance by Bloc Party and 130 patients over 90 minutesduring the performance by Rage Against the Machine. The textingsign needs further investigation to determine whether it isa valid criterion for recovery after faint or panic attack atfestivals as well as in busy accident and emergency departments.

Cite this as: BMJ 2008;337:a2723

We thank the members of the pit crew and Festival Medical Servicesfor supporting us, and Specialized Security, which does sucha great job of getting people who are in trouble out of thecrowd.

Competing interests: None declared.