Emergency care to the Sound of Music

Ms Margaret Murphy1

1Westmead Hopsital, Westmead, Australia


There has been a recent, substantial change in the pattern and severity of drug related harms associated with music festivals in NSW. Following urgent risk assessment, Health Response Teams (HRT), which included emergency nurses, were deployed to NSW music festivals with high risk features, to support event organisers to deliver safer events. This paper provides insight from emergency nurses into the scope of practice for HRT providing care in the music festival setting.


The planning and intervention strategies designed to provide onsite specialist critical care at music festivals are described. This involved the incorporation of existing event management guidelines and principles of disaster management with information from events where a number of festival goers died, or presented with serious drug related illness. Consideration of the site environment through to team skill mix, patterns of serious drug-related toxicity and guidelines on expert onsite resuscitation practices are discussed.


There were over 70 music festivals in NSW between September 2018 and May 2019. There were 5 deaths in 4 months. 29 patrons required intensive medical management at the festival site before transport, including sedation, rapid sequence intubation and aggressive cooling in cases of drug-related hyperthermia. There were 25 drug related intensive care admissions. MDMA toxicity was responsible for the severity of these clinical profiles.


Drug toxicity has been a major driver of drug related harm at NSW music festivals. In this setting, toxicity can progress rapidly with potential for multi-organs failure and death. Early recognition and management of complications by expert HRTs are key to preventing morbidity and mortality. Effective patient management is dependent on front line emergency staff providing appropriate care at the appropriate time, and this may involve exploring and expanding into new horizons.


Margaret is employed as a clinical nurse consultant at Westmead Hospital, Sydney.  She has an extensive clinical background in emergency nursing. Prior to working in emergency Margaret has had experience in Intensive Care, Mental Health, Education and Change Management. She has also worked as a principal project officer at the NSW Ministry of Health. She holds executive and advisory positions with NSW Emergency Care institute and Westmead Hospital Clinical Board. She has consulted on emergency care in Nepal, Malaysia, Sri Lanka and Bangkok. She has been recognised by peers with awards that include Westmead Hospital Nurse of the Year. She has a strong commitment to translational emergency care research and is currently completing her PhD.