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More than 250,000 spectators filled the California Speedway for the NASCAR Nextel race during Labor Day weekend in 2005, making it the highest attended sporting event in California. Although such obvious modalities as telephones and fax machines have been used to transmit simple documents and information, more advanced communications technology has been increasingly used to transmit photographs, video, radiographic images, ECGs and real-time examination findings (e.g., vital signs, lab results and even cardiac auscultation) from the point of current patient care to other experts across town and around the world. In a precursor to modern telemedicine, the military has used satellites to send images of patients in disaster situations, such as the 1985 Mexico City earthquake, the 1988 Armenian earthquake and the Virgin Islands in the aftermath of Hurricane Hugo in 1990.1 On a smaller scale, primary care physicians have used telemedicine to obtain specialty care consultations, such as with dermatology or otolaryngology. Other uses include providing services to extremely rural environments, prisons or long-term-care patients with diabetes or hypertension.

Introduction Electronic dance music (EDM) festivals, also known as raves, are large dance parties attended by up to 100,000 or more people. Raves have generated significant controversy due to the alleged deaths attributed to the drugs taken at the festivals (20). This article will describe the medical care provided at some of the largest EDM festivals in the United States, compare such medical care with other large events, and offer recommendations in planning for such an event. Before discussion is undertaken on the best way to provide medical care at EDM festivals, it is beneficial for those planning medical care at an EDM festival to examine data regarding ecstasy and other drugs utilized at EDM festivals, as well as the toxicology, in greater depth.

When it comes to off-road motorcycle racing, there are a number of variations of the sport, including the following: motocross, supercross, flat track, supermoto, hillclimb, trials, desert racing, and ATV motocross. This article will focus upon motocross motorcycle racing, which takes place outdoors on a course that combines natural terrain with some human-made obstacles (steep inclines, hairpin turns, jumps, sand, and mud). Supercross motorcycle racing is a variation of motocross that has evolved for the more urban environment and takes place inside stadiums on human-made tracks. The first time that a motorcycle race took place on a human-made course inside a stadium was in 1948 at Buffalo Stadium in the Paris suburb of Montrouge.

AT CONCERTS Concert Medicine: Spectrum of Medical Problems Encountered at 405 Major Concerts JEFF T. GRANGE, MD, STEVEN M. GREEN, MD, WARREN DOWNS, Previous authors have described medical support at single specific concert events (Table 1), with patient loads ranging from 8 to 1,000 PPTT. The volume, acuity, and spectrum of pathology appear dependent on a number of variables, such as music type, concert location, audience age, concert length, audience size, crowd density, crowd movement, weather, indoor vs outdoor location, availability of drugs and/or alcohol, and the ‘‘collective mood.’’2–7 Only two studies have reviewed more than a single concert event.7,8 Erickson and colleagues noted that 48% of patients treated at five rock concerts admitted using alcohol or illicit drugs during the events. We wished to identify whether any of four factors (music type, overall attendance, temperature, and indoor vs outdoor location) were predictive of patient load (PPTT) per concert.