Interdependence of Public Safety Services at a Music Festival - Medical and Sanctuary

Summary: Harm reduction services are becoming increasingly prevalent at music festivals, aiming to support the health and safety of attendees. Sanctuary zones — also known as psychedelic crisis, chill, or trip sitting spaces — allow care for select cases provided by skilled peer providers. To date, the benefits of and for medical and sanctuary services, working synergistically, and the benefits to attendees have not been explored. A retrospective chart review of the 2024 edition of a 25,000-person multi-day music festival was performed. All medical or sanctuary visits involving both services in some capacity (e.g., combined field response, inter-service consultation, discharge disposition, patient transfer) were included. De-identified data were extracted, including reason for presentation, timing, and reason for shared care, presentation acuity, treatment given, and length of stay. There were 2,625 and 2,201 encounters at the medical and sanctuary facilities, respectively, with 621 major medical presentations and 759 sanctuary intakes after excluding minor and dispensary visits. At medical, 57 major visits (9.2%) were discharged to sanctuary, accounting for 7.5% of sanctuary intakes. Additionally, 25 of 185 medical field calls (14%) were transported to the sanctuary. At the sanctuary, 26 attendees were sent directly to medical, and 30 were transferred after intake; thus, 4% of sanctuary encounters required medical, and 9.0% of medical visits originated in the sanctuary. Common reasons for transfer from medical to sanctuary were mild intoxication and/or need for ongoing stable observation. In contrast, from the sanctuary, there was a decreased level of consciousness, agitation, or specific medical red flags (e.g., pain, vomiting, etc). Interdisciplinary collaboration between medical and sanctuary spaces is an essential asset within the public safety ecosystem at music festivals. These synergistic services provide ideal care to address diverse presentations with specific management goals and work closely together when patients overlap in their on-site care needs.