(116) Electric Daisy Carnival and Associated Complication Rates in ICU Patients: A Case Series

Introduction: Electric Daisy Carnival (EDC), the world’s largest electronic dance music festival, has grown exponentially to an estimated 500,000 patrons in 2023. However, as EDC has become increasingly popular, medical resource utilization has concurrently increased largely due to polysubstance abuse. MDMA (3,4-Methyl​enedioxy​methamphetamine), known by its street alias “molly” or “ecstasy”, is a popular recreational drug that has historically caused overdoses and deaths at EDC. Since EDC’s establishment in Las Vegas in 2011, nearby intensive care units (ICUs) have noted a surge in drug and heat related admissions each weekend of the festival.

In this case series, we document polysubstance abuse patterns, associated complications, and mortality observed in EDC related patients (EDCRP) that required ICU admission at a tertiary hospital in Las Vegas, Nevada where the EDC flagship festival takes place.

Methods: 7 EDCRP were identified from May 18-22, 2023 via chart review. Data including demographics, hospital days, ICU days, nadir sodium, maximum temperature, maximum creatinine kinase, seizure incidence, intubation status, and mortality were collected. Substances abused were taken from standard 10-panel urine drug screen (UDS), serum ethanol levels, or historical report. UDS positive for methamphetamine was also used as a proxy for MDMA, as the two substances are frequently complexed and pure MDMA is not included in a standard UDS. Benzodiazepines were not included due to likely iatrogenic causes.

Results: 3 EDCRP were male and 4 were female with a median age of 32 years old. 5 identified as White while 2 identified as Asian. 1 patient expired prior to hospital presentation. Of the remaining 6 survivors, 2 suffered significant morbidity and prolonged hospitalization courses. Of the total 7 EDCRP, 4 were febrile (57%), 1 (14%) was hyponatremic, 2 (29%) had rhabdomyolysis, 3 (43%) had reports of seizure-like activity, and 6 (86%) were intubated on admission. 6 reported MDMA use, 2 for cocaine, 1 for fentanyl, 1 for LSD, 1 for THC, 1 for alcohol.

Conclusions: EDC patrons should be aware that significant morbidity is associated with festival attendance and polysubstance abuse. Future studies investigating EDC’s impact on ICU admission rates and risk of intubation and seizure compared to non EDCRP are warranted.