Astroworld event plan warned staff not to perform first aid and CPR if they weren’t properly trained

Festival-goers say staff were overwhelmed by the numbers of people in need of medical attention at Travis Scott’s show

Staff at the doomed Astroworld Festival had been warned not to perform first aid and CPR if they were not properly trained, it has been revealed – as festival-goers have complained about poorly trained and ill-equipped medical personnel trying to handle Friday night’s tragedy.

An event operations plan, by Austin-based promoter ScoreMore Shows and obtained by CNN, details the preparations in place and the chain of command in the event of medical emergencies at Travis Scott’s annual festival in Houston, Texas.

The 56-page document, titled “Astroworld 2021 Event Operations Plan”, specifically details what staff members should do if faced with incidents involving injuries.

It reveals that only certified personnel were permitted to administer first aid and CPR to people in need during the event.

“Event personnel will be limited to providing first aid and CPR treatment at times other than during the event,” it reads.

“Only certified employees (if any) are permitted to provide this response.”

Any further medical aid required on the day of the event must be escalated to the on-site medical provider through event control, the document states.

The emergence of the documents and the revelation that not all staff were trained or permitted to administer medical aid shines further light on the level of chaos which had unfolded at the festival.

Survivors of the deadly crush, which killed eight and left at least five more fighting for their lives in ICU, have said that medical staff were overwhelmed by the tragedy and that some did not appear to know how to correctly administer CPR.

Emergency personnel respond to the Astroworld music festival in Houston (AP)

While it is not clear if the event plan was followed during the “mass casualty incident” that took place that night, the details of the plan and accounts from witnesses suggest staff members may have been forced to disregard protocols in a desperate bid to save lives.

A Texas ICU nurse who was attending the event as a fan of the rapper spoke out in an Instagram post to say she was “disturbed” by the lack of experience the medical staff appeared to have with CPR.

“I don’t think ive ever been more disturbed. Some of these medical staff had little to no experience with CPR. didn’t know how to check a pulse, carotid or femoral,” Madeline Eskins wrote on Instagram.

“EDIT LET ME STATE THESE MEDICS ARE NOT TO BLAME, but a few of them did not have experience in situations with people losing pulses.”

Ms Eskins said she saw some staff even giving CPR to casualties who still had a pulse.

“Compressions were being done without a pulse check so ppl who had a pulse were getting CPR, but meanwhile there was not enough people to rotate out doing compressions on individuals that were actually pulseless,” she said.

“The medical staff didn’t have the tools to do their jobs. and despite the crowd around us trying to get someone to stop the concert they just kept going. even though travis acknowledged that someone in the crowed needed an ambulance.”

One medic pushed back at the criticism in a TikTok video, where he described medical staff being outnumbered by festival-goers in need of life-saving medical attention on Friday night.

The crowd watches as Travis Scott performs at Astroworld Festival at NRG park on Friday 5 November 2021 in Houston. (2021)

In a three-part TikTok video posted under the account name @remi.rich, the man who says he worked as a medic at the festival explained how he found three unconscious people in just 10 minutes in the crowd at Travis Scott’s show.

Officials said on Saturday that around 300 people were treated for injuries at a field hospital while 11 went into cardiac arrest and eight died during the “mass casualty incident”.

The event plan also documented what to do in the event of a “mass casualty incident”.

The document explains that there is no one agreed upon definition of such an incident but defines it as a “time that on-site EMS services become overwhelmed and outside resources need to be summoned”.

In this situation, where “adequate/appropriate patient care becomes jeopardized”, the EMS director is required to “notify Event Control and advise activation of the MCI Plan”, the plan states.

The plan outlines five steps in the MCI Plan including to establish an incident command and notify the local jurisdiction of the nature and scope of the incident, the approximate number of casualties, best access into the area, possible staging area for incoming ambulances and any possible hazards, including if decontamination of patients may be needed.

The incident command is then required to establish communications and triage stations and hospitals must be told to prepare for incoming patients.

On-site EMS personnel will begin a triage system – where levels of urgency of patient treatment is assessed.

“Patients who have obvious fatal injuries will be considered dead and will be assigned no transport status,” the plan states.

Transport officers are required to report to the ambulance staging area and assign patients to vehicles, it states.

It is not clear if the MCI Plan was followed after a “mass casualty incident” was declared at 9.38pm on Friday night.

However, it was almost another 40 minutes before the festival was brought to a halt, with Mr Scott continuing to perform his set until around 10.15pm.