A Sydney music festival may deploy thermal cameras to detect overheating patrons following the death of a young woman shortly after her temperature exceeded 41C.
Central Coast teenager Alex Ross-King died after taking a cocktail of MDMA caps, alcohol and energy drinks on the day of FOMO Sydney in January.
Her body temperature, normally about 37C, couldn't be accurately recorded as the instruments inside the festival's medical tent failed to detect beyond 41C, the NSW Coroners Court has been told.
Four of the other five young people whose MDMA-related deaths at festivals are the subject of inquest also had a body temperature at or exceeding 41C in the hours before they died.
Freelance event manager Holly Gazal told the court on Thursday FOMO Sydney's 2020 edition was investigating the use of "thermal and other non-obtrusive imaging and technology" at entry gates to help identify patrons with high temperatures - an indicator of both MDMA use and heat stroke.
NSW Poisons Information Centre clinical toxicologist Jonathan Brett said MDMA users whose body temperatures exceed 40C have a one-in-two chance of dying as they are no longer able to regulate temperature
"Once you get to 40 degrees, it's a chain reaction," he told the inquest.
"The brakes are off."
FOMO festival is also looking into scannable wristbands that could carry emergency contact information and monitor food and beverage consumption.
Ensuring free water is chilled and patrons have more access to chill-out zones and shaded areas are among other commitments, the court was told.
"The promoter is very open and willing to finding solutions to address it," Ms Gazal said.
The role of sniffer dogs is also under the microscope, after the inquest heard Ms Ross-King consumed two MDMA capsules outside the festival gates out of fear of being detected by them.
Erica Franklin, a co-ordinator at harm reduction Dancewize NSW, on Thursday said her organisation once found a person at a festival who'd consumed 11 MDMA caps at once "because he was afraid".
She told the inquest people have consumed various drugs for thousands of years and drug safety messages had to move beyond "just say no".
However well-intentioned, the zero-tolerance mantra was providing no practical information on how to consume drugs with the least amount of harm possible, she told the inquest.
"We don't condone drug use but we don't condemn it either," Ms Franklin said.
"Many people don't want to tell someone (about their drug use) for fear of stigma, discrimination or potentially a criminal record."
The inquest also heard from a senior police officer who wants police granted powers to shut down music festivals when attendees' health is at risk.
Detective Chief Inspector Guy Viera said he also wants operating hours restricted to no more than eight hours a day to reduce hyperthermia and organisers forced to light pathways between stages.
"It's (sometimes) impossible to see if anyone is unconscious."
Deputy State Coroner Harriet Grahame is overseeing the inquest into six MDMA-related deaths at NSW music festivals.
Ms Ross-King, Nathan Tran, Diana Nguyen, Joseph Pham, Joshua Tam and Callum Brosnan died from MDMA toxicity or complications of MDMA use. They were aged between 18 and 23.
The inquest is set to resume on Friday.
Australian Associated Press