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Dr Christopher Cheeseman leaves the Lidcombe Coroners Court in Sydney, Wednesday, July 10, 2019. (AAP Image/Peter Rae)
The introduction of senior and experienced clinicians at NSW music festivals has been "very, very effective in preventing further deaths", an emergency doctor has told an inquest.
Dr Christopher Cheeseman, from Westmead Hospital, headed the treatment of Nathan Tran after his adverse reaction to drugs at Knockout Circuz on December 16 in 2017.
The 18-year-old was already in handcuffs when brought by up to seven people into the festival's medical tent about 10.30pm, the NSW Coroners Court at Lidcombe heard on Wednesday.
Mr Tran arrived at Westmead's emergency department about 11.30pm experiencing hyperthermia with a core temperature of 41 degrees.
Mr Cheeseman said he was told by ambulance staff Mr Tran had been running from police and fallen, possibly experiencing a seizure, before he was detained.
Despite prolonged resuscitation efforts, he died from MDMA toxicity at 12.50am.
Counsel assisting, Peggy Dwyer, on Wednesday asked Dr Cheeseman whether the "best case scenario" would be for doctors capable of paralysing and intubating drug-affected patients to be at the onsite medical tents.
"That system actually exists, and in subsequent festivals the (NSW) Ministry of Health put in place disaster response teams," Dr Cheeseman replied.
He said patients similar to Mr Tran were identified rapidly by senior and experienced clinicians who were able to administer muscle relaxants and perform intubation to ease airway access.
"(That) in my opinion has been very, very effective in preventing further deaths," the doctor said.
Mr Cheeseman said he believes the teenager required early paralysis and the key intubation drug Rocuronium before it was administered at hospital.
That is what can stop patients reaching Mr Tran's critically ill stage, he said, noting it would have been ideal for him to have been evacuated from the tent earlier.
"If he'd gotten to my department sooner we could have changed his course," he said.
Further witnesses will be called on Thursday to testify about Mr Tran's death.
Deputy State Coroner Harriet Grahame is examining the drug-related deaths of six young people at NSW music festivals between December 2017 and January 2019.
Diana Nguyen, Joseph Pham, Callum Brosnan, Joshua Tam and Alexandra Ross-King - all aged between 18 and 23 - also died from MDMA toxicity or complications of MDMA use.
© AAP 2019