When Bad Things Happen to Burning People Humboldt General Is There

by NrdyGrl

Even if you don’t do something stupid at Burning Man, bad things could, theoretically, happen to you. Like a heart attack. A pesky urinary tract infection. Your eyeballs dry up and fall out of their sockets. Someone gifts their humble self to your bike and you have to crawl what feels like a hundred miles across unforgiving Playa to the nearest Ranger station or the medic tents at the 3:00 and 9:00 plazas. You are so parched you’re in kidney failure.

Maybe it was a little too much of the illegal intoxicant GHB (gamma-hydroxybutyric acid) and, even though there’s no dust storm, you’re having your own personal whiteout.

Or maybe you were like me and flew down the PerVertical Playground slide at 90 miles per hour, right past the beanbag landing off the back of the truck and onto last year’s hard-packed Playa surface, and found yourself suddenly in need of an x-ray.

If you were really unlucky, you were in the three-story structure that collapsed last year, and in an unexpected Rite of Passage, got an ambulance ride to Humboldt General Hospital’s “Rampart” urgent care unit near Center Camp at 5:15 and Esplanade.

If so, you were in good hands

Newbies on the Playa last year, Winnemucca-based Humboldt General Hospital replaced a long-standing deal with REMSA, Reno Emergency Medical Services Authority, in a new five-year contract with Black Rock City’s Emergency Services Department.

Playa-wide, a total of 5,748 Burners needed a Band-Aid or more from BRC’s Emergency Services, a thousand more than the year before. At a peak population of almost 54,000, that’s more than one in 10 Burners needing care at some point during the week–a 911 call every 20 minutes, according to the Burning Man AfterBurn Report. Saturday, the day of the Burn, Emergency Services treated 1,125 patients.

With a nod to the 1970s show “Emergency!” Humboldt General dubbed its 2,000-square-foot, four-wing, 32-bed field hospital “Rampart.” Your ticket supported its budget, which covered 300 paid personnel over the week, six ambulances, mobile ultrasound, x-ray, and lab services. About 4 percent of peak population—2,300 injured Burners—streamed into Rampart’s tent alone during the week.

Burning Man paid HGH $290,000 last year, according to an article (behind a paywall) on the Inside Northern Nevada website . It budgeted $244,000 for personnel and purchase of the mobile hospital unit, as well as additional ambulances. Rampart’s actual costs came in at $250,000 for the week.

The price seems to have been right: BRC’s overall medical services costs dropped 7 percent last year, from $328,000 to $305,000 (according to AfterBurn  2011 and 2010 financials), even though the population was up 5 percent. That cost may rise a bit as Humboldt General adds x-ray service, which was donated last year, to its 2012 budget. Overall, Rampart’s snazzy new lab services, x-ray, and ultrasound meant fewer Care Flight and ambulance rides to Reno hospitals for screenings and tests, saving cold hard cash for Black Rock City.

It’s All About Radical Self-Reliance Until…

With five stations (notably the 3:00 and 9:00 plaza first-aid sites), including its 911 dispatch, and dynamic postings throughout the Playa–yes, they go where the action is–BRC’s Emergency Service medics are typically the first responders to fire and medical crises, with 100 officers and 600 staff. A few are paid professionals, but the vast majority are volunteers. A mobile professional team handles sexual assault, domestic violence, and psychiatric emergencies, as both patient advocates and law enforcement support.

Burners don’t actually CALL 911 — no phones. Black Rock Rangers are often first to come upon a situation and will radio it in to headquarters or kick it sideways to Emergency Services. Radio dispatch abounds on the Playa. “We have about 1,500 radios out there,” said Joseph Pred, chief of Emergency Services. Friends also might run to a medic tent for help, which calls 911 dispatch.

A third, and new way for Burners to reach 911–take note those of you with known medical issues–is to have a Multi-User Radio Service VHF radio. It’s a little more expensive, about $100, but this kind of walkie-talkie has farther playa range than the weaker Motorola FRS “Talkabout” type UHF radios that some Burners use for communication. With MURSBurners can apply for a reserved emergency channel.

For an event that is big on fire, there were no serious burns last year, according to HGH’s Emergency Rescue Director and Playa Incident Commander Pat Songer. The majority of complaints during the week were orthopedic, soft-tissue injuries, blisters, eye problems, urinary tract infections, and dehydration. They ran out of splints faster than expected.

Booze and drug overdoses as the primary reasons for (bad) trips to the medical tent were also “remarkably low,” according to Songer. Emergency Services logged 85 alcohol cases, and 57 specifically drug-related cases over the week, or about 1 percent of patients treated.

There were several major falls. “One female got across the barricades and climbed up on the Man and fell about 30 feet,” Songer reported. She had internal injuries and was flown out. “I think she had a full recovery,” he said.

No one was reported to be seriously hurt in the three-story structure collapse. One individual had a lung injury but was treated and released, Songer said. “Minor injuries, no entrapment or anything, we were very lucky.”

Although HGH documents recorded that incident as a “structure collapse,” Pred countered that “It wasn’t so much a collapse as a slow decline. It was a structure made of pipes, and one of the legs that supported it, made of a buckyball kind of sphere, failed very slowly on that one leg. The structure was intact, but one tiny portion of it failed, kind of slowly kneeled to the ground.”

Aside from the injuries noted above, Pred said the incident was “wholly unremarkable” and that “structure collapses are very rare.”

Failure Not an Option

Like any Playa-fearing, dust- and mayhem-respecting newbie, HGH spent a solid year of planning with BRC’s Emergency Services Department for its first year on the Playa and the entire medical team transition.

“Joseph [Pred] and his group did an outstanding job preparing us for the unexpected, for what the event was about,” said Songer, who himself had never been to Burning Man.

“Everybody is extremely friendly out there, extremely polite,” Songer said. “Interaction was great, people got along with us good, they were very appreciative of the help we were there for. It was not a tough task, I guess you could say. It was an enjoyable task.”

Founder and Chief of Burning Man’s Emergency Services, Joseph Pred said, “Everything had to work. Recognizing how critical it was, we wanted to make the transition as smooth as possible. They exceeded our expectations on all counts.”

Fewer Trips to Reno ERs Is A Win-Win

Rampart’s new clinical services on the Playa last year included labs, a couple dozen ultrasounds, and 200 x-rays. This meant fewer transports off Playa, by ambulance or otherwise, and less burden on Reno emergency departments. Helicopter transport, provided by Care Flight out of Reno, was reduced last year by 55 percent, to five instances.

That’s pretty cool when an unexpected emergency helicopter ride would set an uninsured Burner back $25,000.

Rural Makes Good

Humboldt General is considered a rural emergency service provider, in contrast to REMSA, an urban provider that operates over multiple counties and states. Pred said that rural ambulances are well equipped for long transport times and extended medical care.

“HGH is one of the top five rural EMS providers in the United States,” Pred said.

“HGH is an even better match than REMSA. They are incredibly progressive, values-based, and community-driven, as opposed to the big profit-driven HMO kind of philosophy, and they fit well with Burning Man’s core principles.”

Pred explained one of the reasons that attracted him to HGH.

“When you’re 2 hours or more out from Reno, it’s boring sitting in an ambulance, you don’t have a good view, usually you don’t feel very good, you’re in this foreign environment—it’s not like you can reach over and turn the stereo on. They had installed satellite television so that patients, primarily kids, can watch something and relax and have something to focus on other than, ‘oh my god, I’m going to the hospital.’ There was no bottom line, here. They care about patients in a different way.”

Bringing Burners Home

HGH also offered a unique service to Burning Man that REMSA did not: Returning Burners to the Playa.

Thirty-three Burners were transported off-Playa last year (28 by ambulance, five by helicopter). Songer’s ambulances brought 16 back.

“A lot of times there was no way for a patient to get back out to the Playa,” he said. “When one of our ambulances went in, we made calls to the local hospitals to see if anyone was sitting around needing a return trip. It’s just part of taking care of any community.”

“It’s a really nice service that HGH is providing,” Pred said, “helping people who might be stranded at the hospital get back home.”

Think about it. You’re wearing a costume, you don’t have your wallet, you don’t have your cell phone, your ID, a credit card. You wake up in a hospital. What do you do? How do you get ahold of your friends?

“We do have a system where we can get people information,” Pred said. “The majority of people are picked up by their friends, but a small number aren’t. I would hate to be the person waking up in the hospital in that situation. It’s bad enough that you’re injured and feeling vulnerable. Now you’re extra vulnerable because you’re isolated.

“It also creates stress for your friends, loved ones, and camp mates, who are wondering where you are and spend many hours looking for you or trying to figure out what’s going on. It takes them awhile to get the information. It is also a burden to the hospital because they have a person who’s wearing a hospital gown and doesn’t have any way to easily leave. Their social workers have to get involved.

“If we can reduce the negative impacts to the patient and their camp mates back in BRC and to the hospital, that’s a major win all around,” Pred said.

When asked about his first time at Burning Man, Songer said, “it was a good time. Fulfilling and interesting. I was pleasantly surprised how the whole event is handled, the operations out there.” But his favorite part of the week?

“The Burning of the Man. That was pretty neat.”

So will Incident Commander Songer wear a tutu next year?

“I…haven’t been talked into that yet,” Songer said. But he’s looking forward to returning to his command post. Other than some minor tweaking, they’ll operate in the same vein. He plans to bring more splinting materials, as Burners last year blew past need estimates from statistical years past.

And about NrdyGrl’s fast Rrrrrurtsch! down the PerVertical Playground slide? Arm not broken. Just a bad sprain. Thanks to that x-ray.

A radiology business offered to bring in an x-ray machine for free last year in hopes Burning Man would pay for it in the future. Mission accomplished.

“We appreciated their donating that and it allowed us to integrate x-rays sooner into our overall services,” Pred added. “We are appreciative of the Burners involved who made it happen.”

We Will Eventually Assimilate You

“All of our vendors usually have some kind of Burning Man connection,” Pred noted. If there’s no one in the organization we’re dealing with that are Burners, the funny thing is, after a while, they start becoming Burners. Their staff gets to see the event, they appreciate the community and culture they’re getting to be a part of, and that changes who they are. It’s fairly common that Burners who have a particular resource want to help the community in some way. Everyone contributes the skills and resources to make the event happen.

“Not everybody who comes out to the Playa is an artist or a performer or has the technical ability to build an amazing art car. But they own a radiology business and they say, “I can help contribute this.’ These Burners, who are radiologists and have access to these resources, are contributing in their way. They are not extraordinary, in a way. It’s appreciated and highlighted because it’s a new thing, but when you look around you actually realize that just about every single Burner is doing the exact same thing. An individual strand is not very strong but when you weave it into a tapestry you have a pretty strong cloth. Community is strong because of its diversity and because everybody’s so generous.”

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