2013 marked another exceptional year of partnering with our colleagues at Rampart, the Black Rock City hospital run by Humboldt General Hospital. The perfect combination of professionalism, collegiality, and friendship made for our best year yet! Together ESD and HGH logged 6,781 patient contacts, a 16% increase in patient contacts over the number seen in 2012. We were initially surprised at this number, and a portion of the increase would be expected due in part to a larger city population in 2013.
We wanted to take a more critical look at this steep jump though, so we conducted a retrospective analysis of patient care documentation. We compared the number of patient contacts to the playa population and noticed a steady increase in ESD patient contacts equaling approximately 6.5% of the total population in 2003 to patient contacts equaling nearly 10% of the total population in 2013. We also discovered a steady increase in the numbers of people who could have easily managed their issue on their own had they come to the playa armed with simple household items like bandaids, sunscreen, tampons, etc. We will take the opportunity in 2014 to improve our playa community communications regarding self-care on playa and embracing the ethos of self-reliance.
Approximately 62% (n~2300) of the patients treated by ESD involved minor complaints and injuries. Common patient categories included lacerations (15.04% of total patients), wound rechecks (12.68%), orthopedic injuries (7.72%), dehydration (4.62%), and soft tissue injuries (13.08%). Other medical care categories included rash (2.44%), minor burns (2.9%), eye complaints (4.5%), throat complaints (2.44%) and extremity pain (2.39%). All other chief complaint categories were below 2%. The numbers for alcohol- and drug-related patients continue to be low for an event of this size. In 2013 we experienced a 0.18% increase in incidence substance-related patient contacts (to 0.88%), and a 0.35% increase in the number of alcohol-related patients (to 1.35%). These numbers do not necessarily represent drug and/or alcohol overdoses, only patients for whom drugs or alcohol were the primary reason for seeking medical care.
Treatment category percentages were relatively similar for those patients treated at Rampart. 34 patients presented to Rampart with illness or injury that required care beyond the scope of our great city’s hospital though. Of these 34 patients transported to Reno hospitals for additional care in 2013 (a 15% increase over 2012 but nearly equal to 2011), 20 were stable patients transported by ground ambulance, and 14 (nearly 3 times more than in 2012) were deemed critical enough to be flown out by helicopter.
The ESD Emergency Dispatch Center processed over 1600 calls for service in the 16 days that it was operating which is an increase of 11% from 2012. Call types include everything from requests for traffic control or public assistance to fire and emergency medical calls, including dispatching HGH EMS units in the field. To put that into perspective, 100 calls a day or 4 calls an hour, although we all know that some days and some hours are much busier than that – this would put on track for over 36,000 calls for service if we operated year round. And that number is a bit skewed because we only log a call for service if we dispatch units or have a need to capture the request whereas a traditional 911 center collects data regarding how many times the 911 phone line is answered (like 20 cell phone users calling to report the same incident would count as 20 calls whereas we count it as 1 call for service). To really give you a sense of how busy ESD is – we would process more calls for service than Boston Fire Department did in 2011 (http://www.mass.gov/eopss/docs/setb/call-volume-history-2011.pdf) if ESD operated year -round. In addition to new calls, dispatchers have the task of managing initial requests for Black Rock Ranger or Law Enforcement response, all active ESD calls, and all of the ESD response units in the field, which during peak hours can be as high as 30 EMS, Fire, Mental Health, and command resources.
Mental Health Branch
After a very busy 2012 event (66 calls), 2013 was a nice change for our Mental Health Department with a decrease in calls to 38, nearly equal to the numbers of participants they assisted in 2011. The breakdown by case type includes 20 psychiatric clients, seven cases related to domestic violence, seven possible sexual assault cases and four ‘Legal 2000’ evaluations (to determine if there is a danger to self or to others as a result of a mental illness). The Mental Health team coordinates the transports to Reno as needed and works closely with law enforcement, the sexual assault response team in Reno, and other agencies to support clients once they leave the playa. The remainder of the calls were follow -ups and miscellaneous call categories, and there was one post -event follow-up.
ESD worked closely with the Burning Man community group ‘The Bureau of Erotic Discourse’ in 2013, creating a more collaborative relationship, and helping raise awareness and provide information to participants. We look forward to furthering our partnership with BED in 2014 and beyond.
This year our integration of fire safety teams included the “Silver Suits” for the Man and major art burns. The Silver Suits have been around for years providing added safety to the fire performers, artists and participants. You may have seen them in past years securing the cables for The Man’s arms and pyrotechnics wires before The mMan falls. Having the Silver Suits, our inner circle safety team, and FAST all working together allows our team to identify and effectively deal with hazards in close proximity to the burns. Increasing the level of safety without infringing on the participants experience is our goal.
This year the Fire Branch responded to 18 direct fire calls and a number of requests for technical rescue and hazardous material response. We were fortunate this year, that there were no major fires in RV’s or trailers. Our fire crews did respond to several fires that, had it not been for early notification and a quick response, could have been much worse.
The number of art burns this year was the highest ever and ESD Fire Branch logged hundreds of volunteer hours supporting the burns by providing perimeter safety and RITs (Rapid Intervention Teams). We want to thank all the volunteers for the time and effort they gave to help make all of these spectacular projects so special. We really understand the balance between safety and the thrill of the burns and try to enhance both.
This year we also added a dedicated technical rescue and hazardous material (HazMat) response team. The HazMat team is equipped to respond to spills of fuels and chemicals, hazardous environments, propane leaks, etc., as well as extrication and high angle rescue. The volunteers who work the HazMat team are real -world professionals (just like all of ESD) who bring a great deal of expertise to the playa. As the art and city structures get bigger and more intricate we have to quickly and safely respond to potentially serious situations.
Another first this year was working with BLM on environmental compliance issues. Each day a BLM compliance team would wander the city with a keen eye looking for leaks, drips, spills, burns – anything that might negatively impact the Playa. Rangers and ESD Fire followed up to ensure that proper steps had been taken to clean up the problems and further educate the participants in best Leave No Trace practices. We want to thank all the camps that we contacted for their help and positive response to the compliance team. Keeping the Playa pristine is essential – we hold our event on a national treasure and must respect that fact.
Our goal for next year is to build on the successes of this year and work with our Rampart, Burning Man, and federal and state partners to provide a more unified approach to public safety and emergency coordination. Each year we get better and better at what we do. We have to thank countless individuals for the contributions they’ve made to get all of ESD to the point we are at today. Our volunteers hail from big cities and small communities from around the world and it is a great honor to work with all of the talented and dedicated people serving the most awesome community on the planet, Black Rock City!