Behind the Danger

hgh emsBurning Man is a dangerous place. People die there, get robbed and raped, get injured. Whistleblowers report major safety issues. BMOrg can’t afford to do anything about it other than give us some health hints, even though now the party is taking in $25-50 million per year. And the cops don’t seem to be able to do much to help the safety of Burners, even though their take from the party is now upwards of $2 million/year (plus citation revenues).

Luckily we have an experienced, dedicated, mostly volunteer crew of Emergency Services and medical professionals out there to help us. Medical care on the Playa is free, covered by insurance that comes with your ticket. If you want more coverage, you can also buy special Burning Man insurance.

The Humboldt County EMS team sees half as many people in a week at Burning Man, as they do in an entire year. They manage the staffing of 300-350 employees, who see around 3200 patients in a week from almost 400 ambulance calls. Pat Songer from Humboldt General Hospital EMS, NV, shares some of the stories behind the scenes at Burning Man:

From EMS World:

IMinolta DSCt’s difficult to to schedule 20 people on a spreadsheet, calendar or whiteboard.  Imagine trying to schedule hundreds of people with one of these  antiquated methods of scheduling.  Large scale events require a great deal of support personnel…including security, food service, volunteers, and EMS staff. How to manage, schedule and keep track of all these people is a huge undertaking.

Each year, the last Monday of August signals the start of largest outdoor art festival in North America…Burning Man. A “city” covering seven square miles is built each year in the Black Rock Desert about 120 miles north of Reno, Nevada. Burning Man has been referred to as the largest, planned, mass casualty event in history.

Humboldt General Hospital, in nearby Winnemucca, is the contractor for the massive medical and EMS requirements for Burning Man. “We provide a mobile hospital, a mobile medical unit, and a full ALS ambulance response system for the event. There are about 70,000 participants in the city for the one week festival and we provide all the medical care. We see about 3,200 patients each year at Burning Man so we staff anywhere from 300-350 temporary employees. It’s an enormous scheduling issue dealing with how we schedule the people out there. We use EMS Manager at Humboldt General Hospital and we use it to coordinate all the physicians, administrators and EMS staff at Burning Man.  EMS Manager provides online access so the contract workers can place their availability right from their home months before the event and then we manage the system from our location.  Staff can also login to EMS Manager at the event to pick up more shifts due to no-shows or when people drop shifts.  EMS Manager is excellent.  It’s a very efficient tool for us,” explains Pat Songer, Administrative Director, Humboldt General Hospital, Winnemucca, NV.  

Others responsible for large functions choose to use staff from neighboring EMS agencies.  Scheduling personnel from various agencies and coordinating them into a cohesive team for the duration of the event is a challenge.

Biggest problem? Blisters and cuts. Followed by Dehydration, exhaustion, heat stroke. OK, they have free bandaids. Some Burners didn’t bring enough, or didn’t have them in their pockets when their boo-boo happened. But, can someone explain this to me? Why sell ice and boiled water (coffee/tea), but not sell drinking water? Or, provide water fountains for the public, like most cities do. How much load on the medical system do we need to have, is it going to take someone dying, before BMOrg decides it makes sense that people in a party in the desert should have clearly visible water stations they can go to? We’re human beings, water should be free to begin with.

Although the EMS system can’t help with waters, or sexual assaults, it’s great to know there are so many professional medical people at Burning Man, rostered on to keep us safe. It seems incredible to me, that they have 350 trained medical personnel on the Playa, and at least 130+ Federal and Pershing County Law Enforcement officers – and yet, we are supposed to believe that not one of those nearly 500 is able to use a rape kit on a patient? The nurse or doctor just needs to hand the sealed rape kit to a police officer, thus keeping the chain of evidence sufficiently intact if a case ever went to trial. Is this because it’s the Wild West out there – there are so many crimes being committed, everywhere by everyone, cowboys and sheriffs – that, hey, what’s a few more? Or is it just that this EMS system needs to be improved to schedule in some SANE nurses ? If there aren’t enough trained medical personnel for a city of 70,000, then maybe BMOrg can invest some of those tens of millions into the 40-60 hours of training required by nurses. Seriously: train one nurse, what’s the big deal? Or, even better, train all 350 medical personnel.

The medical staff at Burning Man certainly seem extremely competent to me. Let’s wrap up on a more positive note, with a story about how they saved the life of a guy who had a heart attack out there.

Black Rock City operates as a functional geopolitical entity with fire, police and EMS systems. Each is dispatched from a manned communications center that’s constructed and deconstructed annually.

stretcher patientIn 2011, Humboldt General Hospital EMS in Winnemucca was contracted to provide medical care for Burning Man. Medical care included a fully staffed and operational EMS system, as well as a field hospital called Rampart General and two BLS aid centers.

A total of 2,307 patients were treated. Three-hundred and eighty-two requests for ambulances were made, with 185 patients being transported to Rampart General. Only 33 patients were transported out of the desert for care. The following highlights one of those cases that took place during the event.

On the final day of the Burning Man event, EMS is summoned to a chest pain call in a trailer within the encampment. On arrival, paramedics find a 60-year-old male in acute distress. He’s pale and diaphoretic and in extremis. The patient describes the pain as “tearing” and can’t get into a comfortable position. The EMS crew extricates him from his trailer and moves him to the awaiting ambulance for a more detailed assessment.

He becomes unresponsive shortly after they place him in the ambulance. Paramedics check his pulse, take a quick look at the monitor, and note the patient is in a non-perfusing v tach. On a hunch, they administer a precordial thump, and it works. The patient converts to a sinus rhythm. He’s transported to Rampart General in Black Rock City. Once the patient arrives at the field hospital, the emergency staff rapidly assesses him. He’s alert and oriented, but his blood pressure is undetectable. He’s writhing in pain on the stretcher. IV fluids are given, and his blood pressure is finally detectable at a systolic pressure of 72 mmHg and then up to 76 mmHg. He remains mildly tachycardic. He receives IV fentanyl for pain. Rampart General has X-ray capabilities and a stat chest X-ray is obtained. The emergency physician notes that the mediastinum is wide at 10.5 cm—consistent with a thoracic aortic aneurysm and dissection. A medical helicopter is summoned and the patient is closely monitored and stabilized by the emergency staff.

As soon as the helicopter arrives, the patient is moved to the aircraft and transported to a major medical center about 150 miles away. Once he arrives, he undergoes a computed tomography angiogram (CTA) that confirms the suspected aortic dissection. The patient is emergently taken to surgery where the aneurysm is repaired. The operation is successful, and the patient is moved to the intensive care unit (ICU). Following surgery, the patient suffers a second cardiac arrest and is taken to the cardiac catheterization lab for evaluation and subsequent stenting of a coronary artery lesion. He’s returned to the ICU and remains stable. He’s discharged home with appropriate provisions for follow-up. Despite his ordeal, he’s already planning his next trip to Burning Man.

First, this is not a true “case from University Medical Center” because it didn’t happen at UMC. However, emergency physicians, emergency medicine residents and medical students from the University of Nevada School of Medicine provided much of the medical care at Burning Man. As you can tell, this patient had all the cards stacked against him. He had a critical thoracic aortic dissection, and he was in the middle of a Nevada desert more than 150 miles from a medical facility with cardiothoracic surgery capabilities. Furthermore, he suffered a cardiac arrest. Yet despite all of this, he survived.

“Radical Self-Reliance” doesn’t really capture the essence of Black Rock City. We rely on each other. A big thank you to all the volunteers and contractors who provide the medical, fire, and physical safety for us out on the Playa. BMOrg, buy ’em some freaking radios.

15 comments on “Behind the Danger

  1. Pingback: Help the Helpers | Burners.Me: Me, Burners and The Man

  2. burners xxx you are mentally ill, as crazy as paul addis. I feel sorry for you and your parents who didnt have the good sense to abort you.

  3. sorry….but this is a poorly written, rambling article with no real focus or point. is it that the on-site hospital staff are doing a great job? is it a lack of rape kits and other (?) essential medical/forensic services? is it a discussion on what “radical self-reliance” means. is it a call for help to assist the possibly absolute morons who travel a minimum of 100 miles (from reno) or more into one of the harshest, complete desert environments imaginable, and despite the continued and repeated reminders by BMO (and hopefully their friends) to ensure they have adequaute supplies, and especially water, happen to “forget” to bring water and get de-hydrated? i don’t get the point of this article – it has none.

    • this blog talks about things being discussed on the Internet that relate to Burner culture. In this case, the thing being discussed was the Emergency Management Systems at Burning Man. Watch the video and you’ll be able to understand it better, Frosty. If you follow the injuries link, you can see how many of the 3200 medical emergencies are related to dehydration. The lack of trained medical personnel able to administer a rape kit and hand it to an authorized LEO, is issue #2 among Burners and personally the one that I encounter the most. It seems crazy to me, learning from this story that there are 350 professional medical personnel out there with a sophisticated software system, that they can’t sort this out. And knowing that there are record levels of county, state, federal police, and other agencies, with night-vision goggles and all the latest gadgets – and yet, no-one can figure out what to do in case of sexual assault, other than drive the victim in a police car to Reno. And they think that somehow, collecting DNA evidence many hours after the crime is better than doing so when the crime is reported.
      BTW, BMOrg’s “survival guide” is like 70 pages or something. I don’t know, it’s just some junk mail that I hand to Virgins. I learned to survive in the desert through rave culture long before I ever went to Burning Man. If you have ever been to Burning Man, you’ll know that there are people there who are too wasted to remember what they read in their booklets, and even the most experienced Burners can run out of water after hours and hours of gifting.

  4. If I were camping in the desert, I wouldn’t expect any help. Why is BM any different? People have indeed died of dehydration at BM; they didn’t drink enough water, or often, they drank too much alcohol, or not enough salts. In most of the free bars in BRC you can get mixer/soda without alcohol. If a stranger walked up and asked for water or a sports drink, any burner would oblige without a second thought.

    It turns out that in the default world, the police doesn’t legally have to protect you from a crime. Totally sucks wherever crime happens. 2 years ago I witnessed an incident where a lady across the street yelled after some guy, who took off and then some rangers started chasing him. If he had run past me I would have nailed him. We all need to learn to take care of each other and watch everything around us.

    • two fair points. When you need water in an emergency, herpes and hepatitis seem far away. Unfortunately sharing with strangers spreads disease. I agree that it’s great for people to learn radical self reliance. I just don’t get what would be so bad about having some water stations. If you don’t want commerce, then give the waters away. There are probably plenty of water companies who would sponsor the whole event, just like YouTube does already “official video content monetizer of Burning Man”.

  5. who wrote this piece and where did you get your info other the ems world? Whats your proof? “How many people have to die, before BMOrg decides it makes sense that people in a party in the desert should have clearly visible water stations they can go to?”

    What evidence do you have that people have DIED due to lack of water? From what Ive seen people bring in an average of 20 gallons per person minimum. What makes you think that if BM brought in a million gallons of water and installed spigots that people would drink it and not get heat stroke and dehydration?
    Are you saying to ditch radical self reliance and bring in all the ammenities of a big festival like coachella? Have food trucks? Ditch non commercialism too?

    “Radical Self-Reliance” doesn’t really capture the essence of Black Rock City. We rely on each other. BMOrg, buy ‘em some freaking radios.” What proof do you have that they don’t have working radios? Ive seen them use working radios.

    People with actual medical and law enforcement training and education have written why rape kits need to be done in a hospital off playa. Theyve written many times on it. People refuse to understand it. The crime stats are public. Rape kits on playa won’t reduce rape. All “sexual assaults” are not rape. They might be getting groped. Crime at burning man is similar to any American city of comparable size or LESS.
    There has never been a murder at burning man.

    “not one of those 500 is able to use a rape kit on a patient and hand that to a police officer, thus keeping the chain of evidence sufficiently intact if a case ever went to trial. Is this because it’s the Wild West out there – there are so many crimes being committed, everywhere by everyone, cowboys and sheriffs – that, hey, what’s a few more?”
    Your story is why burners.me is not taken seriously. Its the national enquirerer of burner media.
    The writer is a ill informed, uneducated trolling moron. Most Burners disagree with you

    • you seem to be the troll – repeating the party line. At least we provide links to everything we’re talking about. We’ve covered this a lot already on this site, I really would prefer to drop the issue, but getting these parrotted lines back from the BMOrg is not addressing the ACTUAL problem. The problem isn’t Burners.Me and whatever you think about it. The problem is sexual assault, and the other problem is too many cops. We did a poll on this, check it out: http://burners.me/2013/10/02/what-are-the-burning-issues/ …cops is the #1 issue, rape kits is #2 – surely at least these two should be related? Can’t we ask the cops to suggest some solutions, for $2 million a year of our ticket money?
      PS would love to see the public 2013 crime stats, got a link?

      • The party line is educated and logical and makes sense. youre a moron and you provide links to other moron idiot sites. Youre like drudgereport and ny post, all sensationalist garbage not backed by facts.
        fuck people that are too stupid to drink water. let them learn my going to the hospital and getting an IV. people get dehydration and heatstroke in CITIES with endless water. You cant cure stupidity.
        You want BMORG to spend millions on water for idiots. That will drive up ticket prices for everyone. Ice is sold because its used to preserve food and it melts in a couple of days, retard. gatorade, lemonade is sold in the cafe.
        So you have a problem with crime and you have a problem with too many cops. If we get rid of all the cops would that increase or decrease crime?
        If people cant leave the party for a few hours to get evidence to prosecute, thats their decison. they have their priorities.
        Do you have any concept of logical reasoning? Or are you too burned out from decades of drug and alcohol abuse and mental illness?
        Exactly what is your law enforcement and medical training, doctor?

      • http://www.journalism.org/2011/05/09/drudge-report-small-operation-large-influence/ …bigger influence than Facebook or Twitter, just like our peak reach during Aug/Sep of 137,000 is almost double Burning Man. Don’t knock it ’til you tried it bro! We’re on the side of the lovers, not the haters. Read the article, read the links, we don’t make this stuff up. If BMOrg bullshits us, we call them out on it. They don’t like it, so they respond with information spam bullshit attacks, ad hominem and straw man arguments, parrotting party lines. It is an inept implementation of information war, and lowers the tone of all of our discussions. I keep saying “hey, what about my questions”…and the BMOrg propaganda agents, keep ignoring that question and hitting us with these diversionary attacks instead.

        What’s social engineering all about? See this http://www.youtube.com/watch?v=4rnJEdDNDsI

        …watch this space.

    • “Most Burners disagree with you” … that’s because most burners won’t hear criticism of any kind about the Burn or ANY of the people. It’s a modern day “Emperor’s New Clothes: BRC edition”.

      • LOL Bob, it sure is. If Burning Man looked around Silicon Valley, they could learn a lot, including a very basic lesson from Global Business School 101 – “Product Development should be based on Customer Feedback”. You don’t attack your customers for the feedback, you improve the freakin product!

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