AFTERBURN REPORT 2006
EMERGENCY SERVICES DEPARTMENT
This year was marked by being operationally unremarkable in many ways for the Emergency Services Department (ESD). The department has a "groove" and functions smoothly. Of course there are things that inevitably go awry but that is to be expected when one is putting together something as complex as both the ESD or Black Rock City. This year’s challenges included communications, meal breaks, and an ESD unit accident post event.
In 2006 our communications system experienced a higher level of bandwidth depletion than in previous years due to the additional channels added to the system. This has led ESD to review and revise the system design, including freezing any additions to the system to help eliminate this issue for 2007.
Meal breaks, which have from time to time been an issue for ESD volunteers became an issue again this year, though thankfully the problem was generally isolated to the Medical Branch. Of course, if you were a hungry volunteer this in no way made you feel any better or made you less hungry. Post event debrief meetings attempted to better understand the issue and improvements will be made for the 2007 event year.
Unfortunately ESD suffered a solo vehicle accident post event. One of the rented ESD utility trucks was towing the brand new ESD Hazmat/Rescue trailer (which in addition to its normal compliment of equipment, also contained a lot of fire equipment that was being transported for regular service, repair, or cleaning) lost control of the trailer and crashed into the guardrail. The accident took place on Interstate 80 and both the truck and the trailer were totaled. Fortunately no one was hurt but the cost of replacing the truck, trailer, and associated costs with the accident was expensive and unfortunate. New driving policies will be implemented to help prevent accidents in the future.
Updates realized from the 2005 event debrief process included the addition of a dedicated medical volunteer orientation manager as well as an alpha implementation of computerized patient logs. The addition of the orientation manager greatly improved the medical volunteer orientation process and further improvements are being planned for 2007 based on the lessons. One of the most exciting possibilities is the creation of a basic orientation training video that would be available on-line so that volunteers could orient themselves before arriving on playa, where they would receive a final orientation. It is not known if production of such a video will be complete for the 2007 event season, but will definitely be available for the 2008 event season.
Updates for 2007 that were discussed in the 2006 post event debriefing process included adding additional units to the response system, specifically an extra Duty Chief, adding extra response units earlier in the event cycle, as well as extra EMS units for burn night. The extra Duty Chief position was added to help support the existing Fire and Medical Duty Chiefs, who are on duty to oversee operations but can be overwhelmed with administrative, support, operations, and command tasks when the ESD response system stays busy for extended periods of time. The extra EMS units added for the day of the burn reflect that it is the busiest day for ESD and REMSA during the entire event and unit depletion has become an issue to the point where additional units must be added to prevent the crews from becoming overworked. However, it is worth noting that the increase in call volume is proportional to the growth of the total number of participants at the event. Since no significant changes have occurred in several years to the ESD response unit structure, this update is timely and appropriate to the growth of ESD and Black Rock City.
Medical Branch Report
ESD and REMSA together logged approximately 4,375 patient contacts in 2006 (up 25% from 2005) with a peak combined patient volume of 835 patients seen on Saturday, September 2. Most of these patients are walk-ins with minor medical issues but of the total patient contacts 417 (up 12% from 2005) were significant enough to require an ESD EMS unit, REMSA ambulance, or other ESD first responder resource to respond. That number averages to one EMS response every 34 minutes during the event. It is postulated that the increase in the total number of patients is partially due to the improved documentation practices implemented by ESD this year.
Approximately 47% of the total patient volume involved minor injuries such as blisters or cuts. Other common patient categories included eye problems (9% of total patients), heat-related injuries (15%), and patient care follow-up (10%). The remaining 19% of the total patient volume comprised of all other medical categories, including lacerations requiring sutures, allergies/insect bites, burns, difficulty breathing, and urinary tract infections (each representing 2-4% of the overall total patient volume).
The numbers for alcohol and drug related patients continue to be remarkably low for an event of this size that lasts for this long. In 2006 there was a decrease in drug related patients (19 total, down 68% from 2005) and an increase in alcohol related patients (29 total, up 45% from 2005). The current five year average for drug related patients is 29 total per year and 20 total per year for alcohol related patients. It is worth noting that these numbers do not necessarily represent overdoses, only patients who had drugs or alcohol as the primary reason for seeking medical care.
Of the 52 patients transported (an increase of 30% from 2005) to Reno hospitals for additional care in 2006, 32 were stable patients transported by ground ambulance and 20 were flown out by helicopter.
There was one fatality this year during the event. The cause of death was determined to be from a congenital heart defect.
Mental Health Branch, Fire Branch, and Emergency Dispatch Reports
The Mental Health Branch responded to 33 calls in 2006, which is just one more than the total calls for service from the previous year. The breakdown by case type includes 17 psychiatric clients, 3 domestic-violence related cases, 4 sexual assault cases, 3 Legal 2000 evaluations (to determine if there is a danger to self or to others as a result of a mental illness). Additionally there were 6 other calls for evaluations or client follow-up. The Mental Health Support team was not needed for deployment to any critical incidents in 2006.
The Fire Branch responded to 26 fire-related calls for service, with no major fire responses. Call types include evaluations of various planned and unscheduled burns for safety, performance support, hazard mitigation, vehicle accident response, and extinguishment of small fires that may be unsafe such as an abandoned burn barrel during high wind conditions.
The ESD Emergency Dispatch center handled 656 calls for service in 2006, an increase of 16% from 2005. Call types include everything from requests for traffic control or public assistance to fire and emergency medical calls. The total number of calls averages to a new logged dispatch incident once every 22 minutes during the event. It is worth noting that in addition to new calls, dispatchers have the task of managing initial requests for Ranger response; all currently active ESD calls; as well as all of the ESD response units in the field, which during peak hours can be as high as 30 EMS, Fire, Mental Health, and leadership resources.
Joseph Pred, Emergency Services Operations Chief
Anna Duffy, Mental Health Branch Chief
Tracy McDowell, Medical Branch Administrative Chief
Dave Spencer, Communications Branch IT Group Chief