BRC medical services

[Bless]

I noticed in the latest edition of JRS that they have selected CrowdRx, Inc. to provide medical support services this year.

Haven't medical services been traditionally provided by volunteer staff? Is this the first year that they are going with an outside provider? If so, were there any problems last year?

Thanks for the info.

[Elliot]

To my knowledge, it has been a combination of pros and volunteers, and I would guess this will continue. Seems it was called Rampart the last couple years. And I think Humboldt General Hospital was involved. Not sure exactly how it was arranged, but no, outside pros is nothing new.

[Sham]

There have always been professional medical staff along with volunteer paramedics. There are many ambulances and other emergency vehicles on site at all times.

[Ratty]

I gave a ride on the last leg of the trip to an ambulance driver. Picked him up in Reno at the Sands. He had flown in. He was a paid employee for the duration of the event.

[Molotov]

Volunteers (for the most part) staff the first aid stations at 3 and 9 plazas. Rampart (name based on the hospital from the '70s series Emergency!) is mostly paid staff from the contracted medical provider, HGH last year and CrowdRx for 2015. Ambulances are provided by the medical contractor with paid staff. First response vehicles and courtesy transports are staffed by BRC ESD volunteers.

FYI-more first aid stations are planned for 2015, including 5:15 at Esplanade (near Rampart), a station near the Temple, and two more stations at 4:30 and 7:30 near H or F. These will also be staffed by volunteers from BRC ESD.

[Elliot]

On a casual note.... I lent a bicycle to an MD from England -- a surgeon, no less. She volunteers, but her MD's license is not valid in the US, so she is reduced to advisory duties. She said she doesn't mind, so long as she gets to participate and contribute in general.

[burner von braun]

I have to admit, with everything else that goes on, I never actually identified any of the medical outposts other than rampart. As time goes on I'd like to improve my situational awareness and be able to point out the medical facilities easily if need be. Is there a red cross or other identifier to look for at these field locations?

[mdmf007]

Your UK MD gal is an awesome doc and a blast to work with. All of ESD is limited in scope to bls service regardless of licensure.

You are indeed correct that St3, St9, and our firefighting staff, mental health, communications staff, logistics are almost entirely volunteer. The ALS provider was HGH last year from Winnemucca and in years past was REMSA from Reno. Things change and like any responsible contract holder - periodic review for services and rates needs to be reviewed. In addition Station 5 out at the airport is also a contracted service as well.

[Molotov]

Typical first aid station (3 and 9 at C plazas for now) Marked with an illuminated red cross at night. :

Rampart urgent care near 5 and Esplanade-also marked with a big red cross:

Those big red crosses make pretty good landmarks at night to find your way back home from the open playa.

[Elliot]

Your UK MD gal is an awesome doc and a blast to work with. ...

I wish she were "my gal"!

[trilobyte]

I'm giving this a nudge over to the q&a board, since that's a better fit for general event/prep questions.

Yes, Burning Man has gotten a new provider for the ambulance/emergency stuff. As 007 mentioned ESD is mostly volunteer, but we do have a licensed professional organization contracted to provide all the serious ambulance stuff.

In addition to working with CrowdRx, it was also announced that ESD will be adding two new stations this year, in the 4:30 and 7:30 plazas.

If you've got additional questions for the ESD team, you can go visit their site and reach out to them directly.

[Molotov]

New station will also be added at 5:00 at Esplanade-probably right in front of Rampart to reduce the walk-in patient load at Rampart by dealing with minor stuff. It probably will not be called Station 5-as that is the contractor operated station out by the airport. Station 51 (from TV's Emergency! series) has been submitted as a possible name for that new station.

[Melonblue]

Just read this article from the Reno Gazette Journal on the matter - http://www.rgj.com/story/life/arts/burn ... /25856353/ .

It also looks like the Humbolt General hospital has no interest in working with CrowdRx. I wonder where this leaves - REMSA/Care Flight services? It also says CrowdRx are not licensed as a hospital in Reno, nor licensed to provide ambulance services. (leaving CrowsRx to negotiate 3rd party through independent Nevada registered/liscenced ambulatory units and services?)

Even BLM has concerns about the plan and have not signed the use of the playa until such time as new information about the safety plan comes into play.

CrowdRx who has plenty of history with events like Coachella (40mins of a hospital in major cities) will be doing a desert job for the first time.

There's a ton of angry nurses on FB arguing that this is an unsafe move by BMOrg.
Local Reno nurses and physicians, saying that this will overwhelm their ERs and local emergency medical evacuation services unecessarily as a result of this change.

I'm not sure what to think of that. I guess I'll need more information over the next few months to form an opinion.
But I'm gonna be packing a better First Aid kit and renew my Wilderness First Aid level C.

[trilobyte]

The angry nurse posts I've seen have all read as bitter/unprofessional grousing by people who have issues with change. CrowdRx has pretty considerable experience/expertise dealing with much bigger events at remote locations than Burning Man, and interfacing with regional medical facilities. It's also worth pointing out that at no time in the past has BLM signed off on plans or permits at this stage in the game, that does not usually happen for months.

[Melonblue]

The angry nurse posts I've seen have all read as bitter/unprofessional grousing by people who have issues with change. CrowdRx has pretty considerable experience/expertise dealing with much bigger events at remote locations than Burning Man, and interfacing with regional medical facilities. It's also worth pointing out that at no time in the past has BLM signed off on plans or permits at this stage in the game, that does not usually happen for months.

I'm sure you know better than I do.

But even the article quoted Carl Monzo - the President of CrowdRx as;

Burning Man will be a different animal for CrowdRx. "Nevada is a new venture for us. We will look and see what we need," Monzo said. The most rural environment the company had worked in its 23 years of experience was a Phish concert held in a rural part of New England in the 1990s , he said. "When we're dealing with something like Burning Man, I think we need to double and triple check because it's not like there's resources around the corner," Monzo said. Black Rock City is located about two hours north of Reno in the Black Rock Desert.

It is possible that CrowdRx will reach out to local ambulance and hospital entities for collaboration, according to Monzo. Humboldt General Hospital is not interested in working with CrowdRx, according to Songer, the hospital's spokesman."

So the president of CrowdRx is stating that while they have provided support for more events with more (thousands) of people and they do it more often (hundreds a year). He also said that the desert, was new to them.


One of those angry/bitter/unprofessional people seems to be the Humbolt Hospital Spokesmen.

I work in a Health Unit (but in mental health) and one thing I've learned is those nurses and doctors only turn ugly when someone makes a choice that unnecessarily risks lives or puts more pressure on non-contracted service providers to provide those services in addition to and at the risk of their own community residents receiving timely and effective services.

I don't know very many ambulatory service providers who are afraid of change...they run ER services...they live with the very definition of "change management" on a daily basis. Every case that walks into their Emergency Room is different. They are some of the most respondent, flexible, passionate people I know.

And no...none of these doctors and nurses that I work with are "nice" people on the job. They're all gruff, rough, "smarter than you" people, many are angry; because they worry and care about your wellness and health, and I'd trust them with my life

I'm not saying take an article for all it's worth and throw babies and bathwater or "down with the BMOrg" for making these changes. I'm saying, if the change has the health community raising an eyebrow - maybe its something to keep ears open for.

[GreyCoyote]

It would be interesting to see WHY the BMOrg made this change.

It's been my experience that when something works, you leave it alone. It seems to me the med services have worked very well in the past, so again... why? Budget issues? Personality clash? Alien abductions?

I'm with Melon. The nurses I know wouldn't say shit even if they had a mouth full of it. You REALLY have to push them into a corner to get them to gripe, and when they do, it's important to listen.

Hopefully Larry & Co have their act together and aren't pulling another Wilson. I guess we will see what happens...

[mdmf007]

Mod hat off:

The same questions were raised when HGH took over for REMSA. When it comes to Staffing you will see many of the same faces that worked for REMSA then worked for HGH and will inevitably work for CRX. A lot of vetting went into CRX by professionals in the industry with patient care at the forefront. I am as pessimistic as they come, but know this transition will go well.

MDMF

[trilobyte]

If you have questions for the ESD team (as some have indicated in their responses), you should visit their site and take it up directly with them.

The complaints do seem similar to when Burning Man switched from REMSA to HGH in 2011. Back then they looked like the knee-jerk freakouts of either people who were afraid of change, or friends of the previous provider.

Speaking personally, I don't work with ESD as staff or as a volunteer, and haven't worked with either of those providers either, but between a company who's been to the desert but has little big event experience (outside of Burning Man) and one that's new to the desert (as all of us were) but has a ton of experience with big events, I'd prefer the latter. I also have faith in both Burning Man and the ESD team leadership, I know them to be good people and believe that both personally and professionally they have a pretty significant vested interest in participant survival and safety. I don't believe the sky is falling (just as I didn't before). We'll see how it plays out soon enough.

[some seeing eye]

The only experience I had with medical was an electrolyte depletion event about 10 years ago. Great service, customer-guided care. I self-diagnosed, they confirmed, gave me choices, excellent experience!

The BORG has to deal with costs and logistics, I trust them. To me the most important patient experience BM Medical, including psych, has to "get" is triage and dealing with anxious, exhausted and altered clients. It is an ER, but there is an argument that the problems encountered are more common to a festival than a rural or urban ER, with different cost recovery aims than a hospital. It has a short term charting system with no connection to the patient's historic chart, could be a challenge with BM's diverse age and disability profile. Though followup is offered, how often is it used? Pure conjecture, but selecting HGH may have been related to the various negotiations with that county when the lawsuit was in play.

What's important to BM Medical is BM experienced staff, with as many local previous BM event hires as possible, a way to select out the best each year and re-invite, not the new contractor festival wannabes.

I don't know if ESD has customer surveys for medical interactions, if not, they should.

[some seeing eye]

I find the burners meh website irritating and entertaining. They posted some documents from HGH, who from a medical business standpoint would love to get the business back and will lobby the BLM in their hometown and spread FUD to do so. But reading between the lines here is my theory. HGH brought a much higher level of onsite capability, prescription drug dispension, x-ray, essentially a remote ER. That is an awesome capability, but expensive and hard to believe their costs were covered in what BMORG paid. Then they opened the mass casualty service they could provide at higher cost, maybe to cover their perceived liability. So perhaps what we have is a move by BMORG to contain costs. There also seems to be trend away from MD's, maybe volunteers in the past, to nurse practitioners and EMTs on behalf of HGH. All there are the same trends seen in the healthcare industry outside BM.

[andy]

My concern with CrowdRx is not their professionalism but simply their experience in operating in the self-contained environment that is BM. For example, although they are well-regarded for their work worth Coachella, which is the same size or maybe slightly larger than BM, Indio is a major metropolitan area when compared to the playa, with hospitals, restaurants, and stores. People plan all year for BM and don't want to leave early (or can't) unless it's very very serious. If CrowdRX can work in the mindset that they ARE the local medical service provider, not the first-aid provider, they should do fine. If their mindset is "you need to see a doctor about this" there will be some unhappy burners.