PETs Operational Manual
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Pyropolis Emergency Team
Burning Flipside 2012: Freaky Deaky Time Machine
PET Operations Manual
Statement of Intent: This document is intended to provide the members of the Pyropolis Emergency Team with an overview of the Team and its intentions, expectations, and functions towards the Pyropolis community in the event of an emergency during the Burning Flipside event. The information within this document is not a standard of care, nor is the information set in stone. The only true expectation of the members of the Pyropolis Emergency Team is to:
“Always do the best you can with what you’ve got to insure the safety of yourself, your patient(s), and the Pyropolis community.” aka MacGyver Medicine!
Introduction
Welcome! If you’re reading this document, you’ve chosen to learn a little more about the Pyropolis Emergency Team and its operations. We hope that this document will be able to help answer some of the questions about the Team, how it operates at Burning Flipside, and to prepare PETs for one of the most important, selfless volunteer positions of the event. Thank you!
A Brief History: The Pyropolis Emergency Team (its members are referred to as PETs) first appeared at Burning Flipside in 2004 as a subdivision of the Pyropolis Rangers. In the past, the Rangers themselves assisted the Pyropolis community with their medical needs, from simple first aid for cuts and burns to utilizing ambulance and medical helicopter services to evacuate patients suffering from severe allergic reactions or other serious injuries. Because there was a noticeable lack of medical training amongst the Rangers, the next logical evolution was the creation of a team dedicated to serving the medical needs of the community during the event. The creation of such an entity would also alleviate the responsibility of making critical medical decisions by non-medically trained Rangers. During their first year in Pyropolis the PETs, working alongside the Rangers, achieved what they had set out to do: provide 24-hour basic medical care and support for the Pyropolis community, thereby insuring that help was always available. While PETs has grown into its own specialized entity, we continue to work seamlessly alongside Rangers, Sanctuary and Fire. This document is the result of the experiences since that first year, and it will continue to evolve and improve.
PET Definition: A PET will be a volunteer with a professional background in patient care. PETs provide basic first aid to event participants and, in the case of a serious injury, stabilize patients and work with PET Lead and Ranger Shift Lead to determine if the patient can safely be transported to a hospital via POV (privately-owned vehicle), or if our on-site ALS EMS Transport Service should be activated. All PETs, regardless of their level of training, are responsible for understanding the information contained within this document and our BLS protocols. Upcoming training courses will review this information and answer any questions that arise.
Organizational Structure
PETs fall under the Safety Area umbrella. Below is the organizational structure. In addition to simply being an FYI for you to understand how we are organized, this structure will be utilized should the Incident Command System (ICS) or Chain of Command be activated. Please review the separate ICS module carefully.
Austin Artistic Reconstruction, LLC (updated 1/16/12) – the legal entity that puts on the event: Burning Flipside. On the radio, whoever is on duty can be raised by calling for 'Flipside Actual.' The individual members of the LLC are Sparky Anderson (Sparky), Thomas Monclova (Third Base), Beth Cotton (Mizu), and Scott Sexton (Brisket)
Safety Area Facilitator (updated 1/16/12) – Mark Schade (Kano) oversees PET, Sanctuary, Rangers, Fire, Safety Lighting, Perimeter, Meteorology & Sound. The PETs Lead will contact the AF in the event of an ICS event.
PET Lead – Lisa Burchett, PA-C (Bgodess). Manages operations, logistics, personnel and equipment. Recruits, coordinates and trains medical personnel prior to and during the event. In the event of an ICS event or transport decision, she will respond and act as liaison between Rangers, LLC, other Flipside departments & any outside agencies.
PET Operations & Logistics Lieutenants – Pre-event these volunteers assist in training, scheduling and inventory. During the event they act as Shift Supervisors, interface with Rangers and other departments, track equipment/supply use & patient statistics.
PET Supervisor - 12 hour shift. Oversees stations and crews during shift. Responsible for patient care decisions. Interfaces with LLC, other department personnel and outside agencies.
PET – 6 hour shift. Staffs HQ/Outpost for walk-up participants requiring medical assistance. Responds to medical/psychosocial emergencies in the field. Provides first aid & BLS support to population. Completes appropriate documentation of care provided and materials used. Determines need to activate ICS Chain of Command in situations requiring advance medical care, any transports or mass casualties. Refers non-medical psychosocial emergencies to Sanctuary.
PET Conscierge - 6 hour shift. Greets walk-up participants. Assists licensed/certified crew with paperwork, stocking, cleaning, etc.
Sanctuary Lead – Reina Pristina (Reina). Coordinates & staffs The Sanctuary, a safe, private and comfortable area for participants that need psychosocial support. Counseling and support for non-medical events.
Sanctuary Counselor – The Sanctuary is staffed 24/7 with specially trained personnel to assist participants needing psychosocial comfort and care. True psychiatric emergencies are first seen and cared for by PETs. Should it be determined by Chain of Command that a transport is not necessary, and if the patient is stable and safe enough, our comrades at The Sanctuary will assume care.
Ranger Shift Lead, aka 'Khaki' – Goto person & Safety Supervisor during any given shift. On request of PET Supervisor on duty, activates Chain of Command & ICS, if needed. Dispatches other personnel needed at site of incident.
“Dirt” Ranger – Not the last and not the least. They are the most abundant group in the Safety Team. These Rangers are the eyes and ears of the city. Typically they are the first on scene to any safety incident. Notifies appropriate departments needed for that situation. Handles crowd control, mediates conflict resolution, acts as liaison between Safety Departments, outside agencies and the general Pyropolis population. Most Rangers have some training and/or experience to assist PETs in caring for patients.
Frequently (or not-so-frequently) Asked Questions:
Q: What is the Pyropolis Emergency Team?
A: The Pyropolis Emergency Team is the medical branch of the Pyropolis Safety Team and serves the Burning Flipside community over the course of the event. It is a team of volunteers consisting of certified or licensed healthcare professionals that are dedicated to providing twenty-four hour medical and other emergency assistance during Burning Flipside. All PETs are minimally credentialed with CPR for Healthcare Providers (BLS) and are typically medical professionals in the default world. While most have advanced credentials, they may only legally provide basic first aid & BLS at the event.
Q: How can I find a PET if there is an emergency?
A: There is always at least four (4) PETs on duty at all times during Burning Flipside. PETs are either patrolling around the event in a mobile response vehicle or stationed at the designated PET/Ranger Headquarters (HQ) or Outpost. If a PET is not available at HQ, they will be reachable on radio via "Khaki." On duty PETs are identified by light blue shirts and authentic laminated badge with the PET logos (as opposed to on duty Rangers, who wear khaki-colored shirts).
Q: Will I be charged if I need help from a PET?
A: NO! PETs are trained volunteers that are happy to help the Flipside community with any concern, no matter how big or small it may seem. “Working” as a PET is how we choose to enjoy our Flipside Experience. We provide this healing art as our gift to participants. However, AAR LLC (the folks who put on Flipside) will not offer any compensation for any medical bills from ambulance/helicopter transport or ER visits. (Read the back of your ticket again for more information). Should a POV (per own vehicle, non EMS) transport be recommended, the driver of POV and patient may be required to purchase an IN/OUT pass. The PET & Ranger Shift Supervisors will be involved in this decision making and available to answer questions about IN/OUT passes.
Q: How do I become a PET?
A: The basic requirement to be a PET is to have some sort of formal healthcare background. They must be minimally certified with CPR for Healthcare Providers and undergo Flipside PET orientation training. We welcome all sorts of healthcare professionals to the team: EMTs, Nurses, NPs, PAs, Doctors, and many others.
Q: Do I have to be a Ranger to be a PET?
A: No, you do not have to have Ranger experience to be on the Pyropolis Emergency Team. However, because the two departments work so closely together, it is strongly encouraged that you attend Ranger training to get an understanding of how the Rangers work and acquire their skills in interacting with the participants in an “official” capacity. In turn, Rangers are offered basic PET training so that they may assist us in an emergency requiring more hands on deck (for example, a cardiac event requiring CPR or a mass casualty incident). This cross training is provided during the annual Safetycide Training weekend every Spring.
Q: What is considered an ICS event?
A: For our purposes, any and all potential ambulance or helicopter transports will follow the ICS chain of command and protocol. Ultimate referral decisions rest with the PET Shift Supervisor. Any mass casualty event (natural disaster, structural collapse, wildfire, etc), will activate the ICS protocol. In the unfortunate case of a critically ill patient or death at the venue during the event, activating the 911 system and the ICS Chain of Command is of utmost importance. We are served by a rural EMS crew and the estimated arrival to Gate is a minimum of 30 minutes. Burn Night Operations will follow the ICS Chain of Command *See appendix re: Burn Night Protocol.
Q: How are non-medical, psychosocial emergencies addressed?
A: The Sanctuary offers the citizens of Pyropolis psychosocial support and counseling in the event of a non-medical related event or emergency. The Sanctuary is a safe, comfortable and private space for participants that need a caring listener or low stimulus environment. Sanctuary personnel are trained & credentialed psychiatric professionals (psychologists, counselors, social workers, etc). Once a patient has been cleared medically by the PET on duty, but requests or appears to require additional supervision and/or support, they will be referred to the Sanctuary.
Operational Guidelines
PET Definition: A PET is a volunteer with a professional background in patient care. PETs provide basic first aid to event participants and, in the case of a serious injury, stabilize patients and work with PET Lead and Ranger Shift Lead to determine if the patient can safely be transported to a hospital POV (privately-owned-vehicle) or if our on-site ALS EMS transport service should be activated. All PETs, regardless of their level of training, are responsible for understanding the information contained within this document and our First Aid and BLS protocols. Upcoming training courses will review this information and answer any questions that arise.
PET Shift Basics: PET shifts coincide with the other Safety Team shift schedules: Graveyard 0200-0800, Morning 0800-1400, Evening 1400-2000, Swing 2000-0200.
PETs are expected show up at least 15 minutes before their shift begins.
- oncoming PETs will check out a radio from Ranger Echelon and perform a radio check with the PET Supervisor (bring your ID; you must have it to check out a radio)
- oncoming PETs will receive report from outgoing PETs
- oncoming PETs will familiarize themselves with the available equipment and supplies
- oncoming PETs will check the mobile vehicle's fuel level and functional status, and that the jump kit & O2 are fully stocked
- outgoing PETs will brief the oncoming PETs of current patients/situations
- outgoing PETs will return their checked out radios to Ranger Echelon (be sure to get your ID back!)
- outgoing PETs should give the oncoming PETs enough time to ready themselves for duty
- the Ranger Shift Lead (Khaki) or the PET Supervisor should inform the PETs of any situations previously missed by the outgoing shift
Fitness for duty
PETs are expected to be of a clear mind during their shift and physically capable of performance, which means being sober and reasonably well rested. In the event outside authorities must be contacted, PETs will be expected to interface as necessary with law enforcement and/or emergency service personnel. PETs are representatives of the Community and the Event at large. If there is any doubt as to your physical, mental, or emotional fitness at the time of your shift, contact the PET Supervisor, explain the situation and an alternative solution will be reached.
Dress code/Identification
While certain latitude is given with regard to personal style with the PET uniform, it is expected PETs will maintain a functionally safe and professional appearance. PETs are required to wear their ID laminates at all times while on duty. When assuming care of a patient, be sure to introduce yourself as a member of the medical team.
PET Clinics
The primary PET facility will be situated near the main field along with Ranger HQ, Fire and Sanctuary. The clinic will have comfortable accommodations for patients which may include cots, couches, or chairs. Patients always have priority in regards to the furniture. Do not allow a patient to sleep at PET HQ without a full understanding of their condition. Unless the patient is suffering from a heat related illness or requires additional privacy, they will be assessed and treated under the shade structure. PET crews may rest in the climate controlled sleep spaces immediately before or after their shift. HQ will also be stocked with medical supplies available for treatment purposes. These supplies may include electronic devices such as Glucometers, PulseOx, AEDs, etc. and soft goods to facilitate cleaning, dressing, splinting and bandaging injuries. A basic variety of OTC medications are stocked. No Rx medications, except Oxygen, will be given.
PET Response Vehicles
PETs will have two (2) dedicated response vehicles available for field calls and one (1) vehicle for the Supervisor. They will be used to respond to calls out in the Pyropolis community. A PET airway/trauma bag (aka jump kit) will be located in the 2 response vehicles for the PETs to use. The jump kits will be stocked with a variety of supplies, including an O2 tank. They should remain in the vehicle at all times for responding to calls. Remember to restock the jump kit after using supplies from it. This vehicle will ideally be clearly labeled as the PET vehicle. Anyone other than the PETs on duty or someone under the PET’s direct supervision being witnessed operating the vehicle should be reported immediately to the Ranger Shift Lead (Khaki). Courtesy rides may be given at the Shift Supervisor or PET's discretion provided the vehicle is not needed for a priority call.
Roaming
PETs assigned to mobile vehicles may "patrol" the event grounds as long as: (a) the PET Shift Supervisor and Ranger Shift Lead is informed (b) the PET has their radio and that it is working correctly (c) the PET can return to HQ within a reasonable amount of time for any walk-up patients, if clinic crews are in need of assistance or on break
BSI
Appropriate body substance isolation materials {including, but not limited to: latex-free gloves, masks, gown-like coverings, bunker gear, etc) should be worn with every patient contact. BSI materials are also available to Rangers upon request.
Perks & privileges
Meals: Snacks and a refrigerator & microwave will be available for PETs to use. Gatorade and water are available for consumption in the PET's own drinking vessel.
Sleeping quarters: During the night shift PETs on duty may sleep in the climate controlled space, as long as they are available for response to patients.
Arrival/Departure: PETs are welcome to arrive prior to the event start date so that personal camps can be set up. PETs may depart after GTFO in order to strike personal camps & HQ. Prior PET Lead approval for arrival/departure dates is required.
The Nature of Calls / Patients at Pyropolis
Due to the nature of Burning Flipside, PET responses have the potential to run the gamut of medical and trauma emergencies. All field care should be in line with the PET BLS protocols and within the limits of their training and comfort levels. When in doubt, off-site transport should be considered.
Medical Consent:
Patients cannot be treated without their permission unless they are unconscious, unable to make informed decisions about medical care, or they are a minor by themselves (younger than 17 years old) at the event. Typically because our patients request our assistance, they grant us consent to treat them, but it is still important to keep in mind the legal issues surrounding medical consent. Understand that any attempt to hold or restrain a patient may be considered battery in a court of law. If such a situation arises, exhaust all other options (including calling 911 for assistance) before touching the patient. It is the PET’s responsibility to explain to a patient the risks of their condition, the consequences of not accepting off-site medical transport, and the benefits of seeking evaluation by a physician if the patient is competent to make their own decisions.
Responding to Calls / Patients:
PETs will contact the Ranger Shift Lead when they begin tending to a patient or responding to a call (call ‘khaki’). On scene, a PET may request assistance from any Rangers present; however, no Ranger will be obligated to perform any act that they do not wish to perform. *See the Radio Appendix for more information on when and what to say over the radio during a call* Patient treatment will occur at a location based on the PET’s discretion. Many times, removing a patient to a quieter, less-intense area (Ranger/PET HQ or Sanctuary) can assist with treatment; however, no patient should be moved if it will compromise their health or safety, or the safety of any other participant. Some equipment and medical supplies will be provided by the PET organization for treatment purposes at PET HQ, however possessing a personal kit or bag of portable supplies is encouraged. *See Appendix C for more information* Supplies should not be removed from PET HQ unless specifically needed for immediate patient care or to directly restock equipment used in patient treatment.
Record Keeping:
Every patient seen by a PET should be logged in the Patient Log, no matter the severity of their injury. In the case of a more serious injury, or any time a patient is transported off-site via EMS, a more detailed Patient Care Report should be filled out. The Patient Log will contain simple demographics regarding the patient contact, and the PCR will include vital signs, history, allergies, medications, chief complaint, assessment and a narrative of the event.
Due to the nature of patient privacy laws, we will have a HIPAA Box at HQ. When a Patient Log sheet is full, or when a PCR is completed, it will be placed in the HIPAA box.
Patient Privacy/HIPAA:
Privacy is an incredibly important issue in regards to medical treatment. Federal and State laws prohibit giving out certain information about any patient treated. Due to the size of Flipside, questions may arise about a patient treated. As a PET, you must protect your patient’s privacy to the best of your ability. This may be difficult since our community is so small, so you must exercise discretion when discussing any past or current patient’s condition with anyone not directly involved in the call. Most people are understanding of the idea of patient/provider privacy once they are educated about the laws in place. Patient logs and PCR's will be kept in a secure location and once statistic information has been mined after the event, these records will be stored in a locked file until no longer required to be maintained. In the event of a POV or EMS transport off-site, a patient should complete a HIPAA release if they consent to informing friends and/or family of their disposition. Details of specifics should remain confidential.
Off-Site Transport/Medical Evacuation:
In case off-site transport is needed via ambulance or medical helicopter, the ICS protocol will be activated. The PET on-duty will radio the PET Supervisor and Ranger Shift Lead, who will then follow the appropriate protocols as outlined in the PET Supervisor and Ranger Shift Lead manuals. If the PET on duty believes that the patient can be transported to the greeter station or main gate safely and the PET Lead or Ranger Shift Lead believes it to be prudent, then the patient may be transported in as gentle a manner as possible. The PET will remain with the patient at all times once a transport decision has been reached. PET on duty will provide a verbal hand-off report to receiving EMS provider, as well as a copy of the PCR (original to be retained for PET records).
• Rockdale EMS will most likely respond in case of a medical evacuation. Rangers will organize an intercept to escort them down to HQ or the scene. Upon EMS arrival, the PET Supervisor or PET on duty will provide responding EMTs and Paramedics with a report of the incident, any treatments performed, and any changes noted in the patient.
• STARFlight, or another air ambulance service, may be called in by responding authorities for a variety of reasons. In this event, PETs will work with the Safety Area Facilitator, PET Lead and Ranger Shift Lead to establish a Landing Zone (LZ). Ensure that all rocks, large sticks, and any other object that could be blown about by the rotor wash are removed from the LZ. Do not approach the helicopter once it has landed; abide by all instructions from outside agencies until the helicopter personnel disembark the vehicle and arrive to assume care of the patient. Let them come to you and the patient.
PETs will continue to assist any outside responding agencies until the patient has been removed from the property. A detailed Patient Care Report MUST be completed for any patient transported off the property (retain original, provide copy to receiving provider).
Crowds: Inevitably, a call will draw attention from the curious and the concerned. Fortunately Rangers are great listeners, empathizers, and all-around fantastic people who can work with crowds to give PETs the space they need to treat a patient. If you can, move the patient to a quieter area so the environment is calmer. Be mindful of a patient and his or her concerned friends, and do not allow your purpose or safety to become compromised. Also be mindful of patient privacy rights; use your best judgment when revealing patient information. Sanctuary personnel will also be accessed should the patient and/or bystanders require psychosocial support.
Law Enforcement:
In the event that law enforcement agencies arrive at the property as a result of a medical evacuation, the PET Lead and/or Supervisor, Ranger Shift Lead and the PET on duty will be looked to as the representatives of the community’s leadership and may also be considered as buffers between the event and outside response agencies. Keep in mind that privacy laws protect a patient’s medical condition; handle any instances that might compromise a patient’s medical care with discretion and respect for all parties involved. Understand that responders to Flipside may not understand what they are seeing at the event or may think or act on presumption or prejudice. It is every PET’s responsibility to act as professional, responsible, and competent representatives of the Flipside community.
Fostering Sustainability and strengthening Safety Team member relations
If you would like to commune and camp with fellow Safety team members, Third camp and Waterloo welcome home many PETs, Rangers, Sanctuary, Perimeter and Fire volunteers. All PETs are invited to arrive as early as Monday pre-event in order to render care to DaFT & other setup crews, as well as set up personal camps. PETs are also welcome to stay beyond Exodus/GTFO on Monday post-event to render care to the Post crews, help close up and strike HQ, play at the Monday night Ice Party, help stage for Load Out and be MOOPing FOOLS!
Burn Night Protocols
The night of the burn can easily seem chaotic, with nearly 2,500 people eagerly awaiting the effigy to burn. Fortunately, experience has made this process somewhat less hectic. *See Appendix D for a summary of Burn Night*
• Clinic PETs will remain at HQ to attend walk-ups and stage a mobile unit for calls outside of the main effigy field.
• Pre-Burn Meeting: There will be a meeting that all scheduled Pyro-PETs (burn perimeter PETs) need to attend Sunday afternoon before the burn.
• Attendance: All Pyro-PETs will attend the Safety pre-burn meeting and get their assignments for the burn from the PET Lead. All Pyro-PETs will work the burn perimeter until the effigy has collapsed and the need for a larger amount of emergency personnel is deemed negligible.
• Radios: Based on equipment supplies, PETs may or may not have radios for the burn. The communications plan for the burn will be discussed at the pre-event meeting.
• Identification: Members of DaFT, Rangers, and PETs will be provided with glowsticks to designate them as such on the night of the burn. PETs will assist the Rangers in maintaining the perimeter around the effigy; politely keep participants without glowsticks from crossing the circle boundary and away from dangerous locations such as pyrotechnics or fire lanes. All scheduled PETs are required to wear their T-shirts.
• PET Location: Pyro-PETs will be assigned to different areas during the burn based on planned activities. Most PETs will be distributed around the fire circle perimeter at various “o’clock” points, and will be responsible for monitoring those areas.
• Emergencies: Any situation needing a PET’s attention will be communicated as discussed in the pre-burn meeting. Patients should be removed from the crowd at the discretion of the PET on-duty and transported, if safe to do so, to the Ranger/PET HQ or some other appropriate place for treatment.
• Fire Rehab: Fire personnel will insure that the burn goes smoothly and safely. PETs should assist Fire Personnel as necessary to make sure they are properly rehydrated and cooled off after the burn.
• Post-Burn Protocol: Historically, the busiest period for PETs during the event is from the time the effigy collapses until 10:00 AM Monday morning. For this reason, every attempt will be made to bulk up staffing during this period. Once the PET Lead has given the ‘PET all-clear’ from the burn perimeter, the on-duty PETs will return to PET HQ/Outpost and assigned staging areas.
Frequently Encountered Situations - REFER TO STANDARD OPERATING PROCEDURES FOR CARE PLANS (TBD)
As stated above, at Burning Flipside any and everything can happen that may warrant a PET to respond to an emergency. Listed below are some of the more frequent issues that have arisen in the past. It will be beneficial if you review some of the basic protocols regarding these issues before arriving at Pyropolis. Remember, if any doubt exists, call for off-site medical transport.
Heat-Related Issues: Dehydration Heat Cramps Heat Exhaustion Heat Stroke
Treatment of heat disorders should involve moving the patient to a shaded, cooler, quieter place where they can rest. Have them lie down with their feet propped up. Loosen tight clothing / open their shirts while respecting their privacy. Have an assistant or a friend fan them gently, and in more serious conditions consider placing cool packs wrapped in a towel to the patient’s groin, neck, and armpits but do not cool them off too fast. If the patient begins to shiver, cease active cooling. Oral fluids, if tolerated, can be administered slowly. A 50/50 mix of sport drink and water will assist with rehydration and electrolyte replenishment. Any patient found unresponsive or showing a significantly altered level of consciousness should immediately be examined for heat stroke. The rule of thumb is that a patient with a temperature higher than 105 is likely to be suffering from heat exhaustion and possible heat stroke. Heat Stroke is a true medical emergency! Any patient suffering from heat stroke should be considered for transport to a medical facility.
Respiratory Distress: Asthma Hyperventilation
Respiratory distress can result from numerous causes minor or critical, therefore any situation involving shortness of breath or difficulty breathing should be carefully monitored, especially if there is no apparent cause for it. Two of the more common causes are asthma and hyperventilation. Asthma is an infrequent, but yet potentially severe situation that can arise. Assisting a patient with their asthma inhaler (if they have one available) can many times help remedy the situation. Move the patient, if safe to do so, to a shaded, cooler, quieter place where they can rest and recover from the attack. Administer oxygen if available. If oxygen is not available, encourage the patient to breathe with their lips pursed. Hyperventilation is the result of not being able to breathe out carbon dioxide due to an increased breathing rate and a decreased respiratory volume. Calm the patient, and help them breathe deeply and slowly if they are hyperventilating. Do not administer high-flow oxygen to the hyperventilating patient, rather consider administering very low-flow oxygen (2 LpM via a nasal cannula) as a ‘psychological assist’. Hyperventilation can be caused by many situations; as a caregiver, seek out the cause that lead to the incident and work with the patient to help avoid that situation again, whether it is overexertion, stress, or some other factor. Consider Sanctuary assistance.
Burns:
Fire isn’t simply an element in Pyropolis, it is part of the community. As such, most of those who choose to involve themselves with it are respectful and mindful of it and will take appropriate safety measures. However, burns will still occur. The first concern in any burn situation is to remove the patient from the source of the burn, if safe for the responder to do so. Minor burns can be treated with burn cream. Any patient with a burn large enough to concern a PET should be considered for medical transport to a medical facility. Sunburn is the other prevalent burn seen out at Pyropolis. Prevention will be the community’s best defense against sunburn. Remember that even though we deal with sunburn every year especially in the summer, it is a heat-related burn, and a potential medical issue. Practice prevention and make new friends by offering sunblock to strangers and encouraging them to take care of their skin.
Cuts, Scrapes, and Lacerations:
All severities of traumatic tissue injuries occur at Flipside. Brush up on your bandaging skills, and wear gloves. Remember in case of steady hemorrhage to stop the flow of blood by utilizing direct pressure, elevation, and indirect pressure to manage blood loss. Any laceration causing venous or arterial bleeding is emergent, and off-site transport should be considered. Simpler wounds should first be irrigated and cleaned as best as possible, then dressed with a sterile dressing with antibiotic ointment applied to reduce infection, then covered by a bandage to minimize the route of potential infection. Assess patient's last Tetanus shot & encourage patient to get a booster if it's been more than 5-10 years.
Sprained/Broken Joints/Bones:
Trampolines, rocky paths, and falls from heights are just three of the numerous potential causes for bone and joint injuries during Flipside. Utilize your best judgment when dealing with these sorts of injuries. At the very least, follow the RICE mnemonic for simpler sprains and twists: Rest, Ice, Compression, and Elevation. Crutches should be made available to patients needing them. Remember that if a patient feels that they’ll be able to ‘make it’ for the rest of the weekend, encourage them to get the injury examined by a doctor as soon as possible. For more serious fractures, consider splinting the injury and off-site transport.
Drug Poisoning/Abuse:
Potential overdoses of any substance are extremely serious and should not be taken lightly by Pyropolis Emergency Team personnel. Poisonings can come from many sources: drugs, alcohol, gases, and byproducts of burning substances can release poisonous fumes harmful to the community. As such, any suspected poisoning or overdose should immediately be considered for off-site transport to a medical facility. When taking the patient’s history, be respectful and ask politely about drug and/or alcohol use. Generally, when treating a patient affected by drugs or alcohol, maintaining their airway, breathing, and circulation should be the top priority. Oxygen therapy may be beneficial as well. Communicating with a patient may be difficult. Encourage them to move to a darker, quieter, calmer location (consider Sanctuary) so they are not over-stimulated by the environment. Talk to them in a soft, quiet voice; calm and reassure them.
Once a patient has been cleared from a medical standpoint, contact Sanctuary. Sometimes a patient will only need some time to rest and relax. If you, as the on-duty PET, believe a patient is stable and just needs some rest, refer them to Sanctuary. Do not leave them alone. Ideally, let them rest at Sanctuary or Ranger/PET HQ and continue to monitor them. Most patients under the effects of drugs or alcohol will have an altered level of consciousness. Many times, however, they will be able to communicate with you to some degree. Any patient with a significantly altered level of consciousness should be watched carefully at HQ until their LOC has improved, especially if that patient has exhibited any violent behavior towards others or themselves. Sanctuary personnel is available to assist PETs at HQ. If there is a question about a patient’s history because they are unable or unwilling to interact with you, consider off-site medical transport.
Head Injuries:
Participants may dive into shallow water or they may fall from various structures and injure their head. Any patient with an actual or suspected head injury should be strongly considered for off-site transport, as there may be bleeding within the patient’s brain. Watch for alteration in the patient’s behavior and mental status. This problem may be complicated further if the patient has recently been taking drugs or alcohol.
Food Poisoning:
Undercooked food is a potential problem at Burning Flipside which may result in food poisoning. Vomiting, diarrhea, or a combination of both at the same time, are typical signs associated with food poisoning. Dehydration secondary to purging vital fluids is of concern, since a patient oftentimes will not be able to keep any fluids down. Initiating off-site medical transport will provide a patient with stronger medications to control their vomiting and also allow them to be rehydrated via IV fluids. Lab studies typically will also be performed to determine exactly what has poisoned them.
Allergic Reactions:
Lots of things share the environment with us at Burning Flipside, many of which do not take kindly to their home being invaded by fire-wielding, music-blaring humans. Because of this, bites and stings will inevitably occur. Bees, wasps/hornets, ants, ticks, scorpions, spiders, snakes and centipedes are just a few of the creatures we can expect to see in the Hill Country. Ticks typically can be removed by tweezers. Make sure you pull the head out of the patient’s skin and encourage them to keep an eye on the injury for infection. Bees leave their stingers in the skin of a patient. Use the flat-edge of a card to remove the entire stinger from the skin. There are participants at Burning Flipside that are allergic to one or more kinds of these creatures, and inevitably they will be bitten. Allergic reactions are perhaps one of the most frequent and unfortunately one of the most serious of medical situations at Flipside. Initiating off-site medical transport is crucial for patients with severe allergic reactions; time is of the essence to insure their survival, especially if a patient presents with shortness of breath or an altered level of consciousness following a sting or a bite. Remove the patient from the source of the exposure if it already has not occurred. Get them to a quiet, calmer, cooler place and prop their feet up. If they have an Epinephrine Auto-Injector (EpiPen) and they wish to use it, assist them if you can. If a patient must use their auto-injector, then there is no question about whether to call for medical transport. The patient requires definitive medical treatment; the effects of their EpiPen will wear off eventually; they need to be taken to a hospital.
Poison Ivy
"Poison Ivy is the new STD" - Lumina Bella
The new land presents PETs with The New #1 ailment. Prevention is going to be highly advertised. But it's still going to be impossible to avoid exposure. Be prepared to handle a lot of requests for help soothing and treating the inevitable rash. We will have specialized products meant to remove the toxic oils from skin and medicated salves to calm the itchy rash. Oral antihistamines are also in the treatment arsenal.
Fires
Contact the Pyropolis Fire Department for any fires encountered, and they will in turn extinguish the fire with their own tools and apparatus or call for help if the fire is beyond their control.
Conclusion
The Pyropolis Emergency Team exists to serve the emergency medical needs of the Burning Flipside community. We will not pass judgment regarding the lifestyle choices of our neighbors in the community. We exist so that in case of emergency, there will be trained, respectful, and competent assistance available.
Appendices
Appendix A: Radio Communications
Radio communication is very important at Pyropolis due to the large size of the property PETs and Rangers cover. Radios are sensitive pieces of equipment, and it can be distressing to try and have a radio conversation in a crowd of people near a fire cannon in a camp that is blasting music from six-foot tall speaker stacks.
Call Signs:
- Khaki - Ranger Shift Lead
- Flipside Actual - LLC member on duty
- Kano - Mark Schade, Safety AF
- BGoddess ('Bee-Goddess') - Lisa Burchett, PET Lead
- Propanus -Karen Horan, Shift Supervisor
- Arnie the Nurse- Andrew Waden Shift Supervisor
- Grim - Samuel Stem, Shift Supervisor
- Pot Roast - Jonathan Nichols, Shift Supervisor
- Doc Schultz- Allen Schultz, Shift Supervisor
- PET 1 - HQ Response Vehicle team
- PET 2 - Outpost Response Vehicle team
- Clinic - HQ Clinic team
To call someone, say: “<Their call sign>, <their call sign again>, <your call sign>”
1. Think about what you’re going to say.
2. Key the mic (press and hold the button to talk)
3. Hold the radio several inches away from your mouth. (don’t make out with the radio)
4. Count two seconds or take a breath (this insures that you entire message will be broadcast and the first part won’t get clipped off).
5. Speak your message clearly and at a reasonable volume. Shouting or speaking loudly will garble the message (see #3).
6. Release the button and wait for a response.
When responding to a theme camp or other location on a call, radio khaki:
a. When you’re leaving PET HQ – ‘khaki, khaki, PET#. Enroute to call’
b. When you arrive on scene – ‘khaki, khaki, PET#. On-scene <give the location/theme camp>
c. If you need 911 activation. ‘khaki, khaki, PET#. We’re going to need an ambulance; call 911.’
d. If/when you’re bringing the patient back to HQ for further evaluation and/or treatment. ‘khaki, khaki, PET. Enroute to HQ with patient’
e. If/when you’re clear of the scene and returning to HQ. ‘khaki, khaki, PET. I’m clear the scene, returning to HQ’
Other radio definitions:
'Off Comm': Turning off the radio and not available
'On Comm': Available on channel / back on channel
'Allcom': Attention, everyone. <AllCom, AllCom, Ghost. Dinner’s being served at the commissary.>
'Break': Everyone cease transmissions and listen/emergency. (typically said three times to insure everyone is paying attention: “Break, break, break: <message>”
‘Over’: I’m done talking and waiting for you to reply. “khaki, khaki, PET. Where was the location of that call again, over?”
‘Out’: I’m done talking and you don’t need to reply/the conversation is over. “khaki, khaki, PET. I figured out the location and I’ll be on scene, out.”
'Standby': Hang on while we handle your request. Monitor the channel and wait for response.
‘20’: Location. Short for police code 10-20 (i.e: “what’s your 20”)
Pre & Post Site Operations use the following fun radio codes:
Whisky = 10-4 (received)
Bacon = Out
Chocolate cake = 10-20 (location)
Other Radio Considerations:
-Radios can be annoying to those who aren’t using them. They squawk, they crackle, they chirp. They import strange bodiless voices from the netherworld. If you’re trying to talk to someone face-to-face, (i.e. a patient) turn the radio down or off.
-Radios can be threatening. Radios occasionally remind people of cops. Don’t let your radio make a bad impression for you. As PETs, the community at large realizes the importance of our radios; however keep this thought in mind.
-Be careful how close your mouth is to the mic; too close and you will be unintelligible; too far and no one will be able to hear you. You don’t need to shout!
-Be patient with the radios. Many times the ambience of Flipside will make hearing radio calls for you difficult. Don’t stay in crowded, loud places for too long if you’re out walking in case someone has been trying to get in touch with you and they try to radio you again.
Appendix B: MedKits and Supplies
MedKits (Optional): It might be helpful to put together a medical kit that you can carry around with you when you’re out and about on the field during your shift. Occasionally a situation may occur where it would be more helpful and convenient to have medical supplies on your person rather than having to walk a patient back to PET HQ to treat them for minor wounds. Kits ideally could be backpacks, shoulder bags or hip packs so it’s not a burden to carry. Here’s a list of some suggestions to stock a personal medkit. This is by no means a list of requirements, so pick and choose based on your kit’s size.
Hard Goods
Flashlight / headlamp
Stethoscope
Blood pressure cuff
Tweezers
Medical tape
Scissors / trauma shears
Digital thermometer with disposable sleeves
Wet Goods
Bottle of Hydrogen peroxide or Rubbing Alcohol
Eyedrops
A large bottle of saline
Sunscreen
Aloe Vera
Poison Ivy wash
Hydrocortisone
Triple antibiotic ointment
Medicines
Ibuprofen
Tylenol
Aspirin
Benadryl
Immodium
Soft / Disposable Goods
Several pairs of gloves
‘Crunchable’ ice packs
2”x2” gauze pads
4”x4” sterile pads
5”x9” sterile pads
Band-aids
Roller bandages (i.e. Kurlex or other brand)
Ziplock bags.
Ace bandages
Appendix C: 2004 Burn Night Summary – An Example of How It Went Down
Several hours before the burn, pre-burn meeting called by Ranger Lead.
In 2004, DaFT wore orange glowsticks, Rangers had green and red glowsticks, and PETs had orange, green, and red.
At the meeting, glowsticks, radios, and station protocols explained / assigned.
Fire perimeter established approximately at dusk, with Rangers and PETs maintaining circle security while DaFT made final preparations for the effigy to burn.
The Procession occurred, with the performance spinners encircling the effigy.
Drums and Chanters performed.
Effigy was lit and burned.
Effigy collapsed.
Fire personnel declared the burn to be safe.
Khaki designates ‘perimeter all clear’ (signaled with intense glowstick or airhorn)
Perimeter security released, crowd allowed to move towards the burn.
PETs return to staging positions to respond to calls throughout city overnight.
Burn Night Celebrations began.
Appendix D: Definitions
Call – generalized term used to describe any situation in which a PET responds to a member of the Burning Flipside community.
Burn Night – The night when the effigy is burned.
Rehab – rehabilitation; a cooling off period after fire personnel have been exposed to fire in which they rest and rehydrate.
Pyropolis – The community created by the participants of Burning Flipside.
DaFT – Design and Fabrication Team; those in charge of constructing / burning the effigy
FRS Radio – “Family Radio System”; a set of channels created by the FCC for public use. Also known as Two-Way Radios. Example: The Motorola Talk-About.
