Words and photos by Meghann Gunther, MTI Contributor
Dumont Dunes are located north of Baker, California and encompass several thousand acres of recreational land managed by the Bureau of Land Management (BLM).
Dumont Dunes are a popular ORV (Off Highway Vehicle) recreation area that attracts dune buggy owners and others both California and Nevada. During one recent holiday, I had the opportunity to help staff the EMS operations which included Fire, Paramedic and Law Enforcement resources.
On my first day our team met up in Nevada near the border of California about an hour away from Dumont. It was one of the closer towns which had hotels and places to grocery shop. It would be our home base for the next week. The next morning we all headed out to the dunes. Our first two days were relatively quiet since it was early in the week. We used that time to set up our Command Post and organize gear. We brought in a medical trailer that would act as our on site clinic, a place to store our equipment, and do meal prep for the long shifts ahead of us as the weekend approached. Our main transportation out on the dunes was a Sand Rail, equipped with tires and the power to maneuver on the sand and set up with a mounted Stokes basket to extract patients. These first two days were also an opportunity to meet and brief with the BLM Rangers and local County Fire Department that we would be working alongside during the holiday weekend.
Recreationalists were arriving with their trailers and sand toys, like quads, dirt bikes and all terrain vehicles or ATVs, as early as Wednesday. They continued to pour into Dumont through Friday at all hours of the day and night. An estimated 40,000 people were out playing on the dunes during the holiday weekend.
During the weekdays we had one or two people walk into the mobile clinic with minor medical complaints. But once it rolled into Friday and Saturday our teams responded to multiple trauma calls out on the dunes. These calls involved single vehicle rollovers, and significant crashes involving multiple vehicles and multiple patients.
Some of our most complex calls happened between midnight and 3AM in the morning on Friday and Saturday.
A major challenge of running EMS calls on the dunes was finding the patients, especially in the dark. Everything looked the same once the sun went down. All vehicles driving out in Dumont are required to have both lights and flags, and at night it turned the dunes into a giant moving carnival.
It was chaos with such a large number of people riding around in a concentrated area at all hours of the day and night. During the day it was super dusty with so many riders. Any wind added to the challenge. At night, thousands of fast flashing lights zoomed in every direction. We had diligently avoid collisions when out on patrol or on patient calls.
Over Friday and Saturday we flew a total of five patients out of Dumont on air ambulances with paramedic flight teams.
The first set of air ambulances were called in for two patients, a brother and sister, injured in the same vehicle crash. After initial response and extraction from the crash site, we brought them to the Command Post where the Paramedics continued extended field care. All the medical folks present worked together as a joint team in the care of the two patients who received additional splinting on injured extremities and treatment for secondary injuries, IV’s for saline and pain medicine while waiting for the Airvac. Both patients were immobilized on backboards and Stokes baskets for their injuries and spinal protection.
For my team, field care included locating patients, determining the extent of injuries, stabilizing life threatening wounds and extracting them. Extended care happened at our Command Post where we had a little more of a controlled space and additional medical equipment at our disposal. Our goal was to get them off the sand dunes as soon as possible, back to a more controlled environment and packaged up to get flow out to higher care as quickly as we could.
Another call we responded to involved one ATV that rolled over on a slope at a fast speed with two adults and two children inside. When I arrived on scene, with the other medical and law enforcement resources, I was assigned to do a head to toe assessment on the two little girls who had been riding in the back seat. Thankfully they had been wearing the correct sized helmets and had been in five point harnesses. They were a bit shaken up but not injured. Both were alert and oriented, able to answer all my questions, didn’t have neck or spinal pain and overall were quite calm and brave! It was a good learning moment for me to take my time to do thorough assessments and watch the response of my patients.
In EMT school we were told to remember to treat the patient, not get fixated on the number for vitals and such. In order to do that you have to take the time to watch how your patient looks, how they are answering questions and responding to an assessment, especially on their neck and back after a significant roll over like this one. After my assessment, I sat down with them in the sand and we talked about their weekend, and how they liked the dunes while law enforcement talked to their parents. We talked about how Dumont reminded them of Egypt and how the sand dunes kinda looked like waves you could surf. I was reminded that patient care isn’t only about making sure the numbers are normal and nothing is broken, it is also about connecting with people, being compassionate, kind and remembering to be human.
Our largest call involved five ATVs and six patients. There were four ATVs sitting on the top on a dune ridge and a single ATV came over the top without seeing them, and crashed into them, rolling down the other side of the hill. One patient had significant injuries, including a broken elbow, and she was flown out on an air ambulance. The driver of that vehicle was limping slightly but refused to be checked out by the EMTs, stating he was fine. We recommended that he get assessed but we couldn’t do anything for him since he refused care.
Our two man EMT team had split up to assess and treat all the folks who had been involved in the crash. We each had BLM Law enforcement officers with us. My partner splinted and swathed the broken elbow and transported her back to the Command Post to get flown out. I was driven to the top of the dune by one Ranger to check out the folks that had been run into while sitting on the top of the dune. When I first arrived on scene there were four guys sitting on the ground, upright but holding bandannas to the back of their heads.There were an additional half dozen or so people standing around in a large circle. At first I was overwhelmed, I didn’t have a partner with me, he was treating the lady down the slope, it was dark, chaotic and there were a lot of people in front of me along with several overturned ATVs! But I saw that everyone seemed mobile and alert which was a really good sign.
They had been sitting inside the vehicles when struck which saved them from significant injuries. The four guys sitting on the ground had goose eggs on the back of their heads. Several had small scalp lacerations and a little bit of bleeding. I went through a blood sweep, and spinal assessment on all of them looking for major injuries. They all were alert and oriented, not showing signs of concussions or Traumatic Brain Injuries. Despite having a large group of patients to assess by myself, thankfully there were no major injuries. None of them needed to be transported or required a level of higher care.
The seven days I was out in Dumont was jam packed with learning, from how to set up a mobile medical unit, meeting and working with other medical providers, interfacing with a large number of the public, experiencing sand dunes for the first time and so much more. It was an opportunity for a lot of patient contact, running through assessments and providing treatment in an austere environment. It was a great space to serve, gain experience, and sharpen my EMT skills. The Dumont Dunes are an incredible place and I am grateful for the opportunity to have spent time there. I took away valuable lessons and look forward to running EMS operations there again.
Meghann is a full time wildland firefighter in California.