Out in the open: Wilderness Emergency Medicine training

Posted: March 30, 2012 by None Smith in English, Training
Tags: , , , , , , , ,

A happy patient!

In the larger scale of American emergency medicine, First Responders are quite low on the totem pole. Here in the United States, the general order from least trained to most is: First Aid, First responder, Emergency Medical Technician – which is then divided into EMT-B (basic) and EMT-I (intermediate). Above that you have your Paramedics, Medical Directors etc. Learning any type of emergency medicine however is a crash course in seeing the world differently. Cuts, wounds, a broken leg, how people injure themselves; it all takes on new life. Instead of seeing an accident and saying “Oh My Gosh!” you begin to say, “Cool. How can I help?”

Wrapping a hypothermic patient

Wrapping a hypothermic patient

Wilderness Medical Associates hosted a fantastic 8-day class at an Outward Bound house in northern Philadelphia, PA. The two instructors, Brian and Carl, were a plethora of information and balanced each others personalities quite well. Plus, we learned a thing or two about how to save someone’s life.

For eight days we ate, drank, slept, breathed and literally lived in a world of Wilderness Emergency Medicine. Breakfast at 8, with everyone in the class, class from 8:30 until 6pm, then dinner (again with everyone) and then study time. Study time was going back to our seats in the class room, discussing what we learned, asking questions, and throwing ideas around about different scenarios. During the day we learned the technical aspects and applications to treating and figuring out various symptoms. At night we discussed situations and how these technical aspects would apply. We began to get creative. We began to contemplate wilder and stranger situations. We learned some pretty important lessons through it.

The first: Medicine is always changing and there is no ‘never’ and ‘always’. What might work for someone, might not work for someone else. That being said, not every question has a permanent answer. The answer may change with the context.

With that, we learned about questions that cannot be answered or are unexpected. It was presented in this way.

Instructor: “If you hear hooves running behind you, when you turn around, what do you expect to see?”

Class: “A horse.”

Instructor: “Nope, it’s a zebra.”

Basically saying that not all questions will give you the answer you expect. We had a lot of “zebra questions” throughout our class.

In the end, we learned our 6 protocols for what we’ve been trained to do, and how to do it well. We learned how to deliver certain medications for pain, anaphylaxis and asthma. Spine day seemed to have made quite an impression on me as I had a dream last night that someone got into a fight and I had to “clear” his spine to make sure there were no injuries to the spinal cord.

For anyone that goes on hikes, works outside, has kids or simply is interested in emergency medicine, there is no better company than Wilderness Medical Associates. Everyday we learned something new, the instructors were honest about their knowledge base, and they took all of our questions seriously – including the zebras.

Now it’s up to us to review the information in months to come and make sure it’s fresh in my head. Unfortunately, as with many things, if you don’t use it, you lose it.

I’ll end this post with some quotes I wrote down in my notebook from the instructors. Whether odd, useful, or funny – they all have their place!

“As long as we’re eating and breathing, peeing and pooping; life is good.”

“Despite all our best efforts, good intentions and right decisions, some people just die.”

“Everybody gets one free puke. After that, it’s serious.”

“Repeat after me, ‘I will never, ever, ever, give anyone, insulin. Ever.’ It can kill even the most healthy person.”

“If you learn anything from CPR, remember one thing: Pump Hard, Pump Fast.”

“Treat what you see, do what makes sense.”

“A lot of what we’re teaching you isn’t only for being out in the wilderness. It’s just good medicine.”

“At the same temperature, water takes heat away from our bodies 25 times faster than air.”

And Lastly, one of the more important things our instructors said. It applies to just about any situation whether you’re in emergency medicine, corporate management or making life decisions.

“Do the best you can with what you got.”

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