The Rio Negro sits about a mile from our classroom and is one of our favorite spots for running extended scenarios. After lunch today, students packed up oxygen tanks, oxygen-delivery supplies, survival packs and jump kits (filled with materials needed to initially manage airway, breathing and circulation emergencies) and hiked down to the river.  As promised, they needed to assess and treat patients while setting up for an overnight in the forest.  The underlying assumption for most extended scenarios is that outside help is at least a day away, and that, if it arrives, it may not provide the type of assistance you might expect in a front country emergency in the US.  We stress self-sufficiency and train our students to expect an unexpected night out with a very sick patient.  It is one thing to assess a patient in a sterile classroom and quite another to do so on a rocky streamside shared with biting ants, tree frogs, river debris and the potential for more venomous creatures under anything you move.   There is no substitute for these learning experiences.   

Of course, between scenarios, swimming, wildlife watching and general levity are highly encouraged!