Getting Geared Up for 2014!

2014's Spring Semester in Wilderness Medicine officially begins February 1 in Costa Rica, but we're getting ourselves ready as we speak.

Below are views from some of our classrooms in Montana and Costa Rica.

Contact us at info@aeriemed.com if you are interested.

Vehicle Extrication and Cadaver Lab

Last week ended with quite a flurry of in-town activity.  We started with a great vehicle extrication course at the Missoula City Fire Department's Station 4.  Paramedic-Firefighter Charles Talbot was incredible at getting our students into the middle of everything in order to better understand the process of extrication, both its dangers and advantages.  

From there, we headed over to the University of Montana for anatomy and physiology review at the cadaver lab. EMT and UM faculty Heather Labbe took our students through an amazing practical overview, helping them see the connections between A&P and the signs and symptoms they are training to find.

This week is ending with tons of scenarios in Condon.  For the next two days, students will complete their clinical rotations on the ambulance and in the ERs.  They return for a final push:  our last week of the program!  For family and friends, we are having an open BBQ on Tuesday, April 9th at the Northwest Connections Beck Homestead, from about 3-5 pm.  We will have movies from the course, photos and a graduation ceremony.  All are welcome.

Aerie students as high school teachers

Fresh off their snowy backcountry trip, the Semester students looked like they could use a new challenge. Time to raise the bar.  Yesterday, the Aerie crew spent the day with three busloads of high school students. You heard right: our soon-to-be EMTs paired up to teach wilderness medical skills to over eighty 9th graders from Big Sky High School's Health Sciences Academy.  The day turned out to be an outstanding learning opportunity as well as a community service and outreach experience. 

Max and Katie taught bleeding control and wound management, so of course they needed some gore to spice things up.

David and Tyler P passed on some techniques they learned from Brad Bennett about moving patients under fire.  They added a special twist and turned the whole thing into a race.

David and Tyler offered each group the opportunity to haul the Big Sky teachers around in an improvised litter.

Nami and Max pose proudly with their pupils, who in turn proudly display their improvised splints.   The group learned how to immobilize lower arm and lower leg fractures.

Trenton and Clay offered Community CPR instruction as well as a tutorial in the use of AEDs. The students discovered their school has two AEDs; most had no idea what they were or where they were located and were surprised to learn how simple they are to use.

Dara (our Semester intern) helped teach stations as well. These students of hers perfected the art of a two-person carry.

Special thanks to Bob Vandenhoevel with Missoula Emergency Services who also taught stations during the day. Bob brought in his experience as a flight medic when he threw one eager group into a mock lightning strike, instructing them both in the Incident Command system and in signaling systems for helicopter rescues.

Back from Avalanche Training!!

Everyone is back from their five-day trip in the snowy mountains.  We had amazing conditions; it snowed over 2 feet during our stay at the yurtski area as the students completed three days of intense avalanche training.  Program coordinator Andrea Stephens joined instructors James Pyke and Josh Olsen for this training, which included instruction in snow science, avalanche forecasting, beacon use and emergency care of patients caught in an avalanche.  The overall focus was avoiding avalanches and preparing for a response in case they do occur.  We couldn't have asked for better weather, instructors or students.  To boot, we saw fresh grizzly bear tracks at the lower elevations, a sure sign that spring is almost here.

Traveling above the yurts to get into good terrain for avalanche training

Perfect conditions for avalanche training

A perfect bluebird day for our trip out

Caring for a victim of an avalanche

A tent covered in snow.

Winter Updates

Semester students have spent the last few days familiarizing themselves with the area, including snowshoeing on a dwindling spring snowpack, navigating with map and compass, and using the snow as building material.  Medically, they're focusing on cold injuries, hypothermia, and altitude sickness.

Everyone has been experimenting with a variety of fire starters, including this handful of pitch, lichen, and twigs.  They discovered the lichens don't burn well at this time of year because of the high humidity, and that the pitch will do well only once a pretty sturdy fire has already been started with other material.  

These guys are planning out their route indoors on the warm floor (in-floor heat!)  before heading out into the field.  

Stream crossings can be tricky at this time of year, so it's helpful to find big, fallen trees to use as travel corridors across the water.   

Snug inside a winter survival shelter constructed with snow and tree boughs.

Video

A quick synopsis of the students' activities so far.  See what you think!

http://youtu.be/g22TVnsc2FU

Montana

It's hard to believe that the last time we got together it was 90 degrees with 90 percent humidity.  Students today are wearing snowshoes, working their way around the Swan River as they practice making fires, building shelters and reading North American maps.  The mountains you see below are the Swan Mountains, forming the western boundary of the Bob Marshall Wilderness.  If you turned 180 degrees, you would be looking at the Mission Mountain Wilderness.  

In seven short days, everyone is packing up for a five-day ski trip into southern end of the Swan Mountains, where we will hold our avalanche training.

Back in Montana!!

After a very full month of training in Costa Rica, everyone is back in Montana and meeting this evening in the gorgeous Swan Valley.  We are so fortunate to have this group.  As promised, we are going to start getting some higher resolution photos on this blog as well as some videos.  Here are some of last photos we took at Rafiki, mostly of our day of river scenarios as the students floated the Savegre and encountered patients along the way.

Swiftwater Rescue Training on the Savegre River

Halfway through a full day on the river with Frank Preston of the Whitewater Rescue Institute.  What an amazing educational experience.  Students are learning to read water, to use throw bags, to swim after unconscious victims, all while getting a very first-hand sense of moving water's unrelenting power.  We have some more great videos to add to the blog once we get back to Montana and have access to faster internet connections.

More Rafiki

Three days of extremely intense days of training along the Savegre River that focused on trauma assessments and hemorrhage control.  Now we are transitioning into four days of swiftwater rescue training.

Rafiki

We are packing up here in Mastatal and heading to Rafiki lodge for some tactical medicine and swiftwater rescue training.  Dr. Moore left this morning after an amazing two-day clinic that included house calls to the local communities.  Dr. Brad Bennett arrives in Costa Rica this afternoon and will meet us at Rafiki.  Brad is an internationally-recognized authority on the most recent developments in bleeding control and an authority on heat illness.

We are very sorry to leave the wonderful people of Mastatal.  They have treated us so well!

Clinic Day One

Yesterday we had the first day of our free health clinic.  It took place at a community building in the indigenous community of Zapaton, a few miles from Mastatal.  

The clinic is a chance for students to offer some of their new skills to the amazing people in this area, and also where they begin understanding service from a health care perspective.  EMTs are trained to serve, whether that is a child with a fever or a victim of a car accident.  The responsibilities of an EMT are significant, and real-life opportunities such as this clinic give our students an invaluable opportunity to prepare for those responsibilities while helping people in need.

Mothers show up with their children, grandmothers with their grandkids, high school students  arrive after school is out.  Under the guidance of our medical director, Dr. Greg Moore, students get to assess a wide range of patients and complaints.  

It's a great learning experience, one that we never forget.  

End of the Last Week in Mastatal

It's hard to believe, but our last week in Mastatal is ending.  We have been pushing the students particularly hard, and they deserved a little surprise break.  On Wednesday, they prepared for an extended overnight scenario in the forest.  With all of their medical and rescue supplies, they dutifully hiked into the night.  They were told to build a big fire, which they accomplished with their survival kits and skills.  Then they were told to come get the bodies, which turned out to be some wonderfully marinating steak that our Argentinian-native instructor, Fernando, had prepared for everyone along with his homemade sausages.  The relief was palpable.

But brief.  The next day we resumed in earnest with a prolonged scenario by the river.  There, students found a bloody rock in the stream, which led them to screams up river, which brought them to a patient with a profuse arterial bleed (post machete) and another with a serious head injury.  The students moved their patients out of dangerous positions, stabilized their wounds, set up shelters, built fires and prepared for the night.  They confirmed their locations with map and GPS. All while it was pouring rain (a good reminder that although this is the dry season, we are in the rain forest).  

The next day (yesterday), we elevated the tension a bit further.  Keeping to our promise of offering increasingly challenging and complex scenarios, the students were alerted during their breakfast that they were responding to a mass casualty incident.  They gathered their scant supplies and prepared, knowing no other details.  

It's funny to see good plans and preparation stutter and adapt to unexpected situations.  That is the life of a competent EMT and something we train for at Aerie.  You will never see it all and will never stop taking what you have learned and using it to handle the crisis at hand.  This crisis happened to be school full of elementary-aged students and their cook that were all exposed to toxic levels of carbon monoxide.  Our students were expecting English-speaking adults in a wilderness setting, but they regrouped and managed the scene amazingly well.  Almost every EMT has at some level a base fear of pediatric patients.  Nobody likes to see children hurt.  Parents, other caregivers and witnesses are often frantic.  And suddenly all eyes are on the EMT to make things better.  Add language barriers and the difficulties increase exponentially.  Our students moved their patients to safe ground, triaged and cared for all 11 while arranging for immediate evacuation.  

Of course, we are working with scenarios.  And while these are some of our most powerful teaching tools, they have their limitations.  A completely unique aspect of the Semester is the real-life clinical time students experience during the program.  And, starting Monday, they will set up and run a free health clinic in the local indigenous community of Zapaton.  Our medical director is arriving tomorrow to help us set this up.  During the clinic, students will assess dozens of local children, parents and grandparents, communicate their findings to the doctor, and then watch and learn as he assesses and manages the patients.  The days conclude with round-table discussions of patients, their histories, physical exams and diagnoses.  We can't wait!