Sunday, February 24, 2013

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.








Saturday, February 23, 2013

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.












Wednesday, February 20, 2013

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!

Tuesday, February 19, 2013

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.  






Saturday, February 16, 2013

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!

















Wednesday, February 13, 2013

Wednesday, Week Three

Survival Kits, Fire Building, Emergency Shelter Construction, Litter Construction

It's been another very intense week here in Mastatal.  Students continued adding to their medical, rescue and survival skills.   Training at both ends of wilderness and urban care, they started the week by caring for a patient injured by the river, constructing a litter, carrying her across the river, setting up a shelter, making a fire, finding their location on a map and with a GPS, organizing an evacuation and then hunkering down for a night in the forest.  Later that day, they changed hats, caring for patients with chest pain in town by administering oxygen and nitroglycerin, talking to medical direction via radio, and coordinating with an advanced life support ambulance.  

Today we are concluding our review of medical emergencies and officially beginning with discussions about trauma, including injuries to the head and spine.  Tonight is a surprise night scenario followed by a BBQ!

Internet coverage has been exceedingly slow, but we will continue doing our best to post whenever we have the chance.  















Friday, February 8, 2013

End of Week Two

Each day, students add to their rescue and medical-skills repertoire. Today they learned to build a variety of litters, found patients using a combination of map, compass and UTM coordinates, took a break to swim under a beautiful series of waterfalls, moved a patient out of very thick jungle undergrowth, reviewed cardiovascular A&P and cardiac emergencies, and assessed a number of patients along a local trail.  

We have now completed our second week.  This weekend, some students are heading in to the local big town, Puriscal, for some much-needed sightseeing and shopping.  Others are helping out the Ranch with their amazing agro-forestry projects, and all are working to catch up on reading.  Although we have just begun, we really only have one full week of class here in Mastatal.  After that, we are running our clinic and then heading to Rafiki lodge.  There, students will meet and learn from one of the leading experts on tactical medicine, Dr. Brad Bennett.  With him, we'll review the latest developments in hemorrhage control, including tourniquets and hemostatic agents.  Then we have three days of intense swiftwater rescue.  And then we return to Missoula and immediately ski up to some high-country yurts for avalanche rescue training!

Everyone remains happy and healthy!










Wednesday, February 6, 2013

Day Eight


Students are preparing for their first set of practical examinations, which will occur tomorrow.  Everyone is healthy and working hard.  We have some very cool videos from river-rescue scenarios that we ran yesterday, but the internet connection has kept us thus far from posting these on the blog.  We'll keep trying.

The pictures above are generally looking North, over the football field, towards la Cangrega National park, which borders the Ranch's property.  

Saturday, February 2, 2013

First Day Off

It's the first day of the first weekend.  Classroom gear is stored neatly, quietly awaiting the next scenarios.  Last night, students used the digital projector in the classroom to watch movies and finally catch their breaths.  This morning they are completing a major take-home examination and then have the afternoon to begin exploring some of this area's beauty or catch up on reading (most are doing both).  

Please feel free to post comments on the blog and to share the address with anyone interested in following the semester's progress.  






Friday, February 1, 2013

February 1

We are using each other as human canvasses to review cardiac anatomy and conduction system (middle photo).  The discussion was so interesting that a beautiful flycatcher sat in for some continuing education (do we need to say which photo that is??).  Students are also learning how to ventilate patients with a bag valve mask (bottom photo).  Today will continue with CPR, automated defibrillator use, more knots and more navigation practice.   And then off to a well-earned first weekend!