Spring Semester in Wilderness Medicine Blogs

On the next few pages, you will find daily and weekly posts from our Spring Semester in Wilderness Medicine, which takes place in Costa Rica and Montana.  Enjoy looking through these as you gain a better sense of what we do every day, and let us know if you have any questions.  Direct questions to info@aeriemed.com

Night Scenarios

The last 24 hours have been epic.  Students were on-call all last night, preparing for unknown calamities after being told to expect anything from 5 pm until 5 am.  They gathered survival, navigation and first aid supplies and waited for what turned out to be childbirth at 8pm and two victims of carbon-monoxide poisoning at 0430 this morning.  

Two Roads to Canada

We all arrived in Montana and are enjoying the snow.  Jack and Belinda Rich welcomed us to the Rich Ranch and told us, "there are only two roads between here and Canada, which is a few hundred miles to the North."  It's great being in wild country in the winter and hard to imagine that a week ago just touching a vehicle would burn.

Semester Coordinator Andrea Stephens taught navigation and gave an introduction to winter safety, including a talk about wild animals.  We have grown accustomed to walking through the rainforest with our heads down, searching a perimeter just a few feet in front of us, looking for snakes.  Now we need to look up and adjust to new search images that include lions, bears (which will start emerging from hibernation later this month) and avalanches.

Back in Montana!

No new pictures on this post.  Imagine a lot of snow and you have the idea!

We are gearing up for our first day of class next week at the Rich Ranch in Seeley Lake.  We'll start posting again when we get up there.

Last Day in Costa Rica

Swiftwater training wraps up today.  Cody taught students how to swim in rapids, to rescue unconscious swimmers and to set up rope-rescue systems with mechanical advantage.   After a full day of class today, students will have a short night and leave on a shuttle to San Jose and the airport at 0200 tomorrow morning.

Then we head back to the snowiest winter Montana has seen in years.  It's hard to imagine that now as we sit in 95 degree heat, under a full sun that is high in the sky most of the day, and 100% humidity.

Swiftwater Rescue at Rafiki

Bandwidth is scarce around here and students are lining up to use the internet, so this will be brief.  Swiftwater rescue training here goes very well.  Everyone is happy.  It's beautiful!  

Rafiki

We arrived at Rafiki Safari Lodge yesterday afternoon.  What a beautiful spot!  Dr. Moore headed back to Montana.  We loved our time in Mastatal, loved the people there that made our stay so enjoyable, and are also excited about the next step in the program.

That next step is swiftwater rescue technician training.  Cody Harris arrived to teach that.  He is a world-class kayaker and swiftwater rescue instructor.  Today, students are learning how to read moving water, how to organize a river rescue and how to plan for care of a drowning patient.  Then, following a routine they now know well, they will get out and start practicing. 

Clinic

During the last two days, students worked with Dr. Moore and volunteers from the Ranch to organize and offer a free health clinic.  They assessed dozens of patients, most of whom walked a significant distance to get this care. It was an incredible experience, allowing students to see many of the illnesses they have been reading about in their texts, and it bookmarks the end of our time in Mastatal.  At 1100 today we get on a bus and head to the Rafiki Lodge.  It's about a three hour trip.  Three days of training follow there on the beautiful Sevegre River, during which time students will earn their Swiftwater Rescue Technician certifications from Aerie instructor and owner of the Whitewater Rescue Institute, Cody Harris.  

Last Week in Costa Rica

We are charging through our last week of class in Costa Rica.  Yesterday we completed instruction in management of geriatric patients and spent the rest of the day down at the river rescuing a climber with suspected rhabdomyolysis who had been hanging in his climbing harness for 24 hours, treating a marathoner with heat stroke, and getting a drowned patient out of a shallow river crossing.

Last night our Medical Director, Dr. Greg  Moore, arrived.  He'll be with us for three days sharing knowledge from 35 years of emergency medicine and 10 years of travels with us to Costa Rica.

Sunday

It's a relaxing day-off.  The Ranch folks slaughtered a pig this morning and that will be a big part of our meals for those interested or so inclined.   The pig will also provide good A&P review, particularly for respiratory and cardiovascular anatomy that are hard to visualize, even with decent photos.

Some students headed to a nearby field to play soccer/ football.  Most are staying close to home, completing a 200-question take home exam that is due tomorrow.

MCI day

We think it's safe to say that Semester students get more practical scenarios than most paramedic students completing a year of training.  Today was a good example.  They started the morning responding to a fire at an elementary school, where they had to assess, triage, move and treat 12 students that spoke only Spanish.  Then they went on to manage individual patients having asthma attacks, anaphylactic reactions and chest pain from heart problems.  They finished the day learning about childbirth.  At this moment, most of them are out on the soccer field, playing with the local residents, and blowing off steam after an intense week.

Close to the end of the last full week in Mastatal

Amazingly, we are almost done with our time in Mastatal and most of the EMT curriculum.   We reviewed drowning and high-altitude illness today and had a full course of scenarios.  As the program continues, we'll have more and more complicated scenarios that integrate wilderness skills with wilderness medicine.

Tomorrow is a huge day of scenarios.  In the off-chance that some current students are reading this blog, we wont reveal the nature of the problems, but they will be extremely challenging and a great way to finish the last week here.

Another disaster in paradise

Well, good luck isn't in the cards for people around us.  Today a car with two passengers ran into a bicyclist wearing a climbing helmet (note to all worried parents and friends: this was a scenario).  Luckily, more than a dozen well-trained WEMT students were eager and available just down the road.  Everything ended well, with patients getting secured to backboards, administered oxygen, and transported to local hospitals.  Then everyone went for lunch.  

We expect and hope for more of the same fortune tomorrow.

More Scenarios

Today students learned about diabetes and other causes of altered levels of consciousness.  Then they headed to the river for hours of scenarios.  These included managing four injured patients, moving them through hazardous terrain, setting up a shelter and making a fire for an overnight stay in the rainforest.

Tomorrow we cover seizures and syncope and head out for more scenarios.

Sneak-Peak

Try this one as well!

video

Try this quick video out to see what we are up to (warning:  it's corny!)

More Scenarios

A great day of scenarios, stations and lectures.  Fernando taught our group how to build fires in the rainforest, a skill they quickly applied to afternoon scenarios.

 The group remains strong and motivated and we look forward to the rest of our time here.

Monday February 10

Another full day in the tropics.  Students practiced extricating patients from inside and under vehicles, learned how to clean wounds, manage burns and prevent blisters.  They learned how to splint with conventional supplies and to improvise with various materials they might carrying camping or have with them traveling.  They also had instruction in more knot tying.  They are putting more and more of the skills together in scenarios, making those more realistic and challenging.  Today was also "chocolate day", when the owner of a local organic chocolate farm brings fresh chocolate of various flavors, cookies and banana bread.  Not too shabby.

Tomorrow starts with a big written exam, which has everyone studying.  An average night has 50-100 pages of EMT text to read and practical scenarios to prepare for, so any notion of a relaxing vacation in Costa Rica left on day one!  It's always beautiful here, though, with amazing flowers, birds and other wildlife, so when students do get a well-earned breather, there is plenty to see and do.  

We will also be heading to the river tomorrow for more scenarios and another chance to cool off.  Some poor, innocent tourist/ guide/ fill-in-the-blank person will come close to their untimely end and, amazingly enough, will be happened-upon by a group of highly trained, motivated and capable EMT students with nothing better to do than jump in and help.  More on that tomorrow.

"Day Off"

It's Sunday.  We had an abridged class today:  two hours of bleeding and shock, with instruction in pressure wraps, hemostatic agents and tourniquets.  It's been raining a bit, which for Aerie means "get out and take advantage of it", so we've been practicing protecting people from environments.  You might not think that you can get hypothermic in the tropics, but combine driving rain, wind and an immobile, injured person, and you have the perfect combination for cold patient.