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.

End of Week One!

We hear Missoula temperatures are -20 today.  It's 110 degrees hotter here, so we are taking advantage of the river to run scenarios, have lectures and generally cool off.  It's been a full week of patient assessment, learning about head trauma, spinal immobilization and airway adjuncts.

 

This is an amazing group, full of great energy and enthusiasm.  Everyone is healthy, and we are looking forward to a well-deserved first weekend, which for us starts tomorrow.  Most students plan to catch up on their reading, look around at the forests and relax while making sure to complete a large take home exam.

 

Expect more photos on tomorrow's post!

 

First Day of Spring Semester 2014!

Everyone is here, happy and healthy!  We are settling in to the Ranch, the great food, the amazing people, and the heat.  Today was a full day of introductions, a hike to the local waterfall, risk management strategies, and taking baseline vitals.  From now on, students will arrive at the classroom at 6:45 am, take vitals, have an hour of class, take breakfast from 8 to 9, then return to class until 1pm.  The afternoons have lunch until 2 and then class until 5 pm.

The goal of the program is training outdoor leaders as not "just" wilderness medicine providers, but professionals capable of preparing for and preventing emergencies, navigating through the backcountry, stabilizing potentially dangerous backcountry scenes, treating patients and managing complex evacuations.  It's a very full 10 weeks.  The fact that we get to do this in the beautiful Costa Rican rainforest as well as the snowy mountains of Montana is thrilling, and we are looking forward to the next 2+ months!

Stay tuned for more updates, which will hopefully happen on a daily basis if the internet connection holds out.