Aerie's Semester in Wilderness Medicine

Weekend Update

2012-02-11T07:14:00.000-08:00

There are strong rumors circulating of an Ultimate Frisbee game, Aerie vs. the Ranch. But, game time is about a minute away and we don't see anyone on the field, so this may have been a bluff.

Instructor Andrea Stephens arrives today from Montana. Andrea coordinates the Semester and here is responsible for instruction in route finding, including GPS, map and compass, and basic celestial navigation. She will be with us for the rest of the Costa Rica section and continue the instruction in Montana. Not surprisingly, navigating in the Costa Rican rainforest is different from finding your way in MT. First of all, there is almost declination here; magnetic and true North line up fairly well, particularly for gross-navigation. Missoula's declination is about 17E. Another significant difference is angle of the sun off of the horizon. Right now in Montana, the sun is LOW is the Southern skies throughout much of the day. Here, at 9 degrees off the equator, the sun is straight up throughout the late morning and early afternoon. It takes some adjusting to get your bearings. Finally, bushwhacking takes on an entirely different meaning in the rainforest. The undergrowth is thick, many of the shrubs and trees are thorned, and quite a few of the forest denizens are venomous. In Montana, we think of megafauna, concern ourselves more with the significant distances to care, and generally can find open vistas and routes to follow.

Andrea will prepare our students for these variables within the context of caring for injured and sick people. It's going to be fun!

End of Second Week

2012-02-10T20:08:00.000-08:00

It's hard to believe that our Costa Rica time approaching its mid-point; that is, until we look at what the students have worked through to date. Over the last few days, we have reviewed neurologic emergencies, diabetes and anaphylaxis. Today began with a tour through things that bite, sting and otherwise cause skin irritations, at the end of which everyone was scratching and generally feeling like hiding. To improve spirits, we headed back down to the waterfall for an afternoon of extended scenarios. Students found patients floating in the water and had to safely extricate them to shore, set up emergency shelters and plan for the night out. Moving an unresponsive adult out of a deep river and carrying them over slippery rocks is incredibly challenging on its own. Add to this the need to protect the patient's spine from movement and your own feet from the environment, and this becomes an ever-more challenging exercise. The keys to success are clear communication and leadership. We practice this every day, adding and refining skills, preparing our students to provide care in any environment.

2012-02-07T19:51:00.000-08:00

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!

First Day of Week Two

2012-02-06T20:36:00.000-08:00

Another beautiful sunrise this morning. Today was our hottest to date.

Class today included a full morning of anatomy, physiology and pathophysiology, followed by a review of pharmacology. We increased our knot repertoire, reviewed last Friday's exam, and practiced clearing airways when no formal suction equipment is available.

As a reward for an intense day, we head down to the river tomorrow (after discussing cardiac and respiratory emergencies) for extended medical and survival scenarios that will combine most, if not all, of the skills learned to date. Although the students don't know it yet (they wont be reading this blog until tomorrow night!), they will have to assess multiple patients with chest pain and difficulty breathing, make shelters, build fires and set up for a night out with very sick patients in the rain forest. There is nothing easy about these scenarios; neither are there any quick fixes. Sick patients require ongoing, accurate assessments, stabilization and evacuation. However, evacuations are complicated and strenuous, putting rescuers and patients alike at risk. It should be a great day for learning!

End of First Week

2012-02-04T14:39:00.000-08:00

The week ended an introduction to oxygen administration, artificial ventilations, suctioning and CPR. In addition, we had more knot work and survival shelter construction. We concluded the Friday with an exam. Instructor Trenton Harper flew home today (Saturday). Andrea Stephens arrives next Saturday.

On our first day off, most of us hiked to the Rio Negro, about a half an hour from here, and swam. A few are gathering as we write this to challenge some other people to a game of Ultimate Frisbee. We are all eating at the local (and only) cafe in town tomorrow evening, watching the Super Bowl and generally getting ready for next week. The week will begin with lengthy scenarios down by the river and instruction of anatomy, physiology and pathophysiology.

February 2

2012-02-02T13:15:00.000-08:00

Fire construction went well yesterday, with no burned hands and lot of small fires.

Today, students are adding a knot (trucker's hitch) and using it with other knots to set up survival shelters. We also completed our initial instruction on patient assessment, documentation and communication. Tomorrow we have CPR, automated external defibrillator (AED) use, oxygen administration, use of mechanical ventilation and suctioning, in addition to more emergency shelter construction and knot use. Scenarios to date have been local and fairly brief. Extended scenarios start in earnest next week, when students will take the skills learned this week to find and stabilize patients, set up shelters for the night, and plan for prolonged evacuations.

The daily routine here starts with breakfast at 7 am. We typically have eggs, fresh fruit, good Costa Rican coffee with local milk and fresh muffins or pancakes. We then meet across the road in the classroom at 7:50 to practice taking vital signs. Class officially starts at 8 am with a health check-in, questions and answers from previous day's topics and a review of the upcoming schedule. Class runs until noon, with an hour break at lunch, and then stops again at about 5:30- 6:00 pm. Last night, most of the students were involved in a pickup game of ultimate frisbee. There are rumors of another game for this evening. And then there are study sessions after that to prepare for the next day. Hasta manana!

First Post from Costa Rica!

2012-02-01T12:06:00.000-08:00

Everyone is here, healthy and happy! Access to the internet has been spotty and we've been very busy getting settled, so this is our first post.

The program is off to a great start. After a full morning of practicing patient assessments, we are heading into the field to learn how to make fires in a wet, humid environment. Instructor Trenton Harper, who works in the summer as a paramedic for Yellowstone National Park, is here teaching fire construction and other survival skills. After this week, he will head back to Montana and prepare for teaching survival in the snowy mountains.

Although hot by Montana standards, it's a bit cooler here than we are used to seeing. That has allowed us to ease into our acclimatization, get in some good hiking, and stay healthy.

Aerie instructor Fernando Giaccaglia, pictured below with the water bottle, is leading instruction on knots. In the first few days, we have reviewed bowline, stoppers and taught-lines. As the list of outdoor skills grows, so too will the complexity of our medical and rescue scenarios. Within a few days, students will be navigating through the forest, finding injured patients, stabilizing their injuries, and evacuating them from the field.

Meals at the ranch have been healthy and filling. It is a treat eating tropical fruits at a tropical temperature, particularly when most of those fruits have been grown here on the property. We typically eat dinner around 6:30; after that, most students return to the classroom to study, practice skills, and catch up on reading.

We will do our best to keep the blog active with daily updates. In fact, if we are able, we'll have another posting later today after class.

An Office Update

2012-01-30T08:48:00.000-08:00

Hello, everyone!

The Aerie Office just got word that everyone has arrived in Rancho Mastatal safe and sound! There will be an official update and check in later this week.

Emergency Contact Information for the Next Week

2012-01-20T21:01:00.000-08:00

This coming week, Aerie instructors are headed to Costa Rica to begin setting up our classroom at Rancho Mastatal. Since instructors and students alike will be traveling over the next 7 days, please use the following system if you run into an emergency and need to contact us for any reason (including, for example, travel delays which could cause you to miss the airport shuttle) or if your family needs to reach you in an emergency but can't because you're en route.

Up through January 26

Call Andrea Stephens on her cell phone at 406-824-8820.
If you are unable to reach Andrea, leave her a message with the exact nature of the problem, the number where you can reached, and then call Dave McEvoy (Aerie Director and Semester instructor) on his cell at 406-240-4624.
If you are unable to reach Dave, leave him a message with the exact nature of the problem and the number where you can be reached, and call the Aerie office in Montana (9 am to 5 pm, MST) at 406-542-9972.
If you are unable to reach the Aerie office, leave them a message with the exact nature of the problem and the number where you can be reached.

On or after Friday, January 27

Call Andrea Stephens on her cell phone at 406-824-8820.
If you are unable to reach Andrea, leave her a message with the exact nature of the problem, the number where you can reached, and then call instructor Fernando Giaccaglia's cell phone. Dialing instructions vary depending on if you're still in the US, or if you've already arrived in Costa Rica. From the US, dial 011-506-8376-6969. If calling from inside Costa Rica, dial 8376-6969.
If you are unable to reach Fernando, leave him a message with the exact nature of the problem, the number where you can be reached, and call Rancho Mastatal at 011-506-2-410-6263 (dial 2410-6263 if you've already arrived in Costa Rica).

Please give this contact information to your family/emergency contact people to be used in the event of an emergency only.

December 9th: 1st Meeting!

2011-12-01T14:47:00.000-08:00

2012 SWM students, don't forget that Friday, December 9th is our first get-together. We will meet at the Aerie office, 315 South 4th Street East, Conference Room (second floor), Missoula at 4 PM MST. Anyone needing to Skype in should contact us if you haven't already done-so. Parents and other relatives with questions are encouraged to be there as well.

In addition to being attended, in person or electronically, but all new students, the majority of the Semester instructors will be there, as will a number 2011 Semester graduates.

In the meeting, we will ask:

Do you have your passports, plane tickets, and immunizations taken care of?

What questions do you still have about this?

Have you completed your online background check yet? Don't forget it needs to be notarized.

PLEASE turn in your Univ. of Montana registration paperwork

Do you have any questions about the gear list?

What address should we send your EMT textbook to?

Remember that your first reading assignments and online quizzes from the textbook will begin the second week of January.

What is your plan for paying your final tuition balance?

If you arrive early in Costa Rica, here are a few suggestions for places to stay...

Please think about these items beforehand and come to the meeting ready to ask questions and get answers. The importance of pre-planning cannot be overstated.

We look forward to meeting all of you!

Preparations for 2012 Semester

2011-10-13T19:39:00.000-07:00

We are gearing up for the 2012 Semester, interviewing applicants and finalizing schedules. Our hosts at Rancho Mastatal in Costa Rica, where we will spend the first three weeks of February, are ready. New to this year's program, we will be traveling to the amazing Rafiki Lodge, on the Savegre River, for swiftwater rescue training during the last week of the month. These two incredible tropical locations will be hard to leave; however the transition will be made easier by our return to the beautiful and, by that time, snowy Rich Ranch in Montana on the Southern end of the Bob Marshall Wilderness.

Take a look at posts from last year's program to get a sense of day-to-day life during the Semester. Call our office to get in touch with any of our Semester graduates. The program requires a tremendous amount of hard work. Its academic rigor is balanced by endless outdoor scenarios, practical exercises and training. The Semester offers:

15 University credits
Wilderness EMT certification
National Registry EMT certification
State of Montana EMT certification
Swiftwater Rescue Technician certification
Level 1 Avalanche certification
Wilderness survival training
Wilderness navigation training
Search and Rescue training
Clinical experiences on an ambulance and in an emergency room
Experience offering a free health clinic in Costa Rica

While it takes place in two of the most beautiful places anywhere, it is not a vacation. If this sounds like fun, we would like to hear from you!

End of Program

2011-04-13T21:44:00.000-07:00

We met one last time as a group on Sunday. Students are now registering for their computerized national EMT exams; Tressa, Emile and Lauren will test here in Missoula tomorrow.

We have said this before: this is an amazing group. In addition to their intelligence and motivation, they were phenomenally supportive of each other during two and half challenging and intense months. We feel very privileged to have had them as students and look forward to hearing great things about each of them in the future. Jenna, Emile, Emilie, Sam D, Sam V, Tressa, Savannah, Lauren, Liam, Taylor, Miranda and Dylan: Thank you! Thank you also to our instructors: Darcy, Trenton, Andrea, Fernando, Drs. Moore and Johnson, our swifwater instructor Mike Johnston, avalanche instructors Dudley Improta and Tim Laroche, HazMat instructor Dan Corti, cadaver lab instructor Miranda Lewis, the Missoula City Fire Department, Melissa Diebert and the ambulance staff at Missoula Emergency Services, the staff of St. Patrick Hospital Emergency Department, staff at Rancho Mastatal in Costa Rica and the Rich Ranch in Seeley Lake and numerous others who donned fake wounds, jumped into icy rivers, buried themselves in snow and otherwise acted hurt or contributed their expertise.

Swiftwater Rescue Technician Training on the Clark Fork and Blackfoot Rivers

2011-04-05T10:01:00.000-07:00

It's a theme of the program: there is no substitute for experience. This past week, students were wading off of snow-covered river banks into ice-cold water to learn how to be an effective rescuer (and not a patient!) in a fast-moving river. During this time, they earned their Swiftwater Rescue Technician (SRT) certifications, which are the industry standard for the river-guiding and rescue industry. Skills acquired included assessment of river hazards, establishing safety during river rescues, swimming in cold, fast-moving water, acting as live-bait (swimming out to rescue an unresponsive or otherwise incapacitated person), setting up and using pulleys and ropes (Z-drag systems) to pull objects like rafts and kayaks out of jams, and using throw-bags to get a safety rope to a conscious swimmer. This is now our last weekend, with students completing their emergency room observations and ambulance ride-alongs. The program ends on Saturday, with National and State testing on Sunday. This is an amazingly skilled and motivated group that we expect will do exceptionally well.

Missoula Day Photos and a Mass Casualty Event in Seeley

2011-03-28T09:08:00.001-07:00

We'll start by saying the finger in the top photo is moulaged. This was one of the many (and less serious) injuries that students had to manage during an overnight mass casualty exercise this past weekend. Instructors woke students up at midnight. Students had to find their patients, (who were buried in an avalanche) and care for them throughout the night, while also coordinating with local Search and Rescue (SAR) teams (thanks to SAR members from Seeley Lake and Condon for their help). It was an educational and exhausting event for all. Other pictures include vehicle extrication practice with Missoula City Fire Department, low-angle rescue practice with SAR, and a picture from the top of St. Patrick Hospital here in Missoula, as students discussed backcountry helicopter rescue with Life Flight's RN/ paramedic flight team. This coming week includes jumping in to the river for three days of Swiftwater Rescue Technician (SRT) training with the Whitewater Rescue Institute.

Missoula Day

2011-03-24T21:24:00.001-07:00

Yesterday was an incredible day. Students started at Missoula Emergency Services, Missoula's ambulance service, for a review of ambulance operations. Following that, we were very fortunate to have Dan Corti, Executive Director of the University of Montana's Environmental Health and Risk Management Department, teach students about hazardous materials and EMS responses to HazMat scenes. We then went to Missoula City Fire Department for vehicle extrication, with students putting on turn-outs, learning from professional firefighters and practicing with extrication equipment. Following that, students had an update on recent developments in trauma care from John Bleicher, head of St. Patrick Hospital's Trauma Services. After that, they visited the LifeFlight helicopter at the hospital for a review of helicopter rescue. To end the day, they met at the University of Montana's cadaver lab to review human anatomy and physiology. We have some pictures (minus the cadaver lab) that we will upload over the next few days. Currently, everyone is healthy, back up in Seeley Lake and the snow.

Avalanche, Winter Survival and Navigation Training

2011-03-21T04:56:00.000-07:00

Students returned last night from 5 days of winter survival, route finding and avalanche training. They snowshoed in 11 miles to a backcountry yurt, meeting up with instructors Dudley Improta and Tim Laroche from the West Central Montana Avalanche Center. The focus of this outstanding avalanche training, like that of the Semester, is prevention of injury through assessment and recognition of hazards. They learned to locate, access and treat avalanche victims. Students also learned to make snow-caves/ quinzees, continued honing their route-finding skills, and added more winter survival techniques to their repertoire. Now they are back to their heated cabins. For the next two days, many of them will complete their emergency room observations and ambulance ride-alongs.

More in the Snow

2011-03-13T21:13:00.001-07:00

It is hard to imagine that a little over a week ago we were in 90 degree weather with 90 percent humidity. In Montana, students are honing medical skills in a cold environment, learning about hypothermia and frostbite, and navigating through the snowy mountains. From top to bottom, photos are of: looking East from the Ranch; learning the local topography with Andrea; mountain lion tracks found during the first day of exploration North of the Ranch; what it looks like when you try to run a race through five feet of snow; two groups of two meeting up in the hills overlooking the Blackfoot valley, just above the Ranch. For the next two days, many students are seeing patients in Missoula while riding on the ambulance and observing in the emergency departments.

In the Montana Snow!

2011-03-10T13:04:00.000-08:00

Everyone is here in Montana, healthy, and getting adjusted to an entirely new climate. We are waiting for some good pictures from the first day in the mountains. For now, you can follow this SPOT link to our location near Seeley Lake. The satellite photo was taken in the fall, so you have to imagine the snow (which this year is significant).

Yesterday, we had a great introduction to the facility and the region by Jack that included some poetry and cowboy insight into living and managing risk in the Bob Marshall/Northern Rockies. Students

tried on snowshoes and trucked around, discussing mountain lions and the beginnings of bear awareness and encounters. We worked on North American map skills, UTM, township/range, and orienting to the particulars around the ranch. We talked about the shift in awareness from "look down while walking, stop, look up and around" to "look up while walking, stop, look down and around" snake awareness vs. lion/bear awareness.

YouTube Video Update

2011-03-05T16:07:00.000-08:00

We edited the video a bit, adding some more photographs. View the new version here. Please share this link with anybody that might be interested.

Off Safely

2011-03-02T18:53:00.000-08:00

The last day of the Costa Rica program ended safely with all students heading off on the airport shuttle or for a day at the beach. In a week we will meet in frigid Montana, expecting at least an 80 degree F change in temperature. Other pictures include work on the cobb stove, with particular attention given to Emilie for working so hard on her birthday (!), and the completed stove in front of the local Soda. During the community service project, students constructed and installed two of these simple, efficient and inexpensive devices. These stoves will significantly decrease carbon monoxide and airborne particulate wastes that contribute to so many of the respiratory diseases that we saw during the health clinic.

2011-02-23T12:12:00.000-08:00

This morning we had a mass casualty incident at the local elementary school. During a two-hour scenario, Aerie students triaged, moved and cared for 14 elementary school students (most of whom spoke no English) with carbon monoxide poisoning. The past few days we have been down to the local rivers quite often, caring for patients, building shelters to stay the night, and navigating our way to and from the scenes. We also completed our splinting section, with groups of students making improvised femur traction devises and having them evaluated.

February 20

2011-02-20T14:19:00.000-08:00

This is our first full weekend of the month, with both Saturday and Sunday off. No interesting pictures to upload, as they would only consist of everyone sitting in hammocks reading. Tomorrow is the beginning of our last week in Costa Rica, and it will be the most rigorous yet. We have a number of extended scenarios to complete, most of which will require the coordination of all of the skills learned thus far. In addition, we will spend two days back in Zapaton, where we held the medical clinic, building rocket stoves for families identified as having a particular need for reducing cooking smoke in their homes.

February 18, post 2

2011-02-18T08:50:00.000-08:00

After days of no posts, we're now putting up two in one day! Of the hundreds of images gathered over the past week, here are some highlights of our experiences with actual and simulated patient care. In the top three photos, our intrepid students practice improvising litters and caring for a head injury (simulated blood only!)

The next photograph shows our end-of-clinic table top debrief. For the table top, students present the details of patients they saw during the clinic to staff, including our visiting physician, Dr. Greg Moore. Students were evaluated on their presentations and asked follow up questions by staff and their colleagues. Finally, Dr. Moore elaborated on the patients' histories and gave reasons for his diagnoses. In the final photos, students, instructors, translators, and Dr. Moore all take patient histories, vital signs, and record their findings while visiting patients in their own homes. A good week!

February 18

2011-02-18T07:38:00.000-08:00

Yesterday ended with practical examinations covering map and compass, emergency shelter construction (second photo, with Savannah and Jenna at their station), and a "splint-off", with students competing for the best splints, based on criteria like functionality, durability, simplicity, versatility and aesthetics. In the bottom photo, Liam is using a scripted description of his tib/ fib splint to add impact. It helped, and his splint was excellent, but as of this morning his group remained tied for second. At this moment, Andrea and Fernando are teaching UTM (Universal Transverse Mercator) grids and improvised femur traction splint construction. Those pictures are the two at the top of this post. The photo of the trees is this morning's sunrise.

February 17

2011-02-17T11:24:00.000-08:00

Sorry for the delay: this has been a very busy week with an amazing group of students. We completed two days of house visits and set up a clinic at a community center in Zapaton, an indigenous community about ten miles from Mastatal. We assessed and provided care to about 40 people, ranging in age from 9 months to 90 years. Since the clinic, we have reviewed head, spinal, chest and musculoskeletal trauma. At the moment, students are completing practical examinations for GPS use, emergency shelter construction, and knot tying. Following the mantra, "Beatings will continue until morale improves", students will take their second written medical tests of the week tomorrow, with instruction in the management of bleeding and shock and long term wound care.

February 9

2011-02-09T07:25:00.000-08:00

Yesterday concluded with a full afternoon of practical skill review (Automated External Defibrillator; emergency shelter construction; GPS use) and an extended scenario that used these skills. Groups found patients in the water, safely moved their patients to shore, established a base camp with a fire and shelter, identified their location by map, compass and GPS, and planned for an evacuation and prepared for a night out in the rainforest. This morning we are back in the classroom, debriefing the scenarios, continuing with map and compass instruction, and learning about diabetes and anaphylaxis. In addition, we are adding emergency litter construction with tarps and ropes to the list of wilderness skills.

February 7

2011-02-07T19:12:00.003-08:00

Yesterday was our first day off. Most of us went to the soda to watch the Superbowl and relax. Today included about 10 hours of class time, including more map and compass, pharmacology, pathophysiology and respiratory emergencies. Tomorrow includes cardiac emergencies, altered level of consciousness, instruction in emergency shelter construction and introductions to GPS, with the afternoon of scenarios down at the river. Aerie's Medical Director, Dr. Greg Moore, leaves Missoula on the 10th to meet us in Mastatal. He will lead a full day of house calls on the 11th and head up the clinic on the 12th. Students will be visiting houses, talking to and assessing dozens of local residents during Greg's visit. The pictures are of an emerging cicada at night and map and compass review.

February 4

2011-02-04T15:38:00.000-08:00

Yesterday, we used our male students as chalkboards for sketching cardiac and pulmonary anatomy and circulation. We headed down to a new river today for scenarios and survival training, which included fire-starting. Getting to and from the river included route-finding with map and compass. Lectures included documentation and communication. Tomorrow, Saturday, will include CPR and practical testing of knots, map and compass, and medical skills.

Day 2

2011-02-02T15:55:00.000-08:00

Photos from the waterfall turned out to be too dark to be of much interest for the blog. Our hosts at Rancho Mastatal put on a fairly unexpected but inspired regional variation of Macbeth, titled "Macbetho", last night for dinner-theater. This was a great conclusion to a busy first day.

Today we reviewed knots (bowline and double-overhand stopper- see photo), introduced map and compass use, and had a full afternoon of human anatomy and physiology review. Class ended at 5:30. Dinner is at 6:45. Breakfast tomorrow at 7 am, with class starting at 8.

The area around Mastatal has had a tremendous increase in scarlet macaw populations; we are seeing and hearing these amazing birds throughout each day. It's hot here, but more overcast and a bit rainier than usual, providing a welcome break from the sun.

Day 1

2011-02-01T07:39:00.000-08:00

Day 1, our indoor (or, more accurately, under-the-roof) classroom. This afternoon we are heading down to the river and waterfall to learn about the local flora, fauna, weather and terrain. Pictures and updates to follow.

All here!

2011-01-31T15:18:00.001-08:00

All students arrived safely in Mastatal about a half an hour ago! Dinner is in an hour and a half. Class begins tomorrow morning at 8 am!!

Follow this link from the SPOT navigation system to view our location in Costa Rica with Google Earth. http://fms.ws/4ACuV/9.67082/\-84.37491

Three days until the start of the Semester

2011-01-28T12:44:00.001-08:00

The Aerie staff is putting the final touches on preparation for the Semester. Instructors Andrea Stephens and David McEvoy arrived in Costa Rica yesterday and join fellow instructor Fernando Giaccaglia.

2011 Semester in Wilderness Medicine

2010-08-03T14:30:00.000-07:00

No other wilderness medicine training program provides the opportunities presented in the Semester. We strongly encourage you to confirm this by comparing our program with any other.

This is the Semester's unique paradigm:

Learn anatomy and pathophysiology of diseases during didactic sessions taught by physicians, nurses and paramedics
Reinforce this understanding at a cadaver lab
Observe the presentations of these diseases and injuries in actual patients during extended clinical opportunities or scenarios
Acquire skills to both prevent and manage the problems taught during the class.

The actual patient-care experiences alone are unparalleled. These include spending a full week running a free health clinic in Costa Rica, getting supervision and direction from our Medical Director, Dr. Greg Moore. Students will make house visits, set up a clinic in the community center, take medical histories and vitals on patients ranging in age from 7 months to 90 years. During this week, they will also participate in important community health projects. Last year, students installed rocket stoves in homes. These stoves greatly reduce carbon monoxide and particulate emissions from indoor cooking, and thereby reduce significant causes of the respiratory infections and diseases (such as asthma) that the students will observe while running the clinic.

In Montana, students continue this type of learning when they spend three days on the river in swiftwater rescue training. Not only will they understand the physiology of drowning, but by actually getting in the water and pulling people from the river they will have a unique appreciation of both the prevention and treatment of submersion injuries. In another example, students will take their knowledge of hypothermia and frostbite and apply it during three days of avalanche training in the Swan Mountains. During this time, students snowshoe and ski approximately ten miles into a backcountry yurt. Once there, they will learn about the basics of snow science and become proficient in avalanche beacon use. Through scenarios they will take this knowledge, find buried patients and care for them in extended winter scenarios.

The list of this type of training is extensive and fully outlined on our website. You can also visit the site to see more pictures of our 2010 program. The program is demanding and intense. If this type of experience appeals to you, please contact us for more information.

Highlights of our 2010 Semester

2010-05-14T09:59:00.000-07:00

In addition to studying backcountry medicine, Semester students train as EMTs, including learning ambulance operations, hazardous materials handling, and vehicle extrication. Near the end of the Semester, students participate in an overnight, mass-casualty scenario rescue in the Swan Valley.

Care of Patients in Winter Environments

2010-05-14T09:22:00.000-07:00

March is still fully winter in Montana's high country! Students spent several days in the Swan Mountains studying avalanche awareness and practicing rescue and care of patients in conjunction with the West Central Montana Avalanche Center. This section of the Semester in Wilderness Medicine earns students their Level 1 Avalanche certification.

Back in Montana

2010-03-14T22:07:00.000-07:00

Three days after leaving Costa Rica, students are in the snow and freezing rain in the mountains of western Montana. Aided by the amazing cooking of our chef, Raven (participating in a scenario, first picture below), they are beginning their winter survival, Leave no Trace Trainer and avalanche training. This Tuesday they will put on skis and snowshoes for four days at a backcountry yurt earning their Level 1 Avalanche from Steve Karkanen and Dudley Improta of the West Central Montana Advisory Center. By week's end they will travel to Missoula for a full day of human anatomy instruction at the University of Montana cadaver lab and vehicle extrication with the East Missoula Fire Department.

Swiftwater Rescue Technician Training

2010-03-09T13:34:00.000-08:00

Students spent three days in training, working with throwbags, pulling victims out of the water, setting up tension lines to retrieve boats, and treating victims once on shore.

Students practice rescue skills with Aerie and Whitewater Rescue Institute staff. For video footage of our 2009 SRT class, view this link.

Aerie instructor coaches students during a training session in swimming into and out of river eddies.

Health Clinic

2010-03-09T12:43:00.000-08:00

Aerie students were treated to an exceptional medical education as they made house calls with Dr. Greg Moore, Aerie's medical director, here examining a patient with cataracts.

Aerie's free public health clinic operated for 2 days out of the community center, with the second afternoon reserved for house calls for anyone not able to make it to the clinic.

Clinic operations were supported by the hard work of several language interpreters, in addition to Aerie students with Spanish fluency.

Aerie students made time during the clinic to direct local elementary school students in CPR techniques.

All together, the clinic treated almost 75 patients, split between clinic visits and house calls in the local area.

Community Service Project

2010-03-09T10:51:00.000-08:00

The community service portion of the Semester gives students a glimpse of the links between health issues and daily living. The following photos summarize some of the work done at two different homes. In one case, students' work included providing drainage from sinks, so potential mosquito-breeding pools of water are no longer collecting outside; wiring new lights into the kitchen to enable the cooks to have a light source beyond the flames of the cooking fire; and installing a model rocket stove (a wood-fired stove with low CO and particulate emissions) in the kitchen for a test drive before the family committed to a total overhaul of the current cook top: a wood fire-heated plancha. The second home received a new, permanent double-burner rocket stove made from scratch with local materials by our students and Rancho Mastatal staff.

We installed pipes to divert drain water from bathroom and kitchen sinks away from the back of the house where it collected. The external wall of the kitchen is shown here.

To create a cleaner cooking environment, we pulled this old sink out of the kitchen in one home and replaced it with a similarly-designed, albeit newer, one with a drain pipe.

To make a rocket stove, our students mixed cow manure, straw, clay, rice hulls and lime to form a soft, clay-like building material easily sculpted around the j-shaped fire chamber and vent stack.

Rocket stoves are unique designs which reduce particulate emissions in smoke that can cause emphysema and chronic respiratory problems in family members spending a lot of time cooking indoors over wood fires. They also reduce the need for fuel: this pot of beans boiled in less than 15 minutes with a small handful of twigs! The family invited several friends in to see the stove in action while we were putting the finishing touches on the electrical wiring and tending the fire periodically. This stove was built over a two day period as a test model.

Leaving Costa Rica, headed for Montana

2010-03-05T11:53:00.000-08:00

The Costa Rica portion of the Semester ended with a free health clinic, a community service project, and swiftwater rescue training on the Pacuare river. All students are now in Montana, adding avalanche rescue and winter survival to their training.

First Week and a Half Update

2010-02-10T12:34:00.000-08:00

Our first week and a half have gone by quickly. Students are all well and very busy. We are well into the survival, orienteering and medical curriculum. Computer time is limited, but here are some pictures.

2010 Semester Meeting

2009-10-29T14:14:00.001-07:00

Hello everyone! We are very excited to get final preparations underway for next year's Semester. This blog will serve as one of the primary methods for students to interact with others, post questions, etc. We hope you find this a useful medium to that end. Once the Semester begins, we will turn this Blog largely over to you for official postings to your family and friends. Two or or so times each week, students will log on in Mastatal and Condon (assuming our power is not out!) and provide group updates.

As of right now, we have scheduled our first Missoula pre-course meeting for Thursday, November 12th at 4 pm at the Aerie office. At the meeting, we'll answer questions in-person and let you meet some of your fellow students. Those not in town will be able to Skype in and participate. This is not a mandatory event. Family and friends are welcome to attend.

Let us know if you have any questions.

David McEvoy
Director
Aerie

2010 Semester in Wilderness Medicine

2009-10-19T19:08:00.000-07:00

We hope Semester students will use this blog to communicate with each other about the course before it starts and communicate with their friends and family while we are in Costa Rica and Montana.