Into the Darkness

    In the gathering gloom students marched up Sinks Canyon, breaking trail through thigh-deep snow as Orion’s Belt grew brighter overhead. If there was anyone around to see, they would have noted bobbing headlamps at the end of the line stop, then cut off cross country or deep into the trees as each group of rescuers was peeled off and sent to find their scenario.

    The prospective EMTs had spent an afternoon managing medical patients in another mass casualty incident, getting more experience with the incident command system and more tastes of the complexities they may encounter in EMS – cranky patients, rescuers who become ill, medevac pilots who don’t speak English, and a frantic plumber breaking into radio traffic.

    After a day spent training in the pleasant Wyoming sunshine of late winter, the students were cut loose on their first night rescue to manage trauma and medical emergencies in harsh winter conditions. They were given a hands-on lesson in prolonged patient care in an inhospitable environment; a reminder that after the adrenaline drops off and the excitement tapers, rescuers must continue to care for their patients as well as for themselves.

The Fog of Chaos

Screams set the backdrop to the garbled radio message from the rattled first responder. A bridge collapse had plunged six hikers into the icy Popo Agie river. Within minutes the WEMT class from Lander, WY was on the scene. Despite the panicked urging of the injured, the rescue team refrained from rushing blindly into the incident. A crew was dispatched to evaluate the situation as the Incident Commander organized the strike teams and logistics personnel. Rescuers soon entered the scene to care for the injured and extricate several patients from the river.

After spending a little more than a week learning emergency medicine, the students of the Lander WEMT were introduced to their first Mass Casualty Incident. In addition to treating massive head trauma, a femur fracture, an open pneumothorax and other injuries the rescuers found themselves working in deep snow and cold water.

Up to now the students have learned in the controlled environment of the classroom, with hands-on skills presented in straightforward scenarios. Now they have been confronted with stress, and the fog of chaos they may encounter in the real world.

February WEMT course

We are nurses and Wilderness First Responders; firefighters and outdoor educators; those new to wilderness medicine and those who have been teaching it for years.  And we are newly arrived for the WMI WEMT course stationed at Sinks Canyon Center just outside snowy Lander, WY.

I have been looking forward to this course for years . . . since, in fact, my first WFR with Buck Tilton back in Pitkin, CO many years ago.  Time and circumstances finally came together to allow me to join in the fun.  We seem to have an eager crew of 25, undaunted by the vast amounts of information and practical skills slammed on us like a fire hydrant.  Our hearty instructors, Jess and Dave, keep us awake and oriented even through continuous eight hour days of class-time--a none too shabby feat keeping the interest of folks unaccustomed to being in a classroom with walls and a roof.  Of course, our mandatory play time for scenarios outside breaks up the day nicely.  Clinicals start this weekend.  And soon, we will all be up to speed, flying through patient assessments like old pros, I have faith.

Hopefully, like my WFR's before, our group will find common bonds and common ground over our 4 weeks together.  We are, after all, saving each other's lives every day.

posted by Ben Tettlebaum, WEMT student

Notes from the field

NOLS Rocky Mountain (RM) Outdoor Educator Semester students are in the midst of their first section: an 80 hour Wilderness First Responder (WFR) course at the NOLS RM Three Peaks Ranch in Boulder, WY.  Joining them on the course are students from all over the states including a few NOLS HQ employees. 

Aaron Bannon, NOLS Wilderness Advocacy Coordinator and WFR student, reports from the field.

As our Wilderness First Responder (WFR) course churns through day seven, spirits are high, the learning curve is intense, and the snow is deep. For six of the last seven days, for eight hours a day or more, we have been learning to keep injured people alive and treat their maladies in the foothills of the rugged Wind River Mountains. The Three Peaks Ranch is an ideal setting for mimicking conditions in the backcountry. Below are some students’ impressions from the first few days of the course.

“What I am impressed with is the enthusiasm of all the students and instructors. Everyone not only wants to be here but also wants to learn, which makes for a dynamic environment. Very nice, I like.” Andy McKicctrick, Montana

“Its awesome to find so many people to work on the same desire to become a wilderness first responder. During our first scenario it was NEGATIVE 20 outside. It really got us going and we realized that anything can happen while in the wilderness.” - Brad Gannon, Ohio

“I just learned in our last class how to stabilize a broken femur with a Thermarest, towels, a ski pole and some webbing. Who needs modern medicine when you have a Thermarest?” Brittany Goble, California

On WMI courses, students gain confidence in their skills by learning through scenarios.

As you can see, there is no shortage of personality in our scrappy band of WFR trainees. The positive, spunky attitude makes our eight-hour days feel a little bit shorter, and our time doing scenarios in the cold, deep snow a little warmer.

-Aaron Bannon

Photos courtesy of Marco Johnson

WMI's Instructor Training Course

We’re training 18 new WMI Instructors this week in our annual Instructor Training Course.  These folks are NOLS field instructors, ski patrollers, raft guides, environmental educators and wildland firefighters.  We can hear Spanish, Portuguese, Italian and Australian in the classroom.

For the past two days we’ve been working on our skills as educators.  Sessions on setting up your classroom, teaching adult learners, the variety of learning styles and how to teach through lecture, demonstration and scenarios fill our days along with classes on how to use a white board, handle questions, the pitfalls of a/v technology, and the specifics of the content of our curriculum.  We talk about the difference between content and style in education, the what and the how, and the power of intentionally choosing how to best deliver a topic.   This afternoon the participants begin student teaching the curriculum.   We hear, from this cadre of experienced instructors, how effective this course is in developing the skills of an educator.

This morning we listened to Melissa Gray deliver the state of the school speech.  She inspired us by describing our educational environment as one that engages the students and teaches a systematic way to apply their skills.  They leave our programs competent, empowered to act and feeling confident in their ability to make decisions and care for others in remote environments.   This is the 'WMI Way".

Right now we’re watching Gates Richards build a peanut butter and jelly sandwich following the instructions of the students.   It’s an exercise to demonstrate the precise and intentional use of language when we teach.   Unfortunately, when we told Gates to open the jelly, we forgot to tell him to hold the jar upright.  Jelly, jelly everywhere except the bread…….

An Autumn Day

One hallmark of Wilderness Medicine Institute courses is our realistic scenario-driven curriculum. WMI Instructor Daniel Dekay shares an example of a scenario from a Wilderness EMT course going on right now in Yosemite National Park.

   "We got up early, had breakfast and fed the dog, packed a daypack.  Jerry said, "don't forget to fill the thermos with hot chocolate"..... we were off for a long awaited hike with some friends".

   Mara, Jerry and several others were taking a bus to Badger Pass area for a long day of hiking and enjoying the crisp sunshine of Yosemite National Park. The bus followed a snowplow as it made its way up the mountain road through yellowing oaks and tall pines.  Dozing in the back as the bus rumbled along, all was well for Mara and Jerry.   

   Suddenly the brakes screeched, the bus swerved, and there was the sound of metal against metal, and breaking glass.  The white Volvo stationwagon had crossed over into the oncoming lane, colliding head-on with the snowplow.  The bus smashed into the back of the plow, throwing many of the passengers into the aisles.   Screams, shouts and chaos ensued.  Through the front window of the bus Mara could see a cloud of smoke coming from the direction of the Volvo.  Many were hurt, some already unconsious, a trickle of blood seeped along the tilting bus floor. 

   Stay tuned to find out how what happens next to Mara, Jerry and their friends.      

 

WEMT Course Under Way

With the passing of the equinox our WEMT courses take a turn for better environmental challenges.  Case in point?  Snow!  That's right, even here in the high desert the weather can add extra challenges to the task of providing quality patient care. 

Today is day 6 of our fall WEMT course here in the Lander hometown.  Our 30 students learned their patient assessment system last week, and had the opportunity to hone their skills in the balmy late summer 70 degree weather.  Over the weekend, however, the front moved in and we were greeted with the first snowstorm of the season!  Not wanting to miss the opportunity to challenge themselves, the students asked if we could delay class in order to head outside into the storm.  Little did they know, that was the plan from the moment the white stuff started falling. 

As they geared up to head out on their rescue, sleeping bags and plastic tarps were added to the equipment arriving on scene.  After a few minutes of adjusting to the challenges of performing assessments on wet, cold patients, the lightbulbs went on and the tarps were put to use as mini-shelters.  Each rescue team found itself ensconsed in the steamy light of its newfound plastic cave, and the assessments proceeded apace.  The injured horsepackers were assessed, treated and sent on their way.

The class returned inside to learn about musculoskeletal injuries having had a nice teaser of tomorrow's topics-- environmental challenges!

                        

WMI Curriculum Update

Hydration is a hot topic around this time of year, and with good reason. In recent years, the gear market has become saturated (pardon the pun) with so many different hydration systems and supplements that it can be hard to make the right choices.

                

Am I drinking enough? Too much? What about temperature? Wilderness Medicine Institute Curriculum Director Tod Schimelpfenig explores these questions and others in WMI's Curriculum Updates.

The Wilderness Medicine Institute is a division of NOLS. Focusing on Wilderness First Aid, Wilderness First Responder and Wilderness EMT classes, WMI helps keep NOLS at the cutting edge of wilderness expedition education.

WMI of NOLS Partners with Landmark Learning

In January 2007, Landmark Learning in Cullowhee, North Carolina entered into partnership with the Wilderness Medicine Institute of NOLS (WMI of NOLS) to offer courses in the Southeastern United States. Landmark is an established multicertification training center for outdoor educators and emergency medical personnel. This partnership represents a big step for WMI of NOLS and will expand our course offerings into a region of the US where we have traditionally been underrepresented. The courses will be administered through Landmark Learning's office in the southeast utilizing WMI instructors, curriculum, and materials.

When WMI of NOLS staff visited Landmark in 2006, they quickly realized that Landmark's mission, as well as, its teaching style, was an excellent match for WMI of NOLS. We are excited about this development and look forward to working closely with Landmark. To learn more about WMI of NOLS click here. For information about Landmark Learning click here to visit their website.

Primal Quest 2006

Meteorologists predict a high temperature of 85°F this week in Berlin. Faced with the threat of dehydration, the athletes and spectators of the 2006 World Cup tournament rely on sports drinks and professional trainers to quench thirsts and treat injuries, respectively. Imagine the damage to a disgruntled fan’s vocal cords after a long, hot day of heckling. Consider the danger of running through the streets beneath the guise of paint that, though patriotic, is impervious to sweat. The players endure comparable difficulties. On the field, one might sprain an ankle or twist a knee. Off the field, one might be taunted and chased by hoarse, overheated sports fanatics.   

While soccer enthusiasts bake in Germany, outdoor adventure buffs in the United States face a decidedly different set of challenges. On Sunday, June 25 the 10-day, 500-mile Primal Quest Adventure Race kicks off near Moab, Utah. Meteorologists predict temperatures to exceed 100°F as athletes compete in eight different disciplines.

The potential for injury is as high as the altitude, so Primal Quest relies on NOLS, with whom it has an educational partnership, for safety and guidance. WMI’s Jake Schepps, Jason Buchovecky, Iris Saxer and Darran Wells will spend four days prior to the race leading volunteers through first aid seminars and briefing participants on environmental hazards. They will then assist medical teams at race checkpoints in treating everything from blisters to dislocations. No one knows and teaches wilderness risk management better than WMI staff members. They plan to equip athletes and volunteers with the tools to address the problems you can’t avoid and anticipate the dangers you can.

Of the avoidable dangers, harm to the environment is one of the most critical. Though not necessarily as visible as mobs of roving soccer fans, waste and garbage can irrevocably impact the delicate desert landscape. Thankfully, the on-site WMI crew is certified to lead NOLS courses and, therefore, prepared to reinforce Leave No Trace principles. All 500 miles of the course are in good hands.

To listen to a podcast featuring Schepps, visit www.gofarpodcast.com. To learn more about the partnership between NOLS and Primal Quest, or to stay updated on the race, visit www.ecoprimalquest.com. The omnipresent NOLS bus, which has temporarily joined the Moab media circus, has released no reports of excitable spectators, but the extremes of Primal Quest have the potential to incite abnormal behavior.  Stay tuned.      

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