In Full Swing

What's the best way to really understand hypothermia after spending five weeks in Costa Rica?

a) endless Powerpoints
b) watch Frozen again
c) take off most of your clothes and stand in freezing mud while talking about what your body is going through?

Guess which one we chose for our Semester students?

Back in Montana!

Students are all back in the US, gearing up for their time in Montana while cleaning off some of the sand from Rafiki.

We haven't been able to post for a bit, so here are photos from the last few weeks, starting with the clinic.

FREE HEALTH CLINIC
During three days, students, our medic/ EMT instructors and three MDs ran three separate health clinics.  The first was in an indigenous community, the second in near the classroom itself, and the third in the areas surrounding both while visiting families at home.  These clinics are our chance to give back to the communities that are so gracious to us every year.  They also allow our students a unique opportunity to assess real people (as opposed to their fellow students in scenarios) and to work with health care professionals as they assess and treat their patients.  These were long days.  At night, we gathered back at the classroom to discuss patients are review their care.  Adding to the educational experience, students will now head to MT and complete clinical time in a US emergency room and on an ambulance.

Students and staff receive and triage patients

Some of the equipment we take to the clinics 

Night-time review of patients and the next day's plan

SWIFTWATER RESCUE
After a month in Mastatal that culminated in three intense days of health clinics, everyone headed to the Rafiki Lodge on the Sevegre River.  On the Sevegre, students worked for three days and earned their Swiftwater Rescue Technician certifications, which is the certification typically required by raft guide services.

ESTERILLOS

Before the clinic, we also headed to the beach to practice rescues in a new environment.

Monday, February 16th

It's getting both more difficult and at the same time easier to challenge the Semester students.  They know more, which allows them to respond more appropriately to emergencies, but this new knowledge allows the instructors to give the students more diverse and complicated scenarios.  For example, today students responded in small groups to a person with a severe arterial bleed, another with a rupturing ectopic pregnancy, a third with severe dehydration and a fourth with full thickness burns to the hands.   In addition, as a group they extricated a patient who was entrapped under a vehicle (see photo for the class post-scenarios).  

On the didactic end, they covered management of envenomations as well as management of anaphylaxis.

Wednesday, February 11

Scenario complexity and duration are ramping up significantly.  Every day, students are out in the field, using their skills, following the mantra, "you will respond like you train".  The instructors monitoring these scenarios have years of professional experience taking care of patients in these exact situations, ensuring accuracy and applicability.

Monday and Tuesday

The program has hit full medical stride, with lectures and practical scenarios about head, neck and abdominal trauma.  Students are learning to immobilize spines with traditional backboards as well as with materials found in a typical backcountry setting such as tarps, backpacks and poles.  They will take these skills and put them to the test in extended scenarios that require integration with other core course topics, such as shelter construction.

Additional Skills

Rescuers with high-level medical certifications who cannot read a map, set up a shelter or start a fire are often more of a liability than an asset to a wilderness team.  Aerie developed the Semester in Wilderness Medicine in part to address the gap between medical certifications and outdoor skills by providing the context and skills for everything that happens before and after a backcountry injury or illness.

Knots are a good example.  Throughout the Semester, students learn and use knots common to rescue, shelter and splint construction, including bowlines, various figure of eights, taut-lines, trucker's and clove hitches.  Then they get out into the field, using these knots repeatedly in various scenarios, getting to know how they work, where they may fail, and when they are best used.

By the end of the program in mid-April, students will know these knots well enough to trust someone else's lives with their appropriate use.

Saturday, February 7

Here are a few pictures from this week's activities.  Everyone remains healthy.  Today is a light day: lecture/ review of communication/ documentation from 10 until 12, and then the rest of the day free to catch up on reading, explore the local area, and relax. Students are also completing their second written exam, this one a take-home.

 Tomorrow we have a review session and preparation for the next week, which is going to be very busy.