The Open Road III

Chapter Three

Welcome to Weed (California)

June 26, 2015. Thomas and I pulled into Redding, California, mid-afternoon that Friday and, after dropping him off at his sister’s house, I drove on over to another part of Redding to get dinner with my friend Katie. I stayed the weekend there in Redding, and after going to the incredibly awesome and gifted Bethel Church on Sunday, Katie and I grabbed lunch and parted ways as I continued on my journey to northern California to the small mountain town of Weed.

Weed is right off of I-5, midway between Medford, Oregon, and Redding, California, with volcanic Mount Shasta, the 2nd tallest mountain in California at 14,179 feet, looming over it’s tiled roofs. I drove around a bit before pulling into a mostly empty parking lot tucked away amongst the pines at the College of the Siskiyous. I then wandered around looking for the right building to check in for the month-long NOLS W-EMT course that would start the following day.

Eventually I found it, met my new roommate for the month (Kevin Collins), and unloaded some of my gear into our small dorm room. The following is a very brief account of a very quick, crammed, month-long Wilderness EMT course (with most photos taken by one of our instructor, Tate Higgins – instagram.com/t8higgins):

Training commenced that next morning with briefings, paperwork completion, and introductions. Scenarios became a constant occurrence, with which we would try to render aid to someone with the W-EMT trainee skills we had so far acquired. There was lots of (fake) blood. Actually, tons of (fake) blood and moulage and a healthy bit of confusion (so if the sight of blood displeases you, discontinue reading this post!). Each day started at 8:00 am and ended around 5:00 pm, although we had several night scenarios and longer days that would last until 10:00 pm or later. With many chapters of reading, practice quizzes to take, and tests to study for, we had nearly no time to do anything but focus on the course.

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The National Outdoor Leadership School and the Wilderness Medical Institute did an outstanding job in teaching us all sorts of both Urban and Wilderness medicine techniques and protocols. Our instructors were solid guys – Atila Rego Montero, Tate Higgins, and Daniel DeKay. We learned the Patient Assessment System, Focused Spine Assessments,  and TONS of other topics. By the time we had successfully graduated from the course, we all had the confidence to know what to do if we came across an accident in the city or the wilderness.

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We switched often amongst our groups so that we each got practice in both being the victim and the EMT. Here I am the victim of a motor vehicle collision and am getting backboarded by my pals.

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One of our training events took place at the fire training center on the campus, simulated as an apartment complex after an earthquake, which involved us being inside a smoky multi-level building with a confusing amount of rooms with victims hidden amongst them behind couches, boards, and other obstacles. I absolutely loved this one, especially after having done similar training with the Broken Arrow Community Emergency Response Team at the Broken Arrow Fire Training Center, as well as with Oklahoma Task Force 1 when I was a victim for their Search & Rescue K9s at ORU’s old Braxton dormitory (before it got torn down) and at the Pile during their Type I Certification.

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My partner and I got up to the third floor, and proceeded to the rear-most room to check it for victims. We came upon a 23-year old female who had apparently been hit by a large wooden beam across the abdomen and was going into shock. Unfortunately for us, she didn’t speak any English (or pretended to at least), so by the time we figured out what had happened, her condition had deteriorated quite a bit.

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To make matters worse, the door got slammed shut on us and the radio was filled with chatter from the other teams. So we were a bit trapped and desperately needed a backboard to get her out safely, yet all of the backboards were being used. My partner and I decided to try putting her onto a wood board, but that proved to be too difficult, so we eventually decided to partner-carry her outside, because both the condition of the victim and the building were deteriorating. We made it to the first flight of stairs before being told by one of our instructors to wait for a backboard since it was just a training exercise.

15-07WEMT334-2So we waited and assisted the other teams while constantly reassessing our patient before finally a backboard was free for us to use and evac our patient outside. 15-07WEMT240-2

The scenarios always brought a quick flood of adrenaline followed by a conscious effort to stay focused and address the steps:

1: I’m number one [Is it safe for me?]

2: What happened to you? [Determine MOI]

3: Get that off me [Put on BSIs:gloves/masks/goggles]

4: Are there more [victims]?

5: Dead or alive? [General impression of the patient]

6: Am I in a fix? [Make decision to call for ALS if needed]

This was followed by deciding to stabilize the spine or not, determining level of responsiveness (AVPU), determining the chief complaint, checking the ABCs, then vitals (HR, RR, SCTM, BP, Pupils, Temp, Lungs), then a detailed physical examination and continually reassessing every 5 minutes (or depending on severity).

15-07WEMT163With the mannequins, it wasn’t too hard to stay focused on the steps.
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However, things were much more challenging when our classmates were the victims – the moaning and visceral nature of the scenarios were certainly quite realistic. Since this was a Wilderness Medicine course, it focused a lot on improvising. Hence, when we didn’t have irrigation syringes, we used Nalgenes and Camelbacks on those gnarly tibula/fibula fractures.

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One of my favorite lessons was on Altitude Illnesses and HACE/HAPE, and we actually got to practice with a Gamow (pronounced Gamov) bag. I had done my senior research on AMS and so I was stoked to get to actually learn from instructors about what to do if a real-life situation arose.

The best part of this class was definitely the hands-on, practical skill utilization in the many different scenarios that we were thrust into. We would head out into the woods with a vague “crash at high altitude” or “missing person” description and then boom! we’d come across people bleeding out, bear attacks, screams, everything.

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One time, we came across a victim with multiple injuries, including a femur fracture that was bleeding pretty crazy.

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So we applied some direct pressure on his wound, gave him O2, created a traction splint for the fracture, calmed him down, and got him out as soon as possible.

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Another great part about the scenarios was that the victims wouldn’t be in perfect victim positions, but would instead be in the most awkward, difficult to extract positions.

15-07WEMT056 (Ida Benedetto's conflicted copy 2015-07-25)

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Once, our instructors even had a California Highway Patrol helicopter fly in and land nearby during a scenario. Afterwards, they (the flight paramedics) instructed us on helicopter operations and gave us great advice (like never run toward a helicopter without first being instructed to by the crew chief or pilot, since you might get your head chopped off by a rotor).

Another time, we had to assemble and administer O2 to a classmate with our eyes closed. That was interesting.

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The NOLS instructors did a great job with the course and kept a good balance between making sure we were learning, experiencing, and staying serious during the scenarios. And overall, I’m pretty sure all of us had a good time. I know I did!

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The training definitely paid off already for me, because just weeks after completing it, I was driving back from the Oregon Coast with my friend Seth and my parents, and we came across a recent accident. An 82 year-old woman had been driving the opposite way, when her mobile home slid off the road and almost into a rushing river several hundred feet below. Thankfully, several sturdy maple trees blocked her vehicle from falling, but the pickup truck attached to the back of it was literally dangling precariously over the embankment. I pulled over, grabbed a pair of gloves, and walked over to help as a newly NREMT certified EMT. Another passerby had stopped a few minutes before me and was also an EMT and we both were able to help the lady and her dog. By the time the volunteer ambulance service had shown up, we had the lady assessed and ready to be turned over to the volunteers. She had suffered two broken fingers and had some bruising on her right shin, and although her vehicle was totaled (which contained her only possessions), she was okay.

About a month later, I was at A Jesus Church – Bridgetown in Portland, Oregon, for an evening service when I heard a small commotion in the lobby to my left. I glanced over from where I was sitting and saw a girl collapse onto the floor. I grabbed my keychain that had a small CPR pocket mask on it and walked out to the lobby. The girl’s friend was with her as well as an RN who had seen her collapse. I introduced myself and asked if I could help. The girl was gasping for air but nodded her assent, and her friend said that she was having an anaphylactic attack after being exposed to sunscreen. She had apparently realized what was happening and left the sanctuary to get away from the trigger, but she didn’t have her Epi-Pen with her and just collapsed once she was in the lobby. 9-1-1 had been called, and as the girl’s condition got worse, they told us to administer two rescue breaths until the paramedics arrived. I pulled out my mask and the RN gave her two breaths while I maintained her airway. The medics showed up, gave the girl epi, and thanked us for helping out. I was pretty stoked – twice within two months from graduating from the NOLS WMI W-EMT course, and I had already been able to help two people.

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Continue to Chapter IV. 

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