Friday, August 6th marked the mid-point of my EMT course. That night one of my roommates, Charis, and I drove out to a major California trauma center for the 11pm - 7am emergency room shift. We were blown away by what we witnessed..
Over an 8-hour period we saw 4 patients with various gunshot wounds, 1 patient with blunt trauma to the head with a possibility of a subdural arachnoid hemorrhage (bleeding between the brain and its protective layer that stores cerebral spinal fluid), a multiple stab victim and various other traumas. We stood in the trauma pods and watched medical professionals assessing and treating conditions we've only read about. Seeing real people going through this type of triage and trauma process was quite an education.
As we drove back after virtually no sleep for 2 days, I reflected on the fragility of life. I will not be able to see the ER the same again.
This week holds more coursework, tests, scenarios and studying. I'm thankful for continued opportunities to see the grace of God in the midst of my coursework and medical rotations. Asking for strength and retention this week.
Sunday, August 8, 2010
Reality Check #1: Mass Casualty
After a 1.5 weeks in class, I found myself feeling that the knowledge I was gaining was just the tip of the iceberg in medical response. The scenarios we faced seemed to bring only more questions about what the expect, what to consider and how to treat different wilderness and urban trauma situations. Yet, it was in the midst of these scenarios that I discovered, the knowledge I was gaining was providing a solid foundation for me to assess and respond to any trauma situation, regardless of what it was.
On Tuesday, August 3rd, our class was broken into a team of 'patients' and 3 teams of responders. I was privileged to be selected as the Incident Commander for my response team and facilitated the assessment, extraction and care for a family who had gone rafting and had an accident on the river. Our patients were a mother and her two 20-something year-old children. One patient, half submerged in the water, was deaf and had a mid-femur fracture (the strongest bone in our bodies / the thigh bone), another, which our 
team had to pull from the river, had an open pnemothorax (basically a chest wound that was leaking oxygen into her chest cavity, placing pressure on her lungs and a ticking time bomb for lung collapse) and a diabetic woman in insulin shock with a chunk of wood lodged in her humurus (upper arm). All patients were positive for possible spinal injury and the team backboarded and carried each one up the river bank and to the road approximately 100 yards from the incident.
On Tuesday, August 3rd, our class was broken into a team of 'patients' and 3 teams of responders. I was privileged to be selected as the Incident Commander for my response team and facilitated the assessment, extraction and care for a family who had gone rafting and had an accident on the river. Our patients were a mother and her two 20-something year-old children. One patient, half submerged in the water, was deaf and had a mid-femur fracture (the strongest bone in our bodies / the thigh bone), another, which our 
team had to pull from the river, had an open pnemothorax (basically a chest wound that was leaking oxygen into her chest cavity, placing pressure on her lungs and a ticking time bomb for lung collapse) and a diabetic woman in insulin shock with a chunk of wood lodged in her humurus (upper arm). All patients were positive for possible spinal injury and the team backboarded and carried each one up the river bank and to the road approximately 100 yards from the incident.
I thought, this could happen to anyone along a river that some of my peers and I run along a few times a week. This family is just like any other family on Yosemite, that didn't anticipate an accident but were violently thrown into a time sensitive, trauma situation. When I run that river, I don't see anything the same way I used to..Within a 45-minute period the team had successfully triaged and extracted the family. It was a reality check to see 'patients'
The Yosemite Bug and Wilderness - EMT Course Begins!
On Monday, July 26th at 7:45am, the Wilderness Medicine Institute of the National Outdoor Leadership School course for Wilderness EMT certification began. This day and time marked a really cool transition in my life.. from being able to recall only the very basics of CPR to really gaining knowledge in the area of trauma assessment and treatment in both an urban and wilderness environment!
The course runs Monday through Friday from 8am to 5pm every day with additional class time 7pm to 9pm on Tuesday and Thursday. Time is spread across classroom instruction, hands-on skills practices, mock trauma scenarios and debriefing. While we have only 44hrs. required class time each week, after class each day my 29 classmates and I are actively studying for the course. You can hardly go anywhere at the hostel we are staying at / taking the course at, without tripping over teams who have set up their own mock scenarios, small groups studying quizzing one another on chest trauma and assessment, partners setting up traction splints one another or individuals pouring over any one of the number of reading materials we have for class.
We have 30 participants and 3 instructors and the class dynamic is incredible. Ages range from 20 to 60 and experience is even more diverse. However, we all seem to have a really heart for the outdoors and adventure. It makes our weekends quite an exciting time!
The course runs Monday through Friday from 8am to 5pm every day with additional class time 7pm to 9pm on Tuesday and Thursday. Time is spread across classroom instruction, hands-on skills practices, mock trauma scenarios and debriefing. While we have only 44hrs. required class time each week, after class each day my 29 classmates and I are actively studying for the course. You can hardly go anywhere at the hostel we are staying at / taking the course at, without tripping over teams who have set up their own mock scenarios, small groups studying quizzing one another on chest trauma and assessment, partners setting up traction splints one another or individuals pouring over any one of the number of reading materials we have for class.
We have 30 participants and 3 instructors and the class dynamic is incredible. Ages range from 20 to 60 and experience is even more diverse. However, we all seem to have a really heart for the outdoors and adventure. It makes our weekends quite an exciting time!
The first weekend, one of my roommates, Annie, and I took a 26-mile hike in Yosemite which started out on the Ten Lakes trail in the middle of the park and led us to the Grand Tuolumne (pronounced 'two-all-o-mee') Canyon which borders the northern end of the park. It was spectacular and a welcome break from studying!
Around every turn we came across what seemed like an untouched, brilliant-colored lake, quietly waiting for wildlife and rouge hikers to ripple its glassy surface. Even in the forest and summiting mountain peaks we were able to consider the implications of our most recent class topics.
We met a park ranger that was the first responder to a trauma situation only a week earlier which involved the care of a woman that had tumbled approximately 100 feet from a mountain ridge. He has the same certification we are pursuing right now and was able to confidently say that he and his team provided the best medical care possible before search and rescue could pull her from the steep, rocky terrain.
I am so very thankful for the knowledge I am gaining and was encouraged by Ranger Cliff's story. We don't ever want someone to undergo trauma but if they do, I want to be prepared to respond in a way that gives them the best possible chance of survival.
Around every turn we came across what seemed like an untouched, brilliant-colored lake, quietly waiting for wildlife and rouge hikers to ripple its glassy surface. Even in the forest and summiting mountain peaks we were able to consider the implications of our most recent class topics.
We met a park ranger that was the first responder to a trauma situation only a week earlier which involved the care of a woman that had tumbled approximately 100 feet from a mountain ridge. He has the same certification we are pursuing right now and was able to confidently say that he and his team provided the best medical care possible before search and rescue could pull her from the steep, rocky terrain.I am so very thankful for the knowledge I am gaining and was encouraged by Ranger Cliff's story. We don't ever want someone to undergo trauma but if they do, I want to be prepared to respond in a way that gives them the best possible chance of survival.
Grand Canyon & Yosemite Intro
After Sedona, we headed up to the Grand Canyon for a day of adventure. It was gorgeous on the drive in.. huge full pines, some residual snow still melting off from a particularly cool Spring season, huge puffy white clouds and a bold blue sky. After about 15 minutes at the south rim of the canyon, the skies changed just as quickly as they do in Texas. Apparently there is a well-known season called 'monsoon' in AZ. I learned quickly what the term meant.. over a period of 5 to 10 minutes, the skies went cloudy, temperature dropped from 85 to 65 degrees, rain poured down, follow quickly by hail and brutal winds!
We took a wet stroll along the rim when the lightning subsided long enough for us to gain some confidence about the safety of the activity.. We checked out the museum and information center where we imagined ourselves actually hiking down into the canyon.. It seems so funny that my fear of 108 degree temperatures on the canyon floor was met with a 65 degree monsoon reality! While it wasn't quite what we expected for our day trip, adventure was still had!
After our canyon adventure, we headed to Flagstaff then out to Yosemite. Opting for the 13 hour route (with an approach from the southeast) meant that we could be driving between Death Valley and the Mohave Desert! It was quite a visual treat. Some parts of the desert were white sand, others rolling foothills of orange dirt and brushy stubble, still others shorter green trees and more mountainous views.
Our approach dropped us north of Mount Whitney (the tallest point in the lower 48 states - approx. 20,000') on the east side of Yosemite National Park just before dark. We were able to see more than 2 hours of the most spectacular mountain views on the drive in. Clearings in the pine groves revealed sneak peeks of serene, sleepy lakes which projected mirror images of the surrounding mountains.
On Thursday, July 22, we hiked Half Dome! We charged up a 4800' elevation gain over a 7-mile path up to the summit where we met 400' of vertical cables which led up apex of the granite boulder that is Half Dome. Several thousand weekend warriors take the Half Dome challenge each year, we were happy to be counted among the percentage that made the ascent. The views were well worth the trip up and we enjoyed reflecting upon them during the 7-mile return hike!
On Friday, July 23, we had a picnic lunch then swam in the Merced river at a spot just outside of Curry Village in Yosemite. Then we explored the Mariposa Grove, home of some of the largest trees in California. The sequoias we saw were more than 3,000 years old and were truly spectacular. One of my favorites, the Grizzy Giant sequoia, was 98' around the base, its limbs measured 6' to 8' in circumference and it was taller than a Boeing 747 jet!
After a wonderfully memorable southwest adventure road trip, I dropped Phil off in Fresno to fly back to Dallas then headed to church on Sunday in a town near the Hostel I would be staying at the for next month and started prepping for the beginning of my Wilderness First Responder and EMT course (W-EMT)..
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