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Can you believe that it is already day twenty-three of the Wilderness EMT course in the North Cascades? We have spent the past month surrounded by people who surround themselves with remote settings, where medical care is anywhere from a few hours to a few weeks away. It has been an amazing course and the students have really developed their assessment skills, treatment practices and leadership styles.

The first week of the course defined who the students would become as Wilderness EMTs , we gave them a solid foundation in patient assessment to take them through the course. Starting with simple airway management (or maybe not so simple… when your fellow students are ‘fake’ vomiting apples and granola on you!), and continued full swing with some advanced skills for remote settings, such as suturing. The students got their suture practice on pigs feet (no pigs were harmed, only healed), while gaining a valuable skill for truly remote patient care!

The course cruised along into week two, after students got their first glance at real patient care in the clinical rotations. Each student went for a ride along shift on Skagit County Medic One Ambulance, and an emergency room rotation at Skagit Valley Hospital. The urban skills of the EMT Basic, such as spinal immobilization, and the long-term remote skills, like care of a seizing patient following a head injury really came together. Everyone started to gain an appreciation for how the long term patient management skills can really make you a better urban care provider. Somewhere between the head and spinal trauma, chest injuries, bleeding, and unresponsive patients, we began honing some of the more advanced skills. The Medical Person In Charge (MPIC) certification encompasses some advanced skills that can make the difference for critical patients in remote settings. The advanced skills spanned everything from IV initiation, nasogastric tubes and foley catheters to airway management with the King LT-Ds and the Rusch Easy-Tube.

Urban, remote, and advanced skills all merged as we headed into week three. Night-time rescue scenario? No problem, as the students professionally calmed and cared for frantic patients into the dark night time hours. Five person vehicle extrication? Not to worry, they had the patients packaged for transport in a half hour, while still paying attention to the ‘soft skills’. Truly solid care providers emerged as we delved into the complexities of cardiology and respiratory emergencies.
And here we are, week four. Emergency child birth, high angle rescue systems, and all of the skills from the previous weeks, and as you can see, we have been busy! Leaders have grown from the curious students on the first day. We were introduced to people who spend their time on the vast glaciers of the arctic and antarctic, wilderness trip leaders, and active military personal all blended in with ski patrol, lifetime divers, park rangers, physicians, law enforcement and wildland firefighters. After a month spent in such an exciting course filled with hands on assessment practice and field treatment, I am certain that the students are armed with medical skills that they can use in an ambulance or in the arctic. I can only hope my next course is in as beautiful of a location as the North Cascades!

Until next time,