Today is the day that we get to put all of our hard work to the test. After 8 days of intensive education we are taking a 100 question exam to see how much information we have been able to retain. Along with the written test we will be paired with another student to do one last patient assessment scenario. Our patients will be one of the instructors, so they will be making sure that we do a very thorough assessment. I felt good about my knowledge of the information, but I was still pretty nervous about the exam.

I was paired with Brad for the patient assessment. We really worked well together to complete the patient assessment and verbal SOAP note. We were psyched to get a final evaluation from Rob and to find out that we passed.

After everyone completed the exam we took a lunch break while the instructors graded the tests. Of course we were all comparing mental notes on what we thought we got right and wrong. In the end, everyone passed the exam!

What a great course! The participants were all so much fun. I was really impressed with all of the knowledge that the group was able to share from past experiences. The instructors were fabulous! There knowledge, professionalism, and sense of humor was above and beyond! I feel super prepared and can’t wait to take another wilderness medicine course.

Photo - A Class Photo taken on the final day. (photo courtesy of Jeremy Quant)

We met for class at the usual 8AM start time after our late night Mock Rescue. We were all still talking about what had happened the night before. Chris Sacco joined the instruction team today to talk to us about communicable diseases, poisoning, and lightening. As usual we took park in several scenarios and washed our hands extra good at lunchtime after our communicable diseases discussion. After a hearty lunch we took on the ever serious, but ever entertaining topic of gender specific medical issues. As with the rest of the topics, we had fun with this one!

Tonight we had an evening study session to help us review for the final exam. We met in the classroom and Justin brought down some of his famous salsa to help get the brain juices flowing. I was pretty excited to be able to sit down to review all of the information that we have been learning over the past week.

Today was the best! This morning we were taught about bites and stings and all of the nasty things that can occur when we get these. Our reactions can be totally across the board, so it is great to know how to handle each bite/sting situation. We finished the morning by giving one another injections (of sugar water) to practice in case we are with someone who goes into anaphylactic shock. After lunch we had an intense lesson on diabetes, including the different types and signs and symptoms of each. In the late afternoon we headed out into a shady spot on the lawn to have a discussion about Search and Rescue scenarios. It was a great group discussion lesson that allowed us to really learn all that is involved when there is a the need for a Search and Rescue.

Tonight was our nighttime Mock Rescue. This was a huge rush. We met back just before dark with our packs and headlamps ready to go. Once we were out there and in the moment we really forgot that we were part of a “mock scenario”. It felt so real! We all kicked into high-gear. I would love to tell you about what happened, but that would kill the magic! You will have to take the course to find out.

- Amy

Photo - My wonderful Mock Rescue team! Tony, Dan, Brad, Jenna, myself, and John.

Today was intense.! We spent the morning hours learning about Cardiac and Respiratory Emergencies. It was like being in school again as we looked at a diagram of the heart and re-learned the functions of the aorta, the inferior vena cave, the left and right atrium and ventricle and how they all work together to keep us functioning. In the afternoon we learned about Neurological Emergencies including strokes and seizures. Our scenarios left us working with unresponsive patients. Patients in this state make it a bit harder to do a patient assessment on, but it was great to have to figure it out on our own. We ended the day with an abdominal relay to test our knowledge of where all of our major abdominal organs are. It was a super fun way to test our skills and get us moving!

Six days down, three to go!

Amy

Photo- Students gather in Base Camp, ready for another scenario.

Today we had our first critical mass scenario. We spent the morning learning about environmental concerns from Mairi. She is the Administrative Director of Landmark Learning as well as an instructor and full-time mother of two! She taught us everything that we needed to know about hypothermia, immersion foot, heat stroke and the like. We finished off the morning by rescuing and treating a hypothermic patient that we found in the creek.

After lunch we were faced with an incident involving 3 patients who were part of a biking/ horseback riding collision. I was amazed at how quickly our group leapt to action. A few of the issues we had to deal with were a femur fracture, a flailing chest wound, and a skull fracture. Two of the patients were carried down the mountainside using a backboard and a litter. We made it back to base safely just before a typical summer afternoon thunderstorm. It was a great way to put together all of the skills that we have learned over the past five days! What a rush!

-Amy

Photo- Phil, John, and other members of the team use a backboard to carry our patient down the mountain.  (photo courtesy of Jeremy Quant)

Today Rob joined us as part our the instructor team. He and Justin were clearly thrilled about teaching us to manage common fractures, athletic injuries and how to deal with dislocations. On thing that sets WFRs apart from paramedics and other medical responders is that we can relocate dislocated limbs, as long as we are an hour from definitive care. We learned how to relocate shoulders, fingers, knees and elbows using slow, gentle Traction In Line.

In the evening we returned to learn even more about splinting. If you have never taken part in a “Splinting Extravaganza” you don’t know what you are missing! We enjoyed the cooler temperatures out on the lawn as we splinted for femur and pelvis fractures. When the sun finally set we pulled out our headlamps and kept on splinting. It made for a long day, but no one complained because we were having so much fun!

- Amy

Photo 1 - Brian uses his taping skills to secure my ankle during a lesson on sprains and strains.

Photo 2 - Jenna, Pete and Eric break out their headlamps to finish a TIL splint for my “femur fracture”. (photo courtesy of Jeremy Quant)

Everything that we learned today was great, but I have to admit that the most exciting thing we were taught was the focused spine assessment. Up to this point in all of our scenarios we assumed that the patient had a spinal injury. This meant stabilizing the patients neck and spine until definitive care arrived. Now we know how to rule out a spinal injury by applying a focused spine assessment after the initial steps of the assessment.

We also learned how to treat fractured ribs, fractured clavicles, flail chest, shock and head injuries! The day was full of scenarios that gave us tons of practice assessing patients and using our new skills to get to the root of the problem!

-Amy

Photo 1 - Brad stabilize John’s spine while Bob check his vitals during a patient assessment scenario.

Photo 2 - J-Lo capped off his final day of instructions with an impromptu splinter removal. Rebecca “gloved up” and took on the challenge!

We began day two with a quiz to review everything that we had learned the previous day. After a morning quiz we jumped into CPR. I have taken part in quite a few CPR classes in my life, but today was the best! J-Lo gave us all of the pertinent information and then led us through several scenarios in which CPR was a key component. The hands-on practice and repetition really prepared us to be ready for a real life situation. Each person in the course will receive Adult and Child CPR certification along with their WFR Certification.

The main focus of the afternoon session was spinal cord injuries. We learned to lift and move a patient that had an MOI for a spinal injury by BEAMing, log-rolls, and superman rolls. The instructors supplied us with a back board and a litter. We strapped students in and hiked them around to get a feel for what it would be like haul someone for a long distance. An afternoon thunderstorm rolled in just in time to give us a sense of urgency as we packed and strapped our patient in for evacuation. I can’t believe how much I have already learned, and it is only Day 2!

-Amy

Photo - Brian practices immobilizing Jeremy’s head using an improvised neck collar and head blocks.

JLo, here, tagging on to Amy’s “My Life as a WFR Student - Day 1” entry. I thought it might be insightful for students to get a glimpse into Day 1 of a Wilderness First Responder course from an instructor’s point of view.

The first day of any course, but especially a 9-day course, is always a nerve-racking experience for an instructor of wilderness medicine. We, like the students, leave whatever life we were living rather abruptly for that of a classroom filled with people who will become stinker and closer over the next week. I always get fired up to meet that special group of outdoor enthusiasts. And Amy’s right: we all come from so many different backgrounds! Some students have an immense wealth of experience, re-certifying their WFR for the umpteenth time. Others come with little outdoor experience and are second guessing if dropping over $500 and committing 9-days of their life to a “woofer” course is really what they should have done with the time and money (“What about that climbing trip and that new piece of trad gear…? And what’s a ‘woofer’ anyway?”). Regardless of our backgrounds, though, we’ve all come to learn from each other and gain vital knowledge and skills along the way.

We at WMI of NOLS are careful to set the first day off to a good start. As an instructor, it’s important that people feel welcome and know that they are entering into an open and safe learning environment. We all have stories of arrogant and rude teachers of the past and while no one is perfect, we at WMI work hard to bring our collective experience as wilderness trip leaders and medical care providers to the table in order to serve the students and their learning experience in a humble way. We learn from each other in our courses. And we have fun. We believe that people learn best when they have appropriate fun while learning.

While a wilderness medicine course is fast paced and we cover a lot of information and practical hands-on experiences, as instructors, we think its important to stay in tune to our students’ needs and adapt our teaching to help facilitate learning that will be meaningful and stick with our students. We want you to succeed - both in this course and when you’re faced with providing care during a medical emergency 6 months - 2 years from now. But in order to do that, we start with the basics on Day 1: the safety of the care provider (you!) at the scene of an emergency and the ABCs: Airway, Breathing, Circulation. By the end of Day 1, I always feel good about what’s to come: another 8 days of getting to know students as we all work towards being better wilderness medicine providers.

I look forward to meeting you on Day 1!

J-Lo

Today I began a Wilderness First Responder course at Landmark Learning. The day started at 8AM at the Landmark campus in Cullowhee, NC. Justin, the lead instructor, is the executive director of Landmark and a Paramedic with WestCare. His co-instructor was J-Lo, a Critical Care Nurse at Mission Hospital in Asheville, as well as a WEMT and Landmark instructor. There are 24 course participants who range in age and background. We have a Lawyer from Florida, a college graduate from Wilmington, NC, a computer analyst from Virginia and a school teacher from Nairobi, Africa among the mix. After introductions we jumped right into it. Some of the class time was spent in lectures, and the rest of the time we were participating in mock scenarios. The main focus of the day was on Patient Assessment. By the end of the day we were all feeling great about ABCDE, LOR, HR, RR, SCTM, BP, SAMPLE, and the like. I can’t wait for day 2!

-Amy 

Photo - Dan and Eric show off the wounds they received as patients for one of the afternoon scenarios