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Teaching Wilderness Medicine in the Khumbu

Monday, January 14th, 2019

Tragedy and Purpose

In September of 1999, legendary mountaineers Alex Lowe, Conrad Anker, and David Bridges traveled to Tibet with the goal to ski down the 8,103 m (26,291 ft.) Himalayan peak Shishapangma.  They were part of the 1999 American Shishapangma Ski Expedition. The goal was to be the first American team to ski from the summit of an 8,000 m peak.

Bridges, Anker, and Lowe (left to right)

Unfortunately, tragedy struck on October 5 as they were searching for a route up the mountain.  A large serac broke loose 1,800 m (6,000 ft.) above them, resulting in an avalanche striking all three of them.  Anker survived with multiple injuries, and immediately began attempts to locate and rescue his friends. With the help of others, Anker searched for his teammates for the next two days. Unfortunately, they were unable to locate Lowe and Bridges.

Lowe was survived by his wife Jennifer and their three sons.  Following this tragedy, Anker spent a great deal of time with Jennifer and her three sons.  During this time, the two fell in love and were married in 2001 (Jenni Lowe-Anker wrote more on this in a memoir, it is also discussed in the film documentary Meru).  Together they formed the Alex Lowe Charitable Foundation.  The Khumbu Climbing Center, or KCC, is a result of this foundation and where many of their efforts are focused.

The Khumbu Climbing Center

Located at around 3,960 m (13,000 ft.) in the Khumbu Valley, Phortse is a humble pastoral village that is home to generations of Sherpa climbers and to more Everest summiteers than anywhere else on earth.  Phortse lies off the traditional beaten path to Everest and is often overlooked, as it lies perched among the clouds resting in the shadows of the sacred Himalayan peaks. But if you look across the gaping gorge of the Dudh Kosi River as you ascend to the Tengboche Monastery, you will see a terraced knoll with stone structures scattered about.  It is there that the Khumbu Climbing Center found its home.

Khumbu Valley with Photse visible

Phortse (left mid flat area) with Everest, Lhotse, Nuptse, and Ama Dablam in background

The KCC was founded in 2003 with the mission statement “to increase the safety margin of Nepali climbers and high-altitude workers by encouraging responsible climbing practices in a supportive and community based program.” For 2 weeks each winter, technical climbing skills, English language, mountain safety, rescue skills, mountain geology, and wilderness first aid are taught to students.  Prior student experience ranges from novice climbers/porters to Everest veterans, and to even the famed “Ice Fall Doctors” who painstakingly and courageously find a way through the Khumbu Icefall each climbing season to open the path towards the sacred summit of Sagamartha (Nepali name for Everest).  To date, over 800 students have benefited from this annual vocational training aimed to improve both their quality of life through better employment opportunities and their ability to stay safe as they work high in the Himalayas.

In addition to the annual training that occurs, the KCC has also offered specialized courses over the years including advanced technical rescue and advanced mountain first aid.  The KCC is dedicated to the village of Phortse and over the past years and with countless help, has tirelessly worked to build a permanent building in Phortse.  This building, which is nearing completion, will serve as the home to the KCC and will allow for expanded instruction, will provide access to both visiting Nepali and international climbers year round, and will also serve as a community center, library, and medical clinic for Phortse.  It is but one way that the KCC demonstrates their dedication both to the Phortse and all high altitude workers of Nepal.

Discovery, Reunion, and Collaboration

On April 27, 2016, climbers Ueli Steck and David Göttler were on an expedition to Shishapangma when they spotted two bodies that had partially emerged from the glacier.  Suspicion was high that they were those of Lowe and Bridges.  Shortly after, Anker’s phone rang with news of the discovery and after a description of the bodies, their clothing, and equipment, Conrad and Jenni were convinced that it was indeed Alex and David.

In response Anker said, “It’s kind of fitting that it’s professional climbers who found him. It wasn’t a yak herder. It wasn’t a trekker. David and Ueli are both cut from the same cloth as Alex and me.”

Regarding this discovery, Jenni Lowe-Anker said, “I never realized how quickly it would be that he’d melt out…I thought it might not be in my lifetime.”

Meanwhile in New Mexico, Dr. Darryl Macias, an emergency medicine physician who specializes in mountain/wilderness medicine, was returning home from teaching a wilderness medicine and dive course in Hawaii when he received a phone call.  “Ueli Steck found them!”

Dr. Macias and David Bridges were very close friends and climbing partners that had traveled the continent and Europe together.  Part of Dr. Macias’s desire to focus on, teach, and promote wilderness medicine was inspired and spurned by the death of his close friend David.  Soon after, Anker and Macias contacted each other along with others close to Lowe and Bridges.  Plans were made to travel to Tibet to lay the two to rest, with Dr. Macias serving as the expedition physician.

Shishapangma expedition to recover Alex and David

While emotional, the trip was a success and the group was able to locate Alex and David and lay them to rest according to local custom and practice.  During this trip, Dr. Macias learned about the KCC, its mission/purpose, and was invited by Anker to come and teach at the KCC.   With great enthusiasm, Dr. Macias accepted the invitation and traveled to Nepal in January of 2018.  He traveled there with two other physicians from the University of New Mexico International Mountain Medicine Center, Dr. Jake Jensen and Dr. Hans Hurt, to provide much needed medical education to the amazing group of high altitude workers that call Nepal their home.

(For more on Dr. Macias’s experience dealing the loss of a friend, his journey and experience into wilderness medicine, and his experience at the KCC see his MEDTalk. He starts at 1:31:00.)

Albuquerque to Phortse

Prior to departing, we (Macias, Jensen, and Hurt) discussed what topics we felt would most pertinent for the course. We knew that we would only have 8 hours with each group of 8-10 students, and wanted to ensure that all the information taught would be beneficial.  While we knew we could cover topics such as acute mountain sickness, high altitude cerebral edema, high altitude pulmonary edema, and hypothermia, we also wanted to teach more commonly encountered conditions.  We reviewed the current literature to make an updated list of the most common complaints encountered during expeditions and treks.  Ultimately, we created a small booklet full of illustrations and diagrams that was written in simple English for each student to keep. The booklet contained topics we wished to teach, along with extra topics we knew we wouldn’t have time to cover.

After traveling halfway across the world from Albuquerque to Kathmandu, we met with a small group of other KCC western instructors and flew to Lukla together.  Lukla is often referred to as the gateway to Mount Everest, as most expeditions into the Khumbu region start there.  It is also home to the world’s “most extreme and dangerous airport” as it lies perched on the side of the steep valley amongst 6,000 meter peaks.  From there we began our 3-day trek to Phortse, stopping in Phakding and Namche Bazaar along the way to acclimatize.  We also enjoyed great views of Everest, Nuptse, Lhotse, Ama Dablam, and countless other peaks, often sipping “chiya” at quaint tea houses.  Our arrival to Phortse was a humbling one, as many locals were waiting at a stupa, which marks the entrance into the village.  We were warmly welcomed with cheers, hugs, and khatas (long flowing silk fabrics to adorn the neck) to mark our newfound friendship.

Entering Phortse

Shortly after arrival, the preparation began for the biggest group of students that KCC has ever had.  We assisted in teaching advanced climbing skill updates to the Nepali instructors and gave them a medical refresher course, as it had been years since many of them had received any form of medical training.   This also gave us a chance to test out our teaching strategies using various scenarios, demonstrations, and discussions prior to students arriving.  Based on their feedback, we made minor adjustments and added a few additional topic ideas to benefit the students.

For the remainder of the course, we taught students basic first aid in groups of 8-10 each day.  We began with personal safety, scene size-up, and going over the MARCH algorithm.  Other topics included wound care, blisters, orthopedic injuries, altitude illness, hypothermia, frostbite, and GI issues.  We opted for topic discussions, demonstrations, scenarios, and hands-on activities, eliminating standard PowerPoint presentations.

Jake Jensen and Hans Hurt teaching scene size up and safety

We found that many students understood English, though with variable fluency. With each class we taught we learned more Nepali, making our teaching even more effective.  At times our Nepali words were not perfect, making for many laughs (the Nepali word for knee is very close to a very different part of the male body). However, they understood us, and appreciated our efforts to use as much Nepali as possible.

Darryl Macias teaching how to splint

Each day to start we would have the group introduce themselves to us.  We would ask where they were from, what their medical training background was, and what their experience was working in the Himalaya. Through this, we found that only around 10% had had some form of medical training in the past.  This number was lower than the number of students that had climbed or been on expeditions to Everest and other 7,000 meter (~23,000 foot) and 8,000 meter (~26,000 foot) peaks.  This solidified the importance of our medical course, as for many it was the first formal medical education they had ever received, and it may be the only training some students ever receive.

Darryl Macias and Jake Jensen giving a lecture

Our main focus in teaching was in line with the mission statement of the KCC.  We continually emphasized safety and self-care during every topic we taught. Overall, our instruction was very well received and students did exceptional during the test day, demonstrating that safety was of the utmost importance in caring for ones-self and others.

We enjoyed our time in Nepal, and were glad we could contribute to the cause.  We were all humbled by the experience, and developed a deeper appreciation, respect, and love for the people, culture, and landscape of Nepal.  We all looked forward to a chance to return, unsure when that would be, and discussed how we could improve their education, preparation, and discussed the idea of teaching a Wilderness First Responder course to the more advanced individuals if we were presented the opportunity.

Macias, Jensen, and Hurt in Tengboche with Ama Dablam and Everest in background

We even recorded a podcast for the Wilderness Medicine Society, Wilderness and Environmental Medicine Live! where we discussed our experiences (starts at 20:03). We all looked forward to returning, but weren’t confident when we would have that chance…

The Return

As plans were being laid for the 2019 KCC course, Dr. Darryl Macias and I were contacted by the directors of the KCC.  We were happy to hear they were pleased with our efforts the year before and asked us if we would return.  We jumped at the opportunity, happy to take what we had learned the year prior to improve the education provided.  We would also take with us Dr. Nicole Mansfield, our current Wilderness, Austere, and International Medicine Fellow.

In addition to teaching a one day basic medical course to ~90 students, we were also asked if we could provide a Wilderness First Responder (WFR) course to ~24-30 of the local KCC instructors who also serve as guides throughout Nepal.  Many of them had approached us the year prior with great interest in a WFR course and we eagerly accepted this invitation to provide them with additional instruction.  While there have been other Wilderness First Responder courses taught in the Khumbu Valley, this would be the first aimed to educate the local population that call it home.

Plans were made regarding how we could improve the education to the basic class and a curriculum for the WFR class was developed.  We created an online video library for the WFR students so they could start their learning prior to arrival.  We also began gathering the supplies that we would need to teach.  It was during that time that we realized that it would be best if we could provide them with a medical kit that would match their level of training.

After reaching out to many individuals and groups, we were thrilled when Adventure® Medical Kits responded and stated they would assist us by providing medical kits to the 24-30 local Sherpa guides that we would be teaching a WFR course to.  These kits, the Mountain Series Explorer, will be the perfect kit for this group.

The Explorer medical kits in the hypobaric chamber

The contents of the kit are excellent and is ideal for the WFR training that this group will receive. This donation will go a long ways to ensuring that this group doesn’t just have the knowledge, but also the tools to care for others in a wilderness/remote environment should the need arise.

Darryl Macias in the hypobaric chamber, supplementing kits with extra gloves and gauze. 

In addition to that, we also received additional funding from another source and will be able to provide very basic medical supplies to the ~90 basic class students and will also be able to add some supplies (survival, fire-starting equipment) to the kits provided to us by Adventure® Medical Kits for the WFR students.

Jensen kids making small kits for basic class students

Things have been extremely busy as we search out the equipment we will need to teach, record videos, refine lesson plans, and gather personal gear, but all in all this year is shaping up to be a fantastic one at the Khumbu Climbing Center, and we cannot wait to arrive and provide this much needed education to this amazing group of individuals.  Stay tuned for a follow up on how things went!

Packing the Explorer medical kits and other supplies

About the Authors

Jake Jensen, DO, DiMM, FAWM

Jake Jensen is an emergency medicine physician who completed a Wilderness, Austere, and International Fellowship program with the University of New Mexico. He enjoys teaching wilderness medicine at all levels and has also practiced and taught medicine in Haiti, Chile, and Nepal with plans to continue teaching nationally and internationally in the future.   He has a very loving and supportive wife who puts up with his antics, travels, and hobbies.  He also has 4 adventurous children that love the outdoors, help him pack for his trips, and look forward to when they can travel more with him.  In his limited spare time he enjoys backcountry skiing, mountain biking, backpacking, and simply sitting around the camp-fire.

Darryl Macias, MD, FACEP, DiMM, FAWM

Darryl is a professor of emergency medicine at the University of New Mexico International Mountain Medicine Center. He has been involved in wilderness and international emergency medicine development in Latin America, Europe, and Asia, and has lectured internationally. He is involved in mountain rescue and expeditions, but also enjoys taking his family on crazy trips throughout the world, seeking new adventures in life. You can hear his lively Wilderness and Environmental Medicine LIVE! Podcasts on iTunes and SoundCloud.

More Information

For more information on the Alex Lowe Charitable Foundation and the Khumbu Climbing Center, click here.

To learn more about discovery of Alex Lowe and David Bridges on Shishapangma (also where quotes from Conrad Anker and Jenni Lowe-Anker were found), click here.

Below are the links mentioned above in the blog post along with a few additional ones. Highly recommend you take a look/listen at these.

Dr. Macias’s MEDTalk regarding his story of loss, journey into wilderness medicine, and what the future holds.  Starts at 1:31:00.

Link to the Wilderness and Environmental Live! Podcast where we discuss our experiences during our first trip to the KCC. Starts at 20:03.

Link to the Wilderness and Environmental Live! Podcast where we have a discussion, with the authors, regarding a recent paper that was published regarding the knowledge of porters in the Khumbu Valley when it comes to recognition and treatment of altitude illness. We also branch off and discuss other aspects of medicine and their well-being. Start at the beginning.

Link to The Mountain Dispatch, a biannual newsletter put out by the UNM International Mountain Medicine Center where we discuss last year’s trip to KCC.

Trip Safety: Don’t Get Stuck in the Dark

Thursday, March 22nd, 2018

Embarking on a backcountry adventure can be one of the most rewarding experiences. When all the planning, anticipation, and physical effort culminate in awe-inspiring views, you receive a feeling of escape not available in the front country. While one of the greatest gifts you can give yourself is to continually go deeper and find more remote settings, it’s not without its own perils. As a Search and Rescue (SAR) Member, I’ve seen firsthand how a potentially fantastic day can turn into the worst day of your life for you and your loved ones.

Adventures – no matter how amazing – are not without peril

Preparation is crucial for trip safety in your backcountry expeditions. This simple statement has so many layers to it; it’s easy to brush it off and assume you have done enough. Route planning, properly packing your bag, and even preparing your physical and mental fitness all go into preparation. Today I’ll touch on a couple trip safety tips that, when applied, can help prevent common mistakes for everyone traveling in the backcountry.

Trip Safety: Pack the Right Gear

Gear is sexy. You can read a million and half blog posts or YouTube videos on gear.  From reviews to proper load-outs, there is a lot to learn and it seems to keep getting more complex. However, the basics maintain true. Pack your 10 essentials (Don’t know what these are? Go check out REI’s great post on them). While I firmly stand by my alpine “light and fast” style and agree that the ability to move quicker adds safety, there are certain things that are worth the weight.

Illumination

Last summer, there were multiple rescues to aid hikers stuck in the dark. Even if you’re setting out at sunrise and you feel overly confident you can get your hike done in just a morning, please still bring a headlamp. It makes my wife happy when I get to eat dinner with her on a Sunday night, instead of setting out to rescue hikers stuck in the dark.

Pack a headlamp so you don’t get stuck in the dark

In that same vein, bring extra batteries, especially if you’re working on a big day. Fancy headlamps that use built in lithium Ion batteries definitely help cut weight, but when it dies, it’s dead until you get back to a charger. My climbing partner was the victim of exactly this scenario coming down a 30 degree scree pitch off Mount Temple (BANFF, Canada) at 3 am. Our fast decent turned to a crawl when we were reduced to one headlamp. Learn from our mistake.

First Aid Kits

First aid kits are our specialty here at Adventure® Medical Kits, and I love the fact that I have so many supplies at my disposal to build kits. I’m a huge fan of our Mountain Series Day Tripper Lite kit. It’s perfect for day trip adventures and isn’t overloaded with unnecessary supplies. It also has great organization and labeling; in a rush, you can find exactly what you’re looking for. Another option is the custom bag from the Mountain Series, which lets people like me build their own kit and label it as needed.

My med kit for day hikes: the Day Tripper Lite, QuikClot®, an elasticized bandage, and a C-Splint™

Regardless of if you build your own kit or use a premade version, go through it often. It’s incredible how quickly you forget you used something in the middle of your climb when things start going well again.  A couple things that I mandate in even the smallest med kit are an elastic bandage, some form of a splint, Diphenhydramine, Ibuprofen, a couple big gauze pads, a small roll of medical tape, and an emergency blanket. Knowing what is in your kit is almost as important as knowing how to use it! I highly recommend that every backcountry enthusiast takes a Wilderness First Aid course (WFA), where you’ll learn the necessary skills to administer basic first aid in the backcountry. This can make the difference between a scary and stressful hike out and a confident, enjoyable return to your car.

Footwear           

The Mountains are a rugged place. They require rugged footwear. Most likely your road runners are not going to cut it, and your designer flip flops won’t make it even half a mile. Choose a stiffer, more supportive shoe to give you better protection. Unless you have seriously trained your body, a minimalist shoe can cause you long term issues. Not only does having a supportive shoe protect your feet, but your knees, ankles, and hip will also thank you. Having proper footwear ensures your body is taken care of. There are tons of debates on whether it’s better to have waterproof shoes or not in the summer. Some argue the non-waterproof will dry quicker and breathe better.  In the winter it’s almost no question – go waterproof.

Allow stiffer boots and trail shoes some time to break in. Once they do, you’ll never want to buy a new pair.  The break in process shouldn’t be overlooked; the first couple outings should be a bit easier than your usual hike, as both your feet and shoes need to adjust. Definitely bring some extra moleskin or GlacierGel® for blisters during your break-in period. At the end of the day, waterproof or not, find a shoe which really protects your foot and ankle, gives you good traction, and fits well.

Clothing              

Dressing for a hike is similar to dressing for other athletic activities; however, you must take exposure into account.  Your clothing must work well for extended periods in inclement weather, high wind, or extended sun exposure. The age old saying in the backcountry is that “cotton kills,” as once cotton is wet, it doesn’t insulate anymore.

Take into account ridgeline walking, where exposure to the wind and weather can be intense

In the mountains you can get hypothermia year-round. To combat cold any time of year, dress like an onion – layers layers layers! There are three basic layers: a base layer to move sweat away from body, an insulation layer, and an external layer to protect from elements. The specifics obviously all change depending on the season, but the principals stay the same.

Pest Control

Know the pests in the general area. Bug bites are a really annoying. A bear bite can be catastrophic. Understand that you probably should bring some form of deterrent for bugs and bears if they are known in that area. Ben’s® Clothing and Gear is fantastic to treat you gear before heading out.

From bear spray to head nets to bug repellent, pack for the pests in the area you’re visiting

Packs

One thing the 10 essentials fails to bring up is how to carry all those things. A good fitting backpack is necessary. It’s worth investing in a durable pack to get you through years of adventures. The biggest aspect of any pack should be its fit. Different disciplines have slightly different requirements. For instance, my hiking bag has large, cushioned hip straps, so that the load will sit on my hip bones. My technical climbing pack has minimal hip straps as it will get in the way of my harness. Figuring out the proper size pack is also important (I’ve blown zippers in the backcountry from stuffing my pack too tight). I’ve also had back pain from under-filling a big pack and having the contents rattle around on a decent. Having a number of packs for different outings will keep your back happy and pain-free.

Choose a pack appropriate for your activity – consider both size and fit

Trip Safety: Know Before You Go

Having fun and enjoying the outdoors is best achieved when you are properly prepared. While carrying the proper gear will help mitigate potential issues, there are intangible things that are invaluable in preparing for a hike.

Know what the climate is like where you are going.

In the early spring my SAR team might have 4 rescues in a day, while mid-summer we get 1 in a weekend. Why is this? In the White Mountains, we’re only 2 hours away from Boston on the interstate.  On early spring weekends, weather in Boston may be sunny and warm, with no snow; however, weather in the Whites includes waist-deep snow and raging rivers fueled by the spring melt.  Check the weather and trail conditions where you’re going – don’t assume it’s the same as what you see from your front door.

Seasons can look quite different in different places – like snowy springs in the White Mountains

We live in a wonderful age where Facebook communities, Sub-Reddits, and Instagram posts can help you deem what true current conditions are.  Weather has different patterns in different locations; do some research and see what generally occurs in the area you will be traveling. The weathermen do their best but are often wrong. Getting caught in a surprise summer thunderstorm in the alpine is life threatening. Learn the basics in reading the weather and apply those skills with knowledge of the local weather patterns.

Set a turnaround time before leaving the house.

This should be a firm time in which you know you need to turn back. A turnaround time keeps you honest with how quickly you are actually moving. The mountains will be there another day, and setting the time before leaving the house keeps the emotions in check.

Let someone not on the hike know of your planned route.

Text/call right when you set off and right when you return. In some places people will put detailed notes on their car dash. This is especially helpful for technical routes, as it lets other parties know what line is going to be most crowded.

Account for elevation change.

Elevation gain is not easy, neither is elevation loss. Remember getting to the top is optional, getting down is mandatory.

Don’t just check the mileage – check the elevation change!

Don’t discredit what elevation change is on the hike. The general rule of thumb is every 1,000 feet of elevation change will feel like another mile on the hike. For example, if I hike 4 miles to the summit with an elevation change of over 2,000 ft., that will feel like 6 miles. So a seemingly 8 mile roundtrip hike can really feel like a 12 miler. Plan your hike accordingly. Know your party members and what constitutes a fun day.

Be realistic on where you and your party is at physically.

If you haven’t had a cardio day in months, and you don’t know what leg day is at the gym, pick a more introductory hike. Check your ego and build up to that big hike. There is no shame or pain in hiking something under your threshold. A carry out on rugged terrain with broken bones is pretty miserable. Even hiking a couple miles hungry and exhausted will make you not want to return to the mountains for a while.

Plan for sunshine, prepare for thunder.

You may blow through your hike as fast as you think, but you might not. Bring enough food and water for some extra hours. Think about exposure to the elements: some extra time in the sun or wind or getting caught in a rain storm can make for a miserable outing.

Conclusion

Backcountry travel is no easy task. There are so many variables which go into a good adventure. I’m constantly re-evaluating gear and travel techniques to help keep me safe and have a good time. From gear to pre-adventure prep, there are plenty of trip safety actions you can take to ensure you have a great next adventure.

About the Author

Joe Miller is an alpinist residing in the White Mountains of New Hampshire. He serves on the Pemigewasset Search and Rescue team, which has received some fame from the television show North Woods Law. Joe loves everything about the outdoors and can be found taking full moon laps up Cannon Cliff, ice climbing classics in Crawford notch, and slaying powder on his splitboard. Joe started working at Tender Corporation in 2015, as he loves the proximity to the mountains. When not outdoors, Joe lets his inner geek flag fly; he can be found holed up with his dog and cats tinkering with electronics and computer systems.

Treating Hypothermia with the SOL All Season Blanket at the AR World Championships

Friday, March 2nd, 2018

During the 2017 Adventure Racing World Championships, Team Adventure® Medical Kits‘ captain and team medic Kyle Peter helped save a racer’s life using the Survive Outdoors Longer® All Season Blanket. When one team came into the transition area he was at with a racer suffering from severe hypothermia, Kyle jumped into action to treat him until medical help could arrive. 

On the Last Leg

It was the final night of the 2017 Adventure Racing World Championships.  The sun had just set, and I was sitting at the final transition area just outside Casper, WY.  The top 5 teams were coming off of a relatively easy paddle leg in their pack rafts and onto their bikes for a simple ride over Caser Mountain to the finish line.  Teams were smelling the barn and moving quickly to finish the race and battle for the top 5 spots.

Team Adventure® Medical Kits getting their bikes ready after finishing the paddle leg

“The athlete was completely unresponsive…”

I was cheering on a team from France when I quickly realized one of their 4 teammates was bundled up in the front of a 2 person raft in soaking-wet emergency blankets.  Running to their assistance, I found the athlete was completely unresponsive to slaps on his face.  Severe hypothermia was in play here, brought on by a combination of 4 days of racing hard, sleepiness, wet conditions, and 55 degree temperatures.  My Wilderness First Responder skills kicked in!

Team Adventure® Medical Kits’ captain and medic Kyle Peter was the first responder

We carried his limp body up the boat ramp and put him into the back of a trailer.  I knew we need to call for help and get him as warm as possible.

Teammates gathered around their friend

“The All Season Blanket really helped save this man’s life”

Folks started to spring into action.  Some were boiling water, others called 911, while others ran to get warm supplies.  His teammates and I removed his wet clothing, put him in dry clothes, and got him in a “burrito” hypothermia wrap.  We had multiple sleeping bags, hot water bottles, and his feet warming on my stomach all to help him regain heat.  We used a proto-type Survive Outdoors Longer® All Season Blanket that I had with me to reflect back any body heat that started to return. The heat reflectivity and durability of the All Season Blanket really helped save this man’s life, as he slowly began to regain consciousness.

Kyle used  a prototype of the All Season Blanket as the outer layer of the burrito wrap to reflect any heat back to the patient

After 30 minutes, the ambulance arrived and took the patient to the hospital, where he spent the next 2 nights recovering from a near fatal case of hypothermia.  I am so thankful that I was prepared with the All Season Blanket and was able to help the racer come back from the hypothermia and recover 100% with no permanent damage.

Emergency personnel arriving at the race to take the patient to the hospital

About the Author

Kyle Peter, captain of Team Adventure® Medical Kits, has captained teams to 1st place finishes in 4 consecutive United States Adventure Racing Association’s National Championships (USARA) and to 2nd, 3rd, and 4th place finishes in the World Championships. Since 2003, he has raced in over 140 adventure races with more podium places that he can count, making him one of the most experienced and successful USA adventure racers on the circuit today.  Whether Kyle is paddling his surf ski in the American River or mountain biking in the Sierras, he strives to get outside every day to maintain his physical fitness as well as his mental sanity. Also the team medic, Kyle is a certified Wilderness First Responder so he’s prepared to look out for the health of his teammates or other adventurer racers whenever emergencies occur.

The Survive Outdoors Longer® All Season Blanket is now available for purchase at www.SurviveOutdoorsLonger.com

Lifetime Outdoor Enthusiast. Completely Unprepared. – Lessons in Wilderness First Aid

Thursday, November 9th, 2017

Ever wonder what you’d do if a medical emergency happened while you were out in the wilderness? One of our employees recently took a course in Wilderness First Aid at SOLO Schools. She’s extremely excited to share what she learned! – Adventure® Medical Kits

My dad and I after hiking up Mt. Lafayette

My dad and I after hiking up Mt. Lafayette

An avid hiker, I grew up scaling the White Mountains of NH with my father without injury (excluding your normal blisters and scrape). Though I lacked personal experience with first aid in the wild, I knew wilderness emergencies weren’t uncommon.

I remember the day my father came home from a hike and said he’d spent 20 minutes near the top of Mt. Lafayette helping a stranger descend only a few hundred feet of the trail. The stranger fell and shattered his kneecap on the rocks, making every step excruciating. Thankfully, they bumped into a rescue team on a practice climb that quickly became real, and my dad continued down alone.

My dad and I on top of Mt. Jackson

My dad and I on top of Mt. Jackson

Since that day, I’d often wondered what I would do if faced with an injured hiker on the trail. Would I be able to offer any help at all? Miles from professional care surrounded by trees and mountains, I wasn’t equipped to be someone’s best chance at survival, and what if that someone was my dad?

This year, I was given the opportunity to attend a Wilderness First Aid (WFA) course at SOLO School of Wilderness Medicine. Walking onto the campus, I was unsure of what to expect out of the next two days. If nothing else, I was excited for the chance to learn a few first aid tips from wilderness experts. I learned much more than that.

Wilderness First Aid: Day 1

“Is anyone NOT ready?”

When you have five people about to attempt lifting an injured companion, you don’t ask “Is everyone ready?” You may not here the responding “no” over all of the “yes’s.” With a possible spinal complication, missing something and dropping your injured friend is not an option.

“Okay… one, two, three, lift!”

With one smooth motion, we lifted our patient from the cold ground to waist level, all without moving his spine. Surprised at our success, we froze for a moment, before the team leader (holding the patient’s head) followed up with, “Okay, we move on three!” We traversed the rough ground and safely placed our friend onto a foam pad. Thrilled at our success, we listened to feedback from our instructor and “injured” friend on how they felt our practice had gone.

Practicing making splints at a SOLO course

Practicing making splints at a SOLO course. PC: SOLO Schools

We’d only met each other earlier that morning, but as we stood outside the main building in the afternoon sun, our group was already beginning to turn into a team, forged by a common desire to learn and to be prepared to help others. Like me, my fellow classmates were driven by this desire to take the WFA course at SOLO. None of us were disappointed.

In 2 Days, There’s a Lot You Can Learn

Over the course of those two days, I was immersed in an innovative, hands-on learning experience. I learned how to improvise splints out of coats and bandanas, immobilize a victim’s spine with backpacks and baseball caps, and treat wounds ranging from lacerations to serious burns with items like honey and rain jackets. We covered assessing both unconscious and conscious patients, including identifying and treating life threats, monitoring vital signs, maintaining a soothing presence, and making an evacuation plan.

Improvising a leg splint. PC: SOLO Schools

How often should you change burn dressings? How do you recognize potentially life-threatening infections? When should you be concerned about a spinal injury? What should you do in a lightning storm? What are the early signs of shock, and how can you treat it? These are only a handful of the questions we learned how to answer.

New Skills to the Test

 

Assessing and caring for a patient.

Working as a team to practice assessing and caring for a patient. PC: SOLO Schools

Not only did we learn though – we also did. Hardly an hour of lecture would pass before our instructor had us outside practicing our new skills, with some of us acting as patients and some as caregivers. Outside, lifting companions, assessing broken bones, and applying pressure to stop major bleeds, our class of about 20 learned how to manage difficult patients, quickly assess scenes, and rule out spinal injuries.

Course Highlights

So out of this whirlwind weekend of knowledge and skill application, what did I enjoy most? This is gonna take a list:

  • Our instructor. Seriously – she was awesome! An amazing resource for both professional medical knowledge and practical ideas for when situations actually occur. From improvisation techniques to a great sense of humor, I couldn’t have asked for a better teacher. And she encouraged questions!
  • My classmates. I emerged out of that class with new friends who love the outdoors like I do, yet have a variety of experiences and backgrounds to speak out of. They asked relevant, insightful questions of our instructor that contributed to everyone’s learning. From a grade school teacher who leads the school’s hiking club to a wilderness first responder getting recertified, our differences and similarities worked together to make learning fun and effective.
  • Learning what’s left to learn. Headed into the WFA course, I knew I didn’t know enough… but I didn’t know how much I could know! Now, I have a firm grasp of what wilderness emergencies I’m equipped to handle and which I’m not, and I’m excited about the possibility of furthering my knowledge with another SOLO course in the future.
  • Packing recommendations. Ever wonder what you should be carrying for first aid supplies? Or have a first aid kit but only a vague idea how to use it? That’s part of what makes this course so great – throughout the day, we got tips from our instructor and each other on the most useful supplies to pack and when and how to use tools like an irrigation syringe, triangular bandage, tourniquet, and more.

Choosing to Be Prepared

 

Hiking down Mt. Washington with my dad

Hiking down Mt. Washington

Whether you’re a trip leader or just an outdoor enthusiast looking to become more prepared, I highly recommend the WFA course at SOLO as a great starting point to build a foundation of first aid knowledge that could save your life, a friend’s, or a total strangers. If you own a first aid kit and haven’t taken the time to look through it, this course is a must for preparing you in how to use what’s inside. A bit of advice I learned from my course: first aid supplies are only as effective as the person carrying them.

About SOLO

The oldest continuously operating school of wilderness medicine in the world, SOLO offers wilderness medicine education on a variety levels for everyone from outdoor enthusiasts to trip leaders to trained professionals. The WFA course is a 16-hour course that provides a 2 year certification and covers the basics of backcountry medicine. On the other end of the spectrum, SOLO’s Wilderness Emergency Medical Technician (WEMT) course lasts a month, and participants who pass emerge with the national EMT certificate and thorough training in wilderness-specific medicine and long-term care. Courses can be attended on their campus in Conway, NH, or at off-site locations across the United States.