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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.

Gasoline Geysering on the San Juan River, UT

Friday, January 11th, 2019

Spring of 2018, Canyon Country Youth Corps (CCYC) was asked to work with the Bureau of Land Management on remote sections of the San Juan River, removing and treating the invasive Tamarisk and Russian Olive. The remote work location required CCYC to break out rafting gear and hire a river guide to ensure the CCYC crew could float the lower San Juan safely with all the chainsaw gear, gasoline, and herbicide needed.

Gasoline Geysering

The Southwest gets very hot during the spring, especially with several days without cloud cover. This can create difficulties when working with machines and flammable fuels. Gasoline evaporates as it heats up, which creates pressure in a closed fuel tank, even when mixed with two-stroke engine oil. This pressure buildup in a hot chainsaw has caused a problem known as “geysering.” This is where a literal geyser, or small fountain, of gasoline shoots out of a chainsaw when pressure is released, like when removing the fuel tank cap. This gasoline geysering is exactly what happened while CCYC was working remotely on the San Juan River, a day down river from the put in, and a four day paddle to the take out.

Gas in His Eyes

It was the morning of the second day of work when a Crew Leader walked over to the Field Coordinator and Field Boss and calmly explained, “Will has gas in his eyes and says it’s hard to breathe.” The Crew Leader was advised to inform the River Guide, who was Wilderness First Responder trained.

The field staff grabbed their water bottles and hurried over to Will, who was found shirtless, leaning over a rock and splashing river water over his chest, shoulders, face, and mouth. He claimed his shirt was soaked with gasoline, his skin was tingling, and his eyes were burning severely. When his chainsaw geysered, he was wearing safety eye protection, but the gasoline reached his eyes anyway.

The Field Boss told Will to stand and put his head back, and they started pouring clean water over his eyes and eyelids. Another Crew Leader was advised to retrieve the large Adventure Medical Kit, knowing it contained a large irrigation syringe and eye drops. The Field boss continued pouring clean water over Will’s eyes and eyelids. Just moments later, the River Guide arrived with the Adventure Medical Kit and took over.

The River Guide used the large irrigation syringe to squirt clean water over and directly into Will’s eyes in an effort to wash out all traces of gasoline. Will said his skin was still tingling, especially in the direct sunlight, but his eyes remained the first priority. The CCYC backcountry communication device was on hold, ready to send an evacuation request. CCYC protocol is if loss of life, limb, or eyesight are at risk, an emergency evacuation is organized, which, on a remote section of river, would require a helicopter.

30 Minutes & 2.5 Liters

The rest of the crew waited anxiously; they rinsed Will’s shirt, they checked the chainsaw, and they waited for updates. To many people’s surprise, it took about 30 minutes and 2.5 liters of water for Will to claim the stinging was still present but less severe and his vision was not blurry. The whole crew breathed a sigh of relief. The River Guide advised Will to hold off on work the rest of the evening, to wash his skin with soapy water, and to sit in the shade.

Will rinsed his eyes again after dinner, and then applied saline eye drops. Will confirmed he was feeling better after the end of the day, and an emergency evacuation was not necessary. Thank goodness for the Adventure Medical Kit and for the River Guide who took over when necessary!

The entire crew was surprised at the amount of water and time necessary for Will to feel relief in his eyes. It was an adrenaline-filled morning; however, the entire crew learned a valuable lesson on the dangers of gasoline geysering and how to respond if geysering occurred again. The biggest lesson learned was how to prevent gasoline geysering and injury. Gasoline containers and chainsaws must be placed and stored in the shade when not in use. A STIHL chainsaw fuel tank can be checked through the translucent sides. If a tank is over ½ full do NOT open the tank. Instead, wait for the chainsaw to cool down, then open the fuel tank. When opening a fuel tank, a sawyer must not stand or lean directly over the fuel tank and must instead face away until pressure is released.

Thankfully, Will recovered just fine after the gasoline geysering incident, and the entire crew was able to continue their work on the San Juan River and enjoy floating to the take out. Without a doubt this was one of the most memorable trips for the CCYC spring season.

About Canyon Country Youth Corps

Canyon Country Youth Corps (CCYC) is a youth conservation Corps that trains up to 56 individuals every year on various conservation and restoration techniques. CCYC works across Utah completing projects primarily on riparian restoration removing Russian Olive and Tamarisk, which are common invasive species in Utah that crowd and destroy river banks.

As a result of Tamarisk and Russian Olive establishment, the river banks have become super-stabilized. This is not good for a healthy, moving river, which are supposed to have bends, curves, braiding, slow parts, and fast parts that change over time.

Tamarisk and Russian Olive also shade the river. This extra shade along an entire river results in significant water temperature cooling. This is detrimental to native fish populations that require a specific temperature range for mating and spawning.

With all the negative effects of Russian Olive and no foreseen circumstance of Tamarisk or Russian Olive being outcompeted by native plant species, mechanical and chemical removal has become necessary. This is where Canyon Country Youth Corps comes into play. Throughout the spring and fall seasons, CCYC works along various rivers using chainsaws, hand tools, and herbicide to remove and treat Tamarisk and Russian Olive.

Written by Natalya Walker

Hip Hop in the Backcountry: Developing Soft Skills as a Leader

Monday, October 15th, 2018

Bonney Pass Part 1: 19 Hours & Counting

Its 8pm and we have been moving since 1am. Four of us are staring down the last steep section of Bonney Pass in the Wind River Range. Camp still looks so far away, everyone is exhausted, injuries are becoming big problems, and everyone is sharing in the feeling of defeat after having to turn around 500 feet short of the summit of Gannett Peak, Wyoming’s high point.

Our view from the top of Bonney Pass, with our camp far in the distance, almost too small to see

I rig up another anchor, put Ben on belay, look at Jenny, and without missing a beat we start rapping “I’m just pillow talking with a fish,” the silly lyrics of the song we have been parodying since the 2nd day on the trail. We all crack a smile and gain some energy; camp doesn’t look so far away anymore.

Leadership Training: Not What I Expected

I’ve been told by many people that I’ve got an intense personality. I am incredibly goal oriented and have a tendency to get a little bit obsessive about my goals. When I first joined the New Hampshire Outing Club my freshman year of college, I yearned to be like the senior hardcore leaders, who casually would grind out back-to-back death marches in between major school projects and studying. I signed up for Leadership Training (LT) for the club and got excited about the new skills I would learn. I thought they were going to teach me how to train harder, pack lighter, and fix every medical issue in front of me. Instead when I got to LT, I sat in a circle with my other soon-to-be leaders, and we talked about personal feelings and group dynamics – aka “soft skills.” That was far harder for me than any death march I had been on to date.

Soft Skills: More Important Than You’d Think

As I gained experience, I realized why the soft skills at LT were so important. When leading a trip, your first priority is getting everyone back safe and hopefully happy. Emotions and feelings play a big part in your physical nature and vice versa. When you have a group of people, creating trust, acceptance, and motivation will drastically help get everyone home safe and happy.

For the #BeSafeGannett Expedition, I was lucky enough to start gaining insight into the “soft” side of many of the members. Through the time we spent training and general preparation, I got an understanding of individual tendencies, confidences, humor, and ways to motivate. It’s the soft skills that helped me understand when to take a break, when to push a little bit longer, and what specifically to say (or not say) to get an individual home safely. It was even more exemplified as team members were understanding and acting on my above actions to make impacts on an exponential level.

Rap & Wildflowers

Silly little things can help out with forming group dynamics. Being into hip hop, I taught “trap arms” and rap lyrics to one team member (who was more likely to listen to Wicked soundtrack than wu-tang clan), while she in return taught me about wildflowers and the awesomeness that I would have overlooked. This strengthened a bond and helped create trust, respect, and understanding of each other (it also inspired me to take some super sweet pictures).

soft skills can get you to look at the wildflowers

Noticing the wildflowers can help you take some sweet pictures

20 Questions X 20

That wasn’t the only, nor the biggest, interaction which drove positive group dynamics. Right at about mile 5 we started playing 20 questions. By mile 10, we had to create a whole set of rules based around the reality of said object and in which realm said things were considered real.

We passed a lot of time and miles by playing “20 Questions”

Yeah, we nerded out, and that created a set of inside jokes we could lean on and utilize when we needed a quick pick me up during the remaining 50 miles of the trip.

Bonney Pass Part 2: Down in Time for Dinner

By 9 pm we had finally made it back to camp. Chelsea, being the caretaker she is, had dinner ready in minutes. We were totally worked, super gross, had been defeated by our main objective, and still had a 25-mile trek to the trailhead. A backcountry thanksgiving dinner, busting out a few bars about fishes, and some sentimental words on how well everyone did put everyone to bed with a smile and motivation to trek out in the following days.

P.S.

Some trail jokes will follow you all the way into the front-country. After our return from Gannett, I came home one day to find a fish-shaped pillow. My pup loves pillow talking with this fish! Just one more reason to appreciate soft skills.

My dog Cocoa pillow talking with his favorite fish

About the Author

Joe Miller is an alpinist residing in the White Mountains of New Hampshire. He serves on the Pemigewasset and Androscoggin Valley Search and Rescue teams. 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 cat, 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.

What’s in My Pack: Summer Skiing in the Tetons with Adventurer Thomas Woodson

Saturday, July 23rd, 2016

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I have a pretty good streak for going skiing every month. 35 to be exact — every month since I moved west and started skiing. During these lonely summer months most of my friends have packed up their gear and look at me with insanity when I’m searching for partners. This leaves me on my own, hiking for hours, searching out the last glimpse of shrinking glaciers in the Rocky Mountains.

As a Wilderness First Responder, being out solo can create a challenging headspace. I try to use speed and lightness to create my own margin of safety. But I still carry a first aid kit like the Mountain Series Day Tripper. When you’re in an alpine environment, you’re your own first responder. Emergency response and evacuations take longer out there. So get prepared, the kits include professional quality supplies so it’s worth checking out. You read about many accidents from inexperienced hikers in these locations as well, so I want to feel prepared to assist others.

The SOL Thermal Bivvy is an integral part of my medical kit. Environment is a great concern during wilderness patient care, especially if trauma is involved. Having warmth and protection from the elements can make quite the difference. I also carry base layers in a dry bag, which provide ample warmth underneath a lightweight rain shell in the summer, or can be used to pad a makeshift splint or c-collar.

For communication outside cell range, I carry a SPOT Satellite Messenger with my trip plan tied in with my S.O.S. message. The optional rescue insurance is a plus as well.

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Miscellaneous things… For boot/binding repair when skiing, I carry a multi-tool, duct tape, zip ties and bailing wire. That combined with a ski strap can fix just about anything.

Here are more of my favorite items:

I’m stoked for more adventure and continue to encourage all of my adventure partners to sign up for a Wilderness First Responder course. See you in the mountains!

About Thomas Woodson

I’m a van based adventure photographer chasing film projects and snow storms across the west. My passion for photography overtook my design career after moving to Colorado. Working full-time chasing athletes around the world, I partners with brands to craft authentic stories of adventure. Despite a change in tools, design plays an active role in everything I do. www.thomaswoodson.com.