The past ten days have been total wilderness medicine immersion. I go to bed with lists of vital signs to check whirring through my brain and wake up finding that in my dream I went through the procedure of diagnosing and treating a heart attack. I became a certified Wilderness First Responder yesterday, after ten days of classes from eight in the morning till six at night. After dinner, we would keep practicing and working on homework sometimes past midnight.
I learned how to administer an epi-pen and an inhaler; we even practiced injecting each other with legitimate syringes. We learned how to improvise splints with ace bandages and extra clothing or sleeping pads. We had classes on things ranging from common problems like blisters and headaches to medical emergencies such as pulmonary and cerebral edemas or strokes. I even learned to apply traction to a broken femur using a trekking pole, a fanny pack, and rope. Most importantly, the instructors drilled into us the initial evaluation process for a patient, including checking for life threats, a head-to-toe evaluation, vital signs, and medical history, which are key for being able to find and diagnose problems, be they related to trauma, the environment, or diseases.
Although we spent every moment focused on wilderness medicine, we learned the information in such an interesting and interactive way that I didn’t mind it being the only thing that occupied my mind. After learning about something, a third of the group would be the patients and the other two-thirds would have to complete a patient evaluation and successfully find and treat the number of problems that the instructors dictated to the patients. I still have fake “bruises” that the instructors applied to my ribs with makeup to simulate rib fractures that I can’t get off my skin. One day, four of us jumped into the frigid pool on the site of the course and stayed in there until we were shivering violently to teach the rest how to treat hypothermia. People had to act out epileptic seizures and asthma attacks (which some people could do a lot more successfully than the rest of us).
The most memorable simulation took place about halfway through the course, where four people pretended to be critically injured avalanche victims, and the rest of us had to successfully diagnose, prioritize, and evacuate them all. One patient started off being totally fine and then suddenly fell unconscious with a severe head injury, one lost a hand and also lost consciousness, one had injured his spinal column and had ended up in a river with severe hypothermia (the guy actually had to lie in the river and ended up with some degree of legitimate hypothermia), and one, my patient, had lost an eye and had an exposed fracture in his femur. My patient wouldn’t stop screaming “MI HERMANA!”, especially at the opportune moments when I approached his face to check pulse or pupils, because his sister, apparently, was the patient who lost her hand. At first, the situation was legitimately scary, with this crazy guy with a patch covered in blood where his eye should have been and a blood-coated stick imitating the femur bone sticking out of his thigh screaming at me. However, after applying traction to the femur and cleaning up the wounds a bit, the adrenaline generated from the spurious emergency calmed down and screaming “MI HERMANA!” ended up being sort of a joke for the rest of the course.
The other people on the course really made the course as intense and exciting as it was. I was the only non-Chileno, so the course ended up being a complete Spanish immersion as well as a wilderness medicine immersion. My only worry is that I won’t know how to name some of the medical injuries that I learned how to treat in English now (I had to look up “edema pulmonar de altura” to write this blog). But everyone on the course wanted to learn as much as possible about the course in order to actually be able to apply it someday, rather than only wanting to be able to pass the course. Everyone paid rapt attention in class and both acted and treated with sincerity during the simulations. The environment up in the dome where we took classes after dinner always had lots of energy up until midnight as we practiced immobilizations, patient evaluations, and studied our notes.
Even outside of classes and studying, everything we talked about and did revolved around wilderness medicine. When someone started to cough during dinner, everyone would chant “Tos! Tos! Tos!” as the first step to help someone who is choking. We would listen to music and choose which songs had the perfect rhythm for CPR – 100 beats per minute – and made up special CPR lyrics to go with the songs. Our conversations at dinner turned into bull sessions of telling stories of first aid experiences – whose was most intense? Even when we had an asado on our one free day during the course, we made jokes about chorizos with second-degree burns (due to the blisters) and the onions that fell through the grates in the parrilla and certainly had experienced the necessary Mechanism Of Injury to have injured their spinal column.
Almost everyone ended up passing the course (which isn’t a given, as you might think!) and we went out to dinner last night to celebrate the final day of the course in Santiago. Then, walking through the city, it was almost like we were waiting for an accident to happen… it makes you much more alert once you know that you have the responsibility and capability to act in the case of a medical injury. This year in total has been so wonderful and I am so lucky to have gotten the chance to travel to the places I have and learn what I have learned, and it’s daunting to know that with so much opportunity and the knowledge I am acquiring comes the responsibility to do something with it all some day, but I’m also incredibly excited about that responsibility.