Wilderness Medicine and Outdoor Health

In the afternoon session of the conference I attended a clinical skills workshop put on by our good friends from the Central Maine Medical Center Family Medicine Residency Program (http://www.cmmcfmrp.org/.)

After a brief discussion reviewing the primary and secondary trauma examination surveys (the first for the unconscious, disoriented, unstable patient or one with multiple injuries and the second for a more detailed exam of the pertinent injuries on a stable patient), we broke up into four groups to work on some hands-on skills.

In the first group, we discussed open versus closed trauma and their general management, as well as when to treat an injury and keep hiking versus when to pack out. In the second group, we practiced using various items you may have at a campsite to immobilize and brace a leg, for example using a camping pad and clothes to splint a leg from above the knee to below the ankle.

In the third group, we practiced "unfolding people", safely moving them from positions you find them down after an injury in, back to a neutral position that would make it easier to carry them away from the site. Too bad we didn't have a camera with us at this session; you could have seen your own Jen Hsia professionally unfold me.

Fittingly, in the last group we practiced various ways to carry injured people. We were challenged to come up with ways to carry people alone (piggyback, fireman's carry, allowing them to lean on you) and with a partner (shoulders and ankles, allowing them to brace between you.) One of the best answers was to form a chair out of your and your partner's arms forming a square base. We also experimented to figure out the best way to use a tarp and two long sticks (if you have them) to carry someone out. We decided the best way was to place the sticks on the 1/3 lines of the tarp, folding the tarp over them, using the person's body weight to hold the free ends down.

Overall, it was a great workshop, mixing in some teaching with hands-on practice of some very helpful techniques. It was also nice to see the CMMC people again. They come down about once per year to teach workshops like this at BUSM for the FMIG and some students (myself included) elect to spend their 6 week core Family Medicine rotation up at CMMC in Lewiston, ME.