More pre-hospital medicine & pseudo simulations
Tuesday brought another day of learning and many really interesting stories. Of all our instructors almost are all volunteers and this day our teachers were from Roan State Community College, an assistant chief of the Knoxville Fire Department and a Park Ranger Smokey Mountain National Park. Each was great and really taught us many useful tools for survival and rescue.
Our day started out with learning intubation techniques and airway management in both urban and wilderness pre-hospital settings. I guess now would be a good time to ensure everyone knows what “pre-hospital” means. I wondered the first time I heard it and the answer is the most obvious answer – it is pre-hospital care. Yep, so obvious it almost hit me in the face.
But back to day 3. The morning consisted of learning multiple techniques in securing the airway be it using a bag-mask, endotracheal tube, esophageal tube, double lumen tube, LMA or a needle decompression. 
We discussed various situations in airway management and practiced the techniques. The esophageal tubes were a really ingenious idea for pre-hospital intubation. Also the S.A.L.T. was a great idea for providing a bite block and guidance of the intubation tube right through the vocal cords. How cool is that. In fact, it would have been great for a patient I remember in the trauma bay.
The afternoon consisted of learning to secure the c-spine and spine for mobilization to the hospital (i.e. packaging up the patient for the hospital.) We learned several different methods of stabilization for extraction. We practiced the techniques on each other. The photos you see of me demonstrated how to remove someone not lying on the ground. It was developed by NASCAR for the extraction of drivers but works great for other uses.
After this, we had a short simulation to cement a little of what we learned through four of us acting as victims and the rest as the first responders. We managed the scenes and brought back all the patients. We only made a few errors covered up by the proximity to the base camp. All in all though, no patients were dropped (but one was close), all were successfully immobilized and transported.
We ended the day with a talk by National Park Ranger Hester. His stories of the wildlife, people and hikes were all inspiring. Many hilarious stories of practical jokes Park Rangers play on each other and “green” campers or illegal campers (ones without a permit). Sufficed to say, make sure you have a permit. 🙂 Ranger Hester is a great speaker and I look forward to him returning in the next couple of weeks.
I finished the night with a hike to “David’s Bald” trail head and the Blue Berry trail head before heading to bed after doing some reading.