First Week

Day 1-3 in ABQ - Orientation/Basic Skills

Flew in from Costa Rica but missed the orientation hike. I hate missing things, its akin to my primary pet peeve which is lateness. First day was nerve wracking for me as lots of new people and I'm shy at heart. We learned rescue techniques like litter carries as well as splinting and traction techniques. We had some mock patient scenarios. Iris was our pseudo patient that was having AMI symptoms in Grand Gulch. We had to decide the best course of action. Later we had a suture lab and I taught Clay some simple interrupteds on Babe's foot.

Day 4 at Sandia Ski Resort - Hypothermia Day

Dowsed a few fellow students with cold water and the buried them in the snow. Some were lucky enough to be buried in the snow in the sun others were in the shade. We took control vitals like in any good experiment then monitored them during and after. Unfortunately, we only had the oral thermometers. No one wanted to volunteer for the more accurate rectal, wonder why?

Linda was the first brave sol to get dowsed and buried in the shade. Jason, Dan, Beth, John K, John F & Clay were the other victims. Clay's control temp was 95.5. Then I poured some cold water on him and we buried him. In the snow, he dropped down to 93 after 5 minutes then back to 95 after 10 minutes. When he was extracted from the snow his temp dropped to 90.1 when exposed to the elements. His method of rewarming was warm IVF & PO. Didn't really work so well. Eventually, stripped him of his wet things and bundled him up in some warm clothes. John K's rewarming experience went best. Lucky guy got wrapped in the burrito (trap, sleeping pad, sleeping bag then wrap layers.) Beth snuggled with Yelena and some of the guys commented on YouTube videos. But she got warm pretty quick. Linda, Jason and Dan got kinda screwed as well. Linda was given a blanket and some hand warmers chemical adhesives. Jason just got a space blanket. Dan exercised. John F was given the spa treatment - warm water in a kiddie pool with an attendant to gentle pour the water over him. He said it hurt but he sure did seem to be enjoying himself. Think if he'd had a beer he'd felt better.

Oh, did you notice how much Charolette and Keri (okay and I) enjoyed pouring that cold water!

After the hypothermia day, some peeps braved skiing and some snowshoed. I found a picnic table in a sunny spot and took a nap.

Day 4 in ABQ at REI - Gear/Tracking Day

I like an excuse to be in REI especially before any other customers are there and given free rein to pick out gear. Now, if I'd only have gotten to keep all that gear for free. I've decided that REI is kinda like my version of crack. We were divided into different groups and given different scenarios. Then released into the store with shopping carts to pick out the gear we'd need for the trip. Then we went over the gear that each group selected. There were some interesting choices like the grey parka with fur collar for winter backpacking experience. There was also some great color coordination. It was fun but I wish we'd gone over gear choices a little more or ways to pack lighter as I know I have that problem. We did get a very in depth "pooping" in the woods talk.

Afternoon was tracking. We learned some very in depth tracking terms via power point given by the experts in tracking, aka Boarder Patrol. Then we were let loose to practice. A few lead the way using their "cutting" skills and one of us (I think it was Iris) used her super "high sign" abilities to spot the lost victim (Nalgene bottle)

Day 5 in ABQ - Batcave Extravaganza (aka Simulation Center)

Broke out into small groups. My group consisted of Clay, Charolette, Iris, Dave and myself.

First simulation: Charolette took command. Our patient was 8+ months preggers with no prenatal, suffering from a seizure and sky high BP. Get that baby out, rush her to OB. Oh wait, we're in a small First Aid Clinic in the mountains and its windy so no heli access. Okay,Iris checks for dilation. "Oh Yeaaaaa" says Iris "This simulation model is awesome, feel inside." Well, let's hope you don't say that with your hand up a real woman. But she's right, this simulation model is dilated and the baby's coming. Get her some Labetaolol and Mg. Baby's coming, prepare to deliver. Oh, crap shoulder dystocia. Hmmmm... McRobert's, Wood's, Rubin's, or Zavanelli's. Which maneuver named for a dead white guy should we use. Alright, the baby's coming. it's out, patient's better. Disaster #1 avoided. Go team.

Second simulation: can you say cluster f@$k! We're in Hati and some crazy man has brought in his 2 year old with very high fever (40.1). Crap, I hated Peds and I never got to do much as parents don't like students practicing on their kids. Go figure. Okay, ummm.... I'm don't really remember what happened in this scenario except that we finally got the kid intubated and some ABX started but in real life, I think I just killed that kid. Sh!t, is intern year really only 3 months away.

Third simulation: Dave takes charge. Soldier in Iraq throw from an exploding pesticide plant. Hazmat gear everyone. Primary survey, check. We've got some tachypnea and tachycardia but airway okay right this minute. Strip him down and secondary survey reveals evisceration and shrapnel to the flank. Cover that wound, back board him and get him on the stretcher. Reevaluate his airway as he's breathing hard and appears to be in respiratory distress. Crap, his vocals are edematous and can't get a tube down not even with a bougie. No glide scope available. give him some Epi. Swelling has one down tube is in place. Patient stabilized. Heli transport. Another dummies life saved. Rock on!

Fourth Simulation: Iris mans the helm. 30ish yo male found down in the snow with low core temp and unresponsive. Primary survey, check. Secondary survey, crap his leg just fell off (this was our indication that he had a broken ti-fib). Ortho, splint that sucker. Strip his wets and wrap him in that burritoesque warmer. Oh crap, monitor shows decreased respiratory rate. Exam reveal muffled heart sounds and decreased lung sounds on the left. Needle decompression ASAP. Monitor now shows V-fib. Who remembers ACLS pathway? Chest compression until we can remember the next step. Okay, shock 'em. CPR. Shock. Sinus!!!! Wait to go team!

Fifth simulation: Clay's in charge. Poor chap as this one requires administration of lots of drugs that I can barely remember but he does great with the prehospitalization stuff. Teen male comes in after acting goofy and drinking a "tea" with his friends. We're in a remote mountain clinic. Primary, secondary survey = ""blind as a bat, mad as a hatter, red as a beet, hot as a hare, dry as a bone, the bowel and bladder lose their tone, and the heart runs alone." Atropine poisoning. Intubate and pysostigmine. Stabilized.

As you can read, our team ROCKED IT! (God, intern year is so close. Yikes!)