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Vol. II, #10
October, 2019
CU In
the Wild
University of Colorado School of Medicine
WILDERNESS MEDICINE NEWSLETTER
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Highlighted
Classes
The WMS Winter Conference is not
a U of CO School of Medicine offering, but it is a great way to
continue your wilderness medicine training, networking, and fun.
Plus, you can sign up for workshops to learn how to
self-arrest with an ice axe and/or build multiple kinds of snow
shelters with CO SOM instructor Todd Miner! The conference
will be held in legendary Sun Valley, Idaho, February 29-March 4.
For undergrads or med students try volunteering to get
conference fees waived. More information can be found at https://www.wms.org/conferences/sunvalley20/.
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Alumni
Profile – New Feature!
Well, not quite a profile, but August Pre-Med TA Taylor Ogden
sent us this report, along with photos.
As the other TA’s and I unloaded camping gear from the Pre-Med
Wilderness and Emergency Medicine Course at Anschutz, I was
daydreaming about my upcoming backpacking trip. Over the next
couple days I collected a band of college friends living across
Colorado, from Steamboat to Aspen, and we eventually boarded a
bus to the Four Pass Loop. Hailing most recently from Mammoth,
California I’m a bit of an Eastern Sierra snob, but the Maroon
Bells wow-ed me at every turn of the 26.8 mile loop. On day
one we got off the bus around 1pm, crushing 10 miles and two
12,000 ft passes before dragging ourselves into camp.
The next morning the three of us sat on a downed tree sipping
instant coffee and slapping mosquitoes in a grove of huge pines.
I saw something moving about 80 feet downhill and to the left of
where we sat. Below us was all meadow, with brush so tall I would
be completely hidden walking upright through it. Towering out of
the brush was a bull moose.
“Grant. Soolgi. Don’t make any sudden movements. There’s a
massive moose right there.” So we sat still for a minute,
watching him, talking quietly so he knew we were there. We saw
him see us, and he continued to munch his wildflower breakfast.
That put me at ease a bit; he knew we were there and he didn’t
really care. Still, his trajectory was bringing him right below
our campsite so we stood up and, still facing him, wandered
backwards. For some reason my adrenaline brain told me to grab my
full Nalgene as if that would protect me from this gigantic wild
animal. Or maybe I thought he would take over our camp and we
would need water. He paused about 20 feet below where we sat
moments before.
As we were peeking from behind the trees to watch his progress,
he stared right at us and let out a terrifying huff. At that
point, I recalled Todd’s story of dodging a charging moose on
trail in Alaska. I was ready for something similar, or worse.
After two weeks of wilderness medicine lectures, my mind jumped
through all the possible injuries this big dude could inflict
with his giant antlers and powerful legs. I was thinking about
treating and evacuating someone with those injuries with the
resources we had, recalling other people we passed who had SPOT
devices on their backpacks and wondering if they were camped
nearby.
“He’s showing a little irritation with us, lets give him more
space. And be ready to jump behind a tree if it comes to that.”
Keeping the trees between us, we continued to walk uphill
backwards, losing the safety of the denser trees, but gaining
distance. Finally, he turned his gigantic back to us and
continued to eat his way through the meadow. As he crossed the
creek that ran about 200 ft to the right of our campsite and
disappeared into the brush, we began to materialize from our
cover. I happily sighed out my disaster planning and disarmed
myself of my Nalgene.
Informally debriefing what had just happened, we agreed that
staying calm and respecting his space was the best thing we
could’ve done. We also agreed that he was an absolutely
incredible beast and we were so lucky to see him-even if it was a
little closer than we wanted. Amped on adrenaline and coffee, we
packed up camp and found the trail for another gorgeous day in
the Maroon Bells! I can now confirm that there is no better way
to get energized for a long day of uphill than thinking you’re
about to get charged by a moose
Remember,
we want to hear about you and your journeys, even if they aren’t
quite as wild as Taylor’s! Please send an update about your
life, your journey to medicine to Todd at todd.miner@ucdenver.edu.
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Case Study
Narrow Miss?
You are on a three-day southern Utah canyoneering
trip in late October with 3 friends. You are all in your
mid-twenties. It is the afternoon of day two, in a very
narrow side canyon when you come up to a “pour off” where your
side canyon joins a bigger flow. It’s about a 12-foot drop
with a sketchy move river right that you’ve been told is the way
down. Your most adventuresome friend Liz, skinny with the
nickname “squirrel,” says she’ll give it a try and before you
know it she’s starting down. Liz gets down the first four
feet and all of sudden she slips and tumbles down the remaining
nearly vertical eight feet to the sandstone rock below. Now
you wish you hadn’t rejected the helmets because “they weighed
too much.” You can’t quite see what Liz hit (it happened so
fast) but she landed with an audible “thump” and she isn’t moving
Scene Assessment: You are 12 feet above
her. The ground is cool and wet due to the seeps around
you. Little to no danger of rockfall or flash floods. You
have 50 feet of 7 mm perlon (tensile strength 1325 kg or about
2915 lbs) but no place to anchor.
Primary Assessment: When you finally get
to her you are very relieved to find her with patent airway,
breathing, and no major hemorrhaging. She is still
unresponsive. Nothing other of note.
#1 SAMPLE: Liz is unresponsive, no answers. As a friend
you don’t think she is allergic to anything. She, like the
rest of you ate a good breakfast two or two and half hours ago.
You have all been watching how much you drink as you’re waiting
for the “good drinking water” at the spring that’s supposed to be
another hour ahead of you at the campsite you are hoping to spend
the night at. You think Liz pinched a loaf this morning
(but aren’t sure) as she went behind a big boulder about two
hours ago. You don’t know where she is on her menstrual
cycle.
#1 Physical: You find a bruise and small cut
on her forehead. Otherwise normal though she is
unresponsive (which worries you greatly)
#1 Vitals: Heart rates and
respirations seem to be normal at 80 and 16.
Unresponsive.
Setting: You are in Grand Staircase-Escalante National
Monument. It is 12 miles to the trailhead and your cars at
the end of the canyon and 6 miles back up stream to where you
started, at the end of a deserted dirt road. There is no
cell service and no way out of the canyon except one Class 4
scramble about 5 miles down canyon. You have a SPOT
satellite messenger. It is late Oct. Temps in the
slot canyon are cool (maybe 60 degrees) right now, about 2 pm,
though you know it’s hot up on the top.
What do you do? (Assessment,
Anticipated Problems, Plan, and (immediate) Treatment)
#2 SAMPLE: It is ten minutes after you have gotten to your
patient who is now conscious and responding to your
questions. She complains of nausea, a headache, and
especially about the bruise on her forehead. She states she
is on oral birth control and tells you she is allergic to seafood
and iodine. She last had her period 3 weeks ago. You
accurately guessed the rest.
#2 Secondary Physical: A little more calm,
you do a slower physical and find a couple of minor cuts and
scrapes on her legs. Nothing else of note.
#2 Vitals: HR and RR continue at 80 and
16. She doesn’t remember the fall, though she knows
her name and where she is.
What do you do? Where are
your four people in relation to the drop-off and how and why are
they there? Assessment, Anticipated Problems, Plan, and
(immediate) Treatment
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The
great aim of education is not knowledge but action – Herbert
Spencer
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