Friday, May 30, 2008

Pictures from Moab

Where the Colorado and Green rivers meet



Reptilian paparazzi (I have about 50 pics of this little guy, oops)


Sitting on the edge of Dead Horse Point





Wednesday, May 28, 2008

Out of their element

I have no pictures as promised because I can't download my camera =(. But, have no fear, because stories abound!

We had lecture all morning and covered:
  • Scene size up and patient assesment
  • Wound management
  • Cold injuries
  • Heat injuries
  • Lighting
  • Water purification
  • High velocity injuries
  • Water disinfection
I'll admit, I actually skipped the water disinfection lecture... but I'm pretty comfy with that. The acronyms they teach us are similar to what I learned in my basic class (SAMPLE, AEIOUTIPS) but some are different (COLDERR instead of OPQRST). All in all, I've been really comforatable with the material presented.

We went outside for the afternoon and practiced some patient scenarios (which are always total bull shit, but I guess they serve a purpose). This, I might add is where the EMTs and Paramedics shined. The MDs were a little out of their element. Scene size up what!? Obviously, to graduate from medical school and complete a residency you have to have an incredible depth of knowledge. However, when it came to extricating 'patients', carrying, or log rolling things didn't go do well. I learned from them, they learned from me, we're all friends!

As I sign off, I'd like to leave you with some interesting lightning facts (THE most interesting lecture of the day):
  • The most likely time for a severe lighting strike is before the storm appears and after the storm has passed
  • Rubber boots, rubber tires... they don't mean shit when faced with a unidirectional massive current impulse of 30 million volts. If it traveled 10 miles through the air it'll blow through rubber like nothing
  • For those of us in EMS...A mass casualty incident (MCI) involving a lighting strike should be reverse triaged. Patients may appear dead because the heart initially becomes asystolic after the strike. It will, however begin beating again. There will often be a concomitant respiratory arrest that occurs and the heart may deteriorate back into asystole secondary to the respiratory arrest. This respiratory arrest may last 5-8min (during with the patients is asystolic and apnetic) because of a temporary paralysis of the medullary center. -Long story short, keep them alive and they'll be fine (even if they look dead). If the patient looks ok and is at least semi alert and oriented they'll be fine- take care of the serious patients first.
Finally, the feathering pattern from a lightning "side splash" is amazing looking:
I would totally get one as a tatoo if I ever got hit (as opposed to that OTHER tatoo I was thinking of getting, more of that later).

Cheers!

Tuesday, May 27, 2008

I might be the one who needs rescueing...

I interviewed with the search and rescue team today. It was me, at the head of a conference room table, being interviewed by three sheriff's deputies and three civilians, for an hour. Easily the most nerve wracking interview I've ever gone through. And, yes, this is a volunteer organization! I'm happy that they take things so seriously.

A lot of the questions I felt easy answering. Rock climbing experience? Check. Ice climbing? Check. Hiking, camping, navigating, scrambling? Check, check, and check. And yes, I know what declination is.

Other questions I wasn't so strong on. Name 10 trails in Area X.... um, I know where the trails go. Hand me a map and I can find where I am, where you are, and get there... but the names of the trails? Damnit! I'm also weak on swift water rescue techniques, and anything that involves me driving a snowmobile or ATV (wait, something that doesn't require me to bust my ass to get somewhere? what's the fun in that!?).

Overall, I tried to convey that if I didn't know something they asked that I'd love to learn. That, and I'll do things their way, I don't mind humping a big ass pack up a mountain, and I learn fast. Luckily, I have about four times the medical requirements (50 hours of class time) required- that was a major plus.

I really, really, really, really hope I get on the team. It would be a huge commitment, but it has also been a dream of mine to work SAR since I was about 10 and meet some members of the Ouray Mountain Rescue team in Colorado. I bought one of their hats:
and wore it FOREVER, no one could pry that sucker off my head. I guess if its to be, it'll be. And if its not to be, then I'll work on my weaknesses and reapply.

J

P.S. In moab now... will post pics from the WALS classes as soon as I have them!

Sunday, May 25, 2008

Search and Rescue

I got a call from our local search and rescue team today. They want to interview me for an open position on the team. Excited does not do justice to how I feel. I love the mountains, I love EMS, this is a great combination. I realize that I won't be able to do operations like the picture above for a long time, and that most of the time there isn't much medicine involved (one member of the team impressed me with the quote "by the time we get to them they're usually either stable or they're dead) but I honestly cannot think of anything I'd rather be doing.

If I get on the team it is a huge time commitment though. I would be expected to respond to 66% of all call outs for the first 9 months and 50% of all call outs from there on out. I would also be on call 24/7/365.

My mom (a nurse practitioner) thinks this that if I get on the team it will change everything- that I won't want to go to med school, that I'll be a flight nurse or medic, etc, etc, etc. We'll see about that....

Friday, May 23, 2008

Wilderness Advenced Life Support

Next week I'll be headed down to Moab for a Wilderness Advanced Life Support class. I'm excited for a number of reasons not the least of which is that my whole family will be meeting me there and my dad and I are taking the course together. My dad is one hell of a surly, and excellent, ER doc (formerly family practice) and one of the original members of the Wilderness Medical Society. I've been going to their conferences with him since I was pretty young and I've had the opportunity to meet some cool people (Like Dr. Auerbach, and Alex Lowe among others) and learn a lot about 'improv' medicine- which seems to fit well with EMS.

You see, the people I meet at these conferences give me hope that I won't be miserable if I become a doctor. To often I'm around docs who are workaholics and have completely martyred themselves for the cause. But, at the WMS meetings I've meet doctors (and nurses, and PAs) who have been able to combine their passions of medicine and the outdoors. They are all very much more happy than your average doctor. Most of them use their high level of income to work less (and, gasp, make less money) and play more. They are the doctors I look up to, not the overworks asshole attendings I am usually around.

I'm not opposed to working hard but in the end it has to be worth it. 80 hours a week once your outside of a residency isn't worth it to me. Combining my passions is.

Thursday, May 22, 2008

NREMT

This just in, I passed my NREMT-B exam.

Not that I'm surprised, I would have felt pretty bad if I hadn't. Its a relief none the less.

Wednesday, May 21, 2008

First Busy Week of Summer

My first 'real' busy week of the summer is almost over. I'm thinking I may have bitten off more than I can chew with coaching two evenings a week (plus races on saturday), working in the shop 3 afternoons a week, a summer internship in the mornings, plus two night shifts a week in NICU research lab. All that plus training for some sport aspirations that I thoughts were long gone but seem to have been dredged back up by coaching.

Why do I do it all when most of my friends are content with the easy summer research job? Maybe some summer shadowing? You see, I have a confession. My first year of college, my grades were pretty good. I had a 3.7 or so (although I did withdraw from a calculus class that I retook later and got an A) and was well on my way to an honors degree. Then, I got this hairbrained idea to be a professional cyclist. I'd raced bikes since I was 14 and had some regional success but nothing major.

I applied, and was accepted, onto a European semi-professional team. Classes took a backseat to training and I was on my bike or in the gym 5-6 hours a day. My grades plummeted- at one point I was on academic probation (i.e. below a 2.0 GPA). Far, far from the grades one would need to get into medical school. I up and moved to Europe and said the hell with it all.

This went on for about two years; I was invited back to Europe for a second season and started training hard again over the winter. Then, disaster struck. My hip started to hurt, I assumed it was part of nagging back problems I'd had since I broke 4 vertebrae in a crash years ago, but it got progressively worse. Soon, walking hurt, at times I couldn't even get out of my bed. My dream of becoming a professional cyclist was quickly vanishing.

I also had a lot of free time on my hands because I wasn't able to train so I threw myself into school. The grades went back up, I began doing research, received research grants, and decided I had to make up for lost time. As such, that's how I'm here now. Making up for mistakes on my youth (haha, a whole 2 years ago), retaking almost every class, and hoping somehow it'll work out.

Tuesday, May 6, 2008

Call Me Theodore

If anyone is curious why I there hasn't been any new posts lately its mainly because I'm now living in the mountains. Far, far in the mountains....at almost 7,000 feet...surrounded by snow and trees.

I

Freaking

Love It

Seriously, I was so happy to be out of the city a girl I was hiking with the other day said I was giggling the whole time we were driving back to my house. However, living in a cabin is not very conducive to communication. The BlackBerry's service is spotty and we have one ethernet cable. Not to mention that after school I'm not all that motivated to talk to people at all!

Good things have been happening though. I'm back on the bike again and training reasonably hard. 3 hour rides the last five days are so. Most of those have been with the Junior's (under 18) team I coach. I discovered that I LOVE coaching. Its really a lot of fun, and we have a great group of kids to work with. That, and they've been working me over on training rides. Damn whipper snappers.

Hopefully... more soon.

J

Friday, May 2, 2008

I just assumed....

What is a college student with no finals left to do? Read blogs, of course...

Moving Meat if one of my favorite ER doc blogs. It has come very close to making me very interested in administration (oh god, my dad will kill me now). I found This Post and Dr. Gawande's Writings particularly interesting (although they are just an aside on the topic of the post).

You see, I always assumed that there were checklists like that in place. For instance, when I do a Western Blot in the lab I have a checklist that I've written that I go through. Before I started doing that, our results were sporadic. Afterwards, they became much more consistent. Hell, in almost everything I do I have checklists. Studying, yep. Training sessions, yep. Girls, ok- maybe not everywhere. Why would medicine be any different?

But, do have I used checklists per say on the few EMS runs that I've done? Nope.
Sure, we have run forms, I have my SAMPLE and OPQRST questions that I run through in my head, but that's the extent of it. In fact, a checklist sounds like it would be a pain in the ass. But, if it would be worth it I'd do it in a heartbeat.