To Master A Disaster

To Master A Disaster

June 1st, 2013 Amber Lanier Nagle in Getout Features

Hundreds of doctors, nurses, first responders and health professionals will attend the Southeastern Wilderness Medicine Conference later this month to take their life-saving skills to the great outdoors.

The intrepid among us seek out the most extreme, exquisite corners of the Earth for recreation, adventure and the colossal task of testing the bounds of Mother Nature. But often, the most magnificent outdoor venues on the planet are far off the beaten path-ever-so-distant from doctors' offices, hospitals and emergency clinics. In the wilderness, things go wrong sometimes-there are troubles on trails, catastrophes in caverns, wounds on the water, and calamities on cliffs. Sheryl Olson expects the unexpected, and she's always ready to lend her skillful hands and test her creativity. Take for example, last April in Nepal.

"Our group was on our way down from Everest Base Camp-we had two more days to the bottom," describes Olson, a wilderness medicine expert and adventure guide with more than 30 years of critical care nursing experience. "A guy came over to me and said he thought he had broken his foot. After examining it, I agreed that his foot was fractured." The climb down from Everest's Base Camp is a difficult, often treacherous trek, but Olson, confident in her training and skills, believed she could get the hiker down the world's highest mountain without calling for emergency medics. "I drew on my knowledge of wilderness medicine-problem solving and dealing with injuries in remote environments," she says. "I used a Lidocaine patch to decrease the pain locally and the next morning I taped his foot in such a way that he could still wear a shoe and put pressure on his foot. He walked out."

Olson will join several other wildlife medicine experts-so called, masters of disasters-in Chattanooga later this month to share their stories and expertise at the 9th Southeastern Wilderness Medicine Conference. From managing breaks and dislocations in the backcountry to rescuing the injured in water to surviving wild animal encounters to saving lives in caves, the conference offers close to specialized workshops and superlative lectures geared primarily toward health care professionals who spend time in the outdoors.

"Wilderness medicine is medical care far from definitive care," says Chris Moore, M.D., founder and program director of the conference. "At its core is a dependence on basic clinical judgment and a unique reliance on improvisation. And that's what the conference is all about-giving people the tools and knowledge to care for themselves and others out in a wilderness setting when they don't have access to X-ray machines and other diagnostic and life-saving equipment."

Moore needs to look no further than his many medical missions to Haiti to find examples of the need for keen emergency insight in the most extreme conditions. "I've had to suture patients up in the most horrible of settings," he says. "One time, we had to evacuate someone from a remote village way up in the mountains.

We built a stretcher from scratch, using materials we could find that day. Again, I felt comfortable in that setting because of my wilderness medicine training. I was prepared to take on whatever I was faced with."

But injuries and emergencies can happen anywhere at any time-not just in Nepal and Haiti. Moore notes that injuries and situations requiring outdoor rescues, prompt medical response and improvisation have increased around Chattanooga in recent years-a fact echoed by Amy Maxwell, spokesperson for Hamilton County Emergency Medical Services. "It's not just the death of the hiker who fell off the cliff at Rainbow Falls a few months ago," Maxwell says. "Outdoor accidents are on the rise here. We're seeing more and more inexperienced, unprepared people venturing out, getting injured and getting into trouble. They go on a hike, lose their sense of direction, get lost, get hurt, lose light and suddenly, it's an emergency situation."

Of course, even experienced hikers, climbers, paddlers and mountain bikers can get in trouble occasionally. That's why Moore has organized a session specifically for the general outdoor community the night before this year's conference kicks off. "We're calling it Wilderness Safety for the Outdoor Enthusiast: High, Low, Hot Cold, and it's for non-doctors," he says. "It's scheduled for Friday, June 21 at the Church On Main, and will include world-class speakers and experts discussing lightning, snakebites, frostbite, hypothermia, heat illnesses, the use of an EpiPen, exposure to poison ivy and other relevant topics."

Moore himself will discuss snakebites at the June 21 session, as well as a more detailed presentation during the conference. "People have actually called me from remote areas and said, 'Doc, a copperhead just bit me. What should I do?'" Moore says. "And that's why it is important that all adventurers and outdoor athletes and enthusiasts know how to handle snakebites-and many other things-before they set out."

Moore notes that the two most common venomous snakes in and around Chattanooga are copperheads and rattlesnakes. Both are easy to identify from photos in field guides. "If you or someone you are with gets bitten by a copperhead or rattler, immobilize the limb if you can, but most importantly, get to definitive care as soon as possible," he explains. "I often get asked, 'But what if I'm alone?'

Well, you can't just lie out in the woods waiting for a miracle. You have to get yourself to where's there's help."

According to Moore, you should never use a tourniquet or attempt to suck out the venom from a bite. And no, you should never bring the snake-or the snake's head-to the emergency room.

"And it's important to note that you should never leave a patient alone in the wild, if at all possible," he says. "Of course, every situation is different, and sometimes that may be the only way to get help and save a life."

But wilderness medicine encompasses much more than managing health problems and situations in remote regions. There is also a distinctive emphasis on survival preparation.

Peter Kummerfeldt, who was the Survival Training Director at the United Sates Air Force Academy for twelve years, will conduct workshops at the conference pertaining to emergency shelters, emergency signaling and fire craft.

"Fire is of the utmost importance in the wild," Kummerfeldt says. "You can use it for warmth, for lighting, for cooking, for signaling and for safety. If you believe you can somehow make a fire by rubbing two pieces of wood together, then you are setting yourself up for disaster."

Kummerfeldt, who is also the owner and chief instructor of OutdoorSafe, Inc., teaches very practical, straightforward techniques to help get his students through an unplanned night in the wilderness. "I teach things that an average person can do," he says. "Like, to start a fire, all you really need is a fluffed-up cotton ball, a dab of Vaseline, and a metal match, and you should always carry those items with you in your pack. I also demonstrate my own technique for building a fire-a rather simple technique that has evolved through my 50 years of experience in the wilderness."

The great outdoors calls to us, and we must go. But when we take a nasty spill on a remote mountain bike path, crawl into a sleeping bag with a black widow spider, dislocate our shoulder while kayaking the rapids, or find ourselves on the verge of a heat stroke on a distant mountaintop, it's comforting to know that so many in our midst have studied wilderness medicine and are ready, willing and able to care for us.