Last week I was on a training course to develop my medical skills and improve my knowledge and experience from Outdoor 1st Aider up to Wilderness Emergency Medical Technician.
As many of you know www.challenge-firstaid.co.uk the Event Medic Paramilitary wing of www.challenge-running.co.uk have for the last few years been providing 1st Aid cover at events.
Anything from mostly races to functions, Sports days and other events.
I enjoy doing this work and it’s developed from covering my own events to a very useful portion of my business with us covering over 20 events each year.
I have always tried to keep my knowledge up to date and over the years have done many outdoor 1st Aid courses and read many articles on endurance runners and treated lots of runners at events.
I pride myself on Reading the latest papers and info on nutrition, hydration and foot care etc.
I decided I needed to step up my skills and ability and really test myself and my knowledge, A couple of years ago I heard about the WEMSI courses. A set of bespoke Wilderness Medical Courses which are internationally recognised as possibly the best courses you can do for Wilderness and remote medicine. WEMSI stands for Wilderness Emergency Medical Services Institute and it’s an organisation with it’s roots in the US that set up in the UK in 1997 after some Irish Mountain Rescue guys managed to get a course taught in Ireland.
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| We loves a sticker for the Pickup Truck |
Since then it has been run in Ireland and Scotland once a year, those teaching it are at the very top of their respective medical fields. Doctors, Nurses, Physios, Expedition experts and all of them with medical and event, expedition or rescue experience. The knowledge and instruction passed on is second to none. Some of the info passed on was only just presented from fresh studies and will take years to filter down into regular medicine even for doctors and experts. It was a privilege to be taught by these guys.
The courses taught come in three flavours, Wilderness First Responder aimed at those without and medical experience or qualifications and it did not include things like diagnosing and use of drugs or medicines and more invasive techniques.
Wilderness Emergency Medical Technician, aimed at those with good experience or medical skills or qualifications. This had use of drugs and invasive techniques and you were expected to make differential diagnoses and plan treatment and evacuations for patients.
Wilderness Physician, only for doctors with prescribing rights and advanced medical knowledge. Helping them understand the Wilderness environment and give advice and authorise medications on the phone if an expedition EMT or similar need doctor support as well as if they are out on expedition themselves as a doctor.
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| The Home of Mountain Training in Scotland |
I felt I had the knowledge contained in the First Responder Course already but may not be quite ready for the EMT course as its very medical in it’s content, I emailed Robin the Course Director listing my previous experience Military/Fire Service and 1st Aid at events etc. They allowed me to come in at the EMT course level which I was happy about but this meant it was a very challenging learning curve to even get through the recommended pre-course reading. I spent half my time reading and half looking up what certain medical words meant!
The Pre-Course reading included 2 books, The Field Guide to Wilderness Medicine (1000 plus pages) and the Wilderness Medical Society Practice Guidelines for Wilderness Emergency Care. Both great books but aimed at doctors and advanced Medics so fairly substantial reading.
The EMT course is the highest level you can do without already being a doctor. WEMSI courses are recognised the world over and in line with my IML training the Expedition Leading I will start to do next year this would give me the best skills possible for future work and knock my CV up a notch.
The course is 8 days long and held at the fantastic Glenmore Lodge National Mountain Training Centre in Scotland. Known for being stunning and cold and wet in winter in equal measure.
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| The Facilities at the Lodge are excellent |
The course sounds expensive at £850 but once you consider that includes accommodation, food and the level of equipment and tuition provided on the course I think it’s actually great value.
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| Stores Area used for indoor training and a meeting point on the course |
All the instructors are volunteers and are not paid to teach on the course and the fee simply covers costs. The instructors are all here to pass on knowledge and help future Medics provide the best care wherever they may be. Very much a pay it forward situation.
I drove up on Saturday afternoon after we put away the caravan as Maxine was going to walk the West Highland Way whilst I was on the course as a bit of “me” time and a challenge of her own.
I stayed over at a Travelodge near Perth Saturday evening and Sunday took a leisurely drive up to Glenmore Lodge arriving Early afternoon. I got my room sorted and relaxed until the group meeting and first course briefing at 6pm.
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| My Room at the Lodge so much better than basic bunks |
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| En Suite too |
It was obvious from the first meeting I was very much one of the least qualified medically and my experience was lower than most too. There were 3 of us with a mix of doctors, nurses rescue professionals and expedition leaders. Many from as far away as Canada and various tropical climes, clearly the course attracted people from all over and was genuinely respected everywhere.
Sunday was just a brief introduction and the course proper started on Monday. The programme looked mental and the days were very much full on with lessons and activities starting at 8:15 after breakfast and continuing through till late night around 9:30pm. A short lunch of 30 mins most days and only a few 15 minute breaks and you can see they are trying to get as much knowledge into the course as possible along with practical sessions and skills stations.
The language used during lessons was very medical and occasionally I was flummoxed by a word or phrase and had to look it up or ask the lovely Nurse (Bernie) next to me but the pre-course reading had helped out a fair bit with understanding medical terms.
Generally each day would have several hours in the classroom in the morning covering things like Pharmacology, Anatomy and Systems with medical definitions and treatment of various trauma or illness aimed at the outdoor environment. Stuff such as Altitude and tropical diseases, the did this to get us all to the same basic understanding medically and give us the same platform to develop from.
Each day we would also do practical skills sessions in things like patient care and packaging to airway management including the use of airways and other invasive techniques. Some of theses skills sessions including strapping for bites and sprains and reducing (putting back in) dislocations such as shoulders.
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| Scenarios out in the forest most days for several hours |
Then more classroom stuff and usually some scenario based practical training in the evening, then a quick pint in the bar before bed to ease the discombobulation of the brain from all that learning.
As the week went on there was more emphasis on practical skills and tests and less on theory with more detailed patients with more complex needs and diagnosis. Everything from ectopic pregnancies to Hypoglycemic seizures. This really to test your newly found skills and get you comfortable with the principles of getting the information and treating the serious needs and making diagnosis and planning treatment and evacuation plans based on how remote you were and the type of transport you had for extraction. You could have a helicopter in 10 mins or be 3 days from a road in the jungle. They tested us well and I don’t mind admitting that I made mistakes and learnt from them, the team did well prompting each other with no big glaring ego’s trying to take over and everyone contributing to the gathering if info and vital signs in testing conditions.
Each scenario had a member of staff in charge who would give you the scenario and info about what you had and where you were then send you off as a team to discover the scene somewhere up the road or in the woods. There would be a designated team leader, medic, scribe and the remaining members would assist with protecting the team and patient from the environmental conditions which in the case was genuine cold wet snowy conditions for most of the week. The casualties previous attendees to the course or faculty with some of the teams children joining in. Make up was applied to simulate fractures and bruising etc. You really did have to get to skin on many occasions to find what was going on. Every time you took a vital sign like a pulse or blood pressure you would look at your angel and they would either state “as is” or make up a number that suited the injury or illness you were presented with or as a reaction to your treatment. If you got stuff right they got better or stabilised and if you got it wrong they got sicker. Occasionally patients died! This made the scenarios very real and stressful and exactly what you needed. You would always get a debrief at the end and discuss the points of what you did and why, not in a “you got it wrong” way but a “how could we do that differently” or “what can we learn from that” way. As your skills improved you got better but the situations you were presented with got more complicated.
Pretty soon the busy days rolled on and we got to Friday which is the Main test day, you had some classroom sessions then more complicated after lunch that really tested you including multiple casualties in a serious car crash. Then it was into the Practical Exam, this consisted of you being presented with a casualty with an assistant who cant advise you but can physically help you and you have to assess them and treat them and plan for evacuation based on all the skills you have been taught during the week. In my case I had a woman who had tumbled down a hill and suffered an injured ankle. Given the serious tumble this included clearing her spine and a neurological check along with giving pain relief before addressing and strapping the injured leg so she could walk out with assistance. She had allergies also which affected the treatment and history taken. I did OK on this but could have been a little slicker on the assessments. I then Assisted another medic on their Assessment before being told I was done.
Then an hour or so later we had a written exam, essentially it was 30 medical questions with each have 5 statements that could be true or false based on the patient described or question posed. essentially 150 answers we had to decide were true or false. Some of these were really hard and very medical in nature and included very detail pharmacology questions about dosage amount for certain drugs for certain types of patients. I was one of the last to leave the room after going through my answers twice to make sure I was as happy as I could be with my answers. Some were very much guesses or educated guesses. We would find out in due course how we did!
That evening we had more practical skills sessions inside and outside and during this period some people were spoken to privately to retest some practical stuff or questions stuff. I don’t know which but I was just glad I kept my head down and was not spoken to, was that a good or bad sign I did not know at the time.
Saturday was all about the large scale final scenario, essentially we worked as a massive team on a large scale incident that included explosions, cold injuries, serious trauma and a multitude of injuries with casualties being stretchered to pretend helicopters out of the forest on sleds or carried by teams. Patients died and patients lived and things changed dynamically all day long, the scenarios was physically and mentally challenging and lasted some 6 hours outside in the cold and wet.
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| Final scenario where everything that could kick off did! |
Only after the exercise were we taken back into the classroom and told whether we had passed or would only receive a attendance certificate. I was very relieved to have passed it seems!
That night there was a Ceilidh where much drinking and merriment was had at the bar with some great live music. It was a great way to let off steam after a very tough week.
Sunday morning was about packing up all the kit and saying goodbyes to team mates and staff alike. A massive thanks to Robin and his team of Doctors and Experts who ran the course and a big thanks to the team who were stuck with me for the week.
Bernie (Very Skilled Experienced Nurse), Jade (Expedition Leader and Jungle Instructor) , Steve (Sottish Fire Service and International SAR) and David (Experienced Doctor and Ski Patrol) who all worked as a team and Made the week more enjoyable.
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| The course including staff |
We had our Certificates presented to us by the team as the final thing we did at the end of the course.
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| The amazing team responsible for it all |
A truly great course I would recommend to anyone with the base level of knowledge to take part, you won’t believe how much you can learn and improve in just 8 days. Though it will take many months of more reading and practice to really hone my new found skills and keep them up to date.
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| Slightly better than a 50m swimming certificate |
Most of all we got a shiny certificate and some stickers and a badge, whats not to like.
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| We love a pin badge we does! |
God help any of you lot who come see me at an event now as I will be wanting to do all sorts to you to practice my new found skills!
Lindley