UNM Wilderness Medicine News

It was the best of times. Period.

2010-03-25T16:37:00.000-07:00

Hope you enjoyed the sunny day. It is sad to see you go-we've all had a marvelous time together saving mannequins, testing improvisational ideas, inititing IV's, stoking fires, catching water, sinking in snow, rescuing comrades on the rocks, shooting up the town, petting fish, and releasing blisters. Mixed in with a little uncertainty where the last trip was to be, make sure you have fun tomorrow. By the way, I have an extra pair of women's New Balance tennis shoes, a silver water bottle and backpack cover. I need my firestarters and compasses (someone made of wit my Rock and Ice, but no biggie). Tomorrow, be ready to par-tay! If you have grade forms, please give them to me tomorrow. Au revoir...
d

2010-03-24T15:00:00.000-07:00

Here is the roll out for the final exam teams. It looks like it will be a clear and sunny day, but we will be at 10,000 feet and there will be a lot of snow and ice so be prepared for full winter conditions. You will be hiking about 2.5 miles over various terrain, some terrain that is hazardous, so get ready.

Team 1 Team 2

Rescue Leader: Charlotte Rescue Leader: Gabriel

Jaclyn Sam

Jonathan Lynn

Jason Nate

Natasha Iris

Team 3 Team 4

Rescue Leader: Erin Rescue Leader: Ben

Seth Clay

Lena Cuoghi

Linda Kari

Dave John K.

Antonia Cory

I anticipate that we will be done with the final exam by 3 or 4pm. The end of the rotation party will kick off at 6:30pm. Map to my house posted below. Please feel free to bring friends/family. I will provide some drinks. If you guys want food I will let you all coordinate that. If you have been working on a creative project and would like to present it I will have a projector and a computer. There is limited parking around my house but a lot of spots at the park across the street. From Tramway and Paseo Del Note head North. Turn Right, east, onto Cedar Hill. Take the second left onto Cedar Hill Ct. 727-12. See you all there, call 505-249-0170 if you get lost.

Jason View Larger Map

Tomorrow and final exam info!

2010-03-23T18:47:00.000-07:00

Hey everyone. I just talked to Joe and we have decided to cancel tomorrow's mountain biking trip due to the impending weather tomorrow. If you have already rented a mountain bike we will reimburse you. As of now there is a slight possibility of mountain biking on Thursday morning and that will be discussed at the aquarium tomorrow evening.

On thursday we will be meeting at the EMS Academy / Center for Disaster Medicine at 11am for the snake bite lecture. This an awesome opportunity to learn about snakes and snake bites and also see live rattlesnakes....

Moving on to the next and sadly the final event. So, Get ready for the Primal Quest of Rescue! This coming Friday we will be meeting at the Sandia Peak Tramway at 8:30am to begin your final exam. Please do not be late, as the tram will leave at 9am with or without you...

Once on top of the Sandia Crest we will break into our 4 rescue strike teams, which will be listed on the blog tomorrow, and your first scenario will be given. Medical equipment will be provided for you. Please bring your RESCUE ORIENTED day pack and be prepared for a long day on the mountain. If for some reason the tram shuts down, most likely due to wind, we will be hiking 8 miles down the La Luz trail. Check the weather…. http://www.wunderground.com/cgi-bin/findweather/getForecast?query=87122&wuSelect=WEATHER. Below is a list of skills that will be assessed throughout the day. The Strike Team that is most proficient in the skill sets based off of the instructors recommendations will be awarded the "Golden Carabiner" at the party.

Movement over terrain

Land Navigation

Patient Packaging

Improvised Patient Transport

Improvised Splinting

ACLS

Hypothermia Treatment

Survival Skills

Teamwork

Communication

Group Leadership Dynamics

Stress Tolerance

If you own a harness and a helmet please bring it with you. For the rest of the class harnesses will be provided for you. Strike Teams listed below:

If any questions or concerns arise feel free to call. Map and directions below. See you all on Friday!

-Jason

505-249-0170

From Tramway Blvd. and Paseo Del Norte head North. You will come to a stop sign, Tramway Rd., head West. You will come to a gate house where at 8:30am there may or may not be a guard. If there is he will want one dollar for parking... tell him you are with Albuquerque Mountain Rescue going to a training and he will let you proceed. Note: Google Map takes you a different way... Click on view larger map for the directions

View Larger Map

Mountain Biking

2010-03-23T14:05:00.001-07:00

Tomorrow:

UPDATE: MOUNTAIN BIKING IS CANCELED FOR TOMORROW - GONNA RAIN! TAKE THE MORNING OFF :) WE WILL RECONVENE TOMORROW AT THE AQUARIUM.

1) The aquarium date is happening for sure. Meet at the Albuquerque Biopark Aquarium (on central just east of the Rio Grande) at 4:45pm. We are going in after everybody else leaves, through the back entrance, so don't be late or you won't be able to get in!

2) Mountain biking. Weather dependent. There is a good chance of rain tomorrow and we are going to cancel if it is a downpour. So stay tuned.

If it is a go:

The bosque ride is a fun, winding singletrack ride through cottonwood trees in flat terrain down by the river. You can go fast or slow on this one. You will see Canada geese and maybe sandhill cranes, possibly porcupines, while whizzing by on your bike. There is a didactic component to this, so be prepared to learn something about biking injuries!

Directions: Go to the Alameda Trailhead at 9:00am. Directions: take I-25 north to Alameda, go left. Just before you cross the river, turn left into the parking lot. Contact me if you need help with your bike, etc. Tentative plan for now is to meet at 10:00am. I am going to check the weather again later and confer with Dr. Rimple, who may be joining us. This blog will be updated soon.

Gila and Bataan Trip March 19!

2010-03-17T20:38:00.001-07:00

Hope all goes well for you that are matching! Pay attention to this information for the trip!

ITINERARY
Friday 3/19 Day 1-meet at UNM Continuing Ed Center to pack into vans at noon. We will head to the Three Rivers Campground near White Sands. We will take a day hike, so carry a daypack for this.
Saturday 3/20 Day 2-leave White Sands for Las Cruces-sorry for the backtracking; we are meeting up with the Disaster Med Teams at 1600, then going to the White Sands Missile Range. No helmets needed! Will sleep at clinic on range (cots)-sorry, not "roughing it."
Sunday 3/21 Day 3-Bataan Death March marathon-we will be divided into teams manning tents on various rest stops along the course. Hope to leave by 2000 at night to head to the Scorpion Campground near Middle Fork Gila River (42 miles north of Silver City-gonna be a long drive?)
Monday 3/22 Day 4-Overnight in Middle Fork area where there are also hot springs. We are working on hiking groups-for now, water levels may be high, and cold-be ready for adventure!
Tuesday 3/23 Day 5-Complete the hike and head for Abq (around 2300 at night).
In all, an experimental trip-sorry for the short overnighters, but should be fun!

WHAT TO BRING
This will consist of mini trips: White Sands hikes and sand surfing, Bataan (medical), and Gila backpack. For the Bataan, bring:
1. Govt issued photo ID
2. Extra work shirt for Sunday, stethoscope (the ortho guys just said "Yeah, right!"); trauma shears if you have; hand sanitizer, pen, whatever other med essential kits you would like to bring; and an IPOD prn. My understanding is that we might wake up early (5am )and have a nice long day. BY THE WAY-NO SHORTS OR OPEN TOED SHOES ON WORK DAY! I will have a pair of BDUs-all this stuff we will van store while in the Gila-don't want to lug this stuff on a 26 mile hike!

For Gila, do not bring too much. Check the weather and plan accordingly. Think of your food needs. Should have plenty of water. Maybe can have small fires down there-not Cabezon fires tho. No trash pickup, so pack everything out. Maybe an extra pair of shoes or even neoprene booties (fly fishing stuff). Let Jason or myself know if this poses problems. TRY to pack no more than around 35 pounds. If interested, see the You Tube video I made for the disaster team for the Haiti deployment under WildernationalMed at:
http://www.youtube.com/watch?v=9Md62LlFz3o

It was a quickie video-oh well! Skip the helmet, and adapt the ideas for you. And you can take "personal valuables." Mosquitoes no problem, and think about a small stove. I took my down jacket that is compact. If concerned about bulky sleeping bags, think about a smaller bag with a vapor barrier liner, if you have this. Tents: one or 2 person, or tarps, especially for those going on the longer trips. LASTLY, PLEASE CARRY YOUR OWN PERSONAL MEDS! And blister stuff!

Good luck!
d

Ballistics Day March 16

2010-03-15T09:13:00.000-07:00

For the Shooting Range Day, meet at 8am at the UNM Continuing Ed Center. Dr. Albert De La Garza will lead the carpool to toe APD shooting range near the airport. You can bring your guns, unloaded of course. Bring ammo if you have some. BUT YOU MUST BRING EARPLUGS and safety glasses!
At 2:30 pm, we will reconvene at the CDM for the animal lab (vet lab) portion of the day. Hope all goes well with you all-sorry not to be there; I will be "saving" lives in the ED.
dario

Helicopter Operations

2010-03-14T19:09:00.000-07:00

Tomorrow we will be meeting at the NM National Guard hanger in Santa Fe at 10am. Plan on leaving ABQ by 9 to make it to the hanger by 10. It looks like it will mostly be inside lectures and scenarios, but as always come prepared to be active.

Directions: Head out of ABQ on I-25 North. Get off on exit 599 (The Santa Fe relief route) and head West. You will come to Airport Rd./Paseo Real where you will make a Left. Then make your next Left onto Huey Rd. where there will be a security gate. Tell the guard that you are with UNM Wilderness Medicine and are traveling to the Guard Hanger. They will direct you to its location.

If you have any questions feel free to call: 505-249-0170

-Jason

Note: Click on "view larger map" below to see the correct arrow on HUEY RD, which is right of the arrow shown in the map below.

View Larger Map

Great Job in Taos!

2010-03-11T20:27:00.000-08:00

Team, hope you all made it back and are loving the oxygen rich environment of Albuquerque. Sounds like the trip was worthwhile-can't wait to see more pix. We will begin our high angle SAR activity at the parking lot of Embudo Canyon, all the way up Indian School Road towards the foothills, at 0900 this Saturday 3/12. If you have helmets and harnesses(plus food/drink, not bourbon or moose backwash), bring these, and check the weather. By the way, no nav class tomorrow the 12th, looks like it will be on the 17th at Elena Gallegos Open Space-more to come later. Don't forget to see the trailer video below that won Joe Alcock the Oscar Awards for Best Wilderness Picture!
dario

Survival Weekend and Taos

2010-03-07T20:26:00.000-08:00

The first week of wilderness medicine was awesome. I have managed to put you thru a rigorous bootcamp experience, and NONE of you complained-we as instructors are proud of you all! The survival weekend was wet, but we made the right decision on leaving early. The folks who went back for the truck with the locked keys inside told me the roads worsened, so we might have been skiing in the mud in Cabezon instead of Taos snow!
To change gears, it is time for a little mountain medicine this week. Hope that some of you can enjoy the resort before meeting at the Abominable Snowmansion Tuesday at 5pm. We will start our talks at 6p, then go to the Guadalajara Grill for a little mexicano foodo. To get to the hostel, take Interstate 25 north to Santa Fe: just before the town, take the Bypass ("599b") to avoid the stoplights, and continue on State Hwy 68 thru Espanola, and into Taos. About 9 miles north of Taos is a junction to either the ski valley (left), Questa/Red River, or Tres Piedras. Take Hwy 150 to the Taos Ski Valley. About 4 miles is Arroyo Seco; on a left hand side where a rather sharp curve is is the hostel. You go further to get to the resort. The Taos ski report is at http://www.skireport.com/newmexico/taos.
When we go to the yurt (2.1 miles from the Taos Ski parking lot, elev. about 11k feet), we will do the snow cave building (for those interested) and do journal club part 1. The next day (Thurs) are the workshops. Ski or snowshoe up is the best way to get up, and I hope to do a little backcountry turning Wed. afternoon. May you dry out, and get ready for another week of "educational excitement!"
Dario

Memory jogger-the 5 H's and 5 T's for pulseless electrical activity

2010-03-01T19:57:00.000-08:00

Great first day-tomorrow will be bizy. Here is a memory jogger-have fun in ACLS!
HYPOXIA
HYDROGEN ion (acidosis)
HYPOVOLEMIA
HYPERKALEMIA
HYPOTHERMIA
TABLETS (drug overdose)
TAMPONADE-CARDIAC
TENSION PNEUMOTHORAX
THROMBOSIS-CORONARY
THROMBOSIS-PULMONARY

Map of Domenici Center

2010-02-28T20:07:00.000-08:00

Hi folks,
to get to the Domenici Center, go west on Lomas past the front of the Health Sciences Center, turn right on Yale till the roundabout and turn on the second right till you get to Tucker. Take a right on Tucker and park somewhere in the parking lot and follow the map, or ask where the Center is, or the bookstore. We will be in room 3010 at 0800-see you there! 505-553-5150
dario

2010-02-22T10:04:00.000-08:00

Check out some video of the final exam last year taken by the TV show "New Mexico Wild." See the link below. Get psyched!

Jason

http://www.youtube.com/watch?v=1uyFKoXFiUw

Sorry, I am out in Haiti

2010-02-16T17:29:00.000-08:00

You may all be frantic about the upcoming wilderness med course. Fear not! You are all in good hands. Before leaving for Haiti, I posted a You Tube video on how to pack for an austere mission-maybe you will have your ideas on how to pack for New Mexico. I must say that I am comfortable with what I packed in the video-it really works! We will teach you how to do as well-remember, we not only teach this stuff, we live it!
Orevwa,
Dario

Wilderness Medicine 2010 Update 1/23/10

2010-01-27T09:42:00.000-08:00

As of this writing, we have had about 2 feet of fresh powder here in the San Juan Mountains, just outside of Telluride. Albuquerque is having some nice snow as well, with four inches of the fluffy stuff at my house, and more up in the local mountains, the Sandias. Highs are about 37 degrees, lows of 25. Can’t tell you what it will be like in March, but historically it has been cold for the first half of the month, warming up later.

So, what to bring? We will be taking hikes, bikes, and climbs. Snow and desert camping will be the fare after the first week in Albuquerque, where we cover lots of basics. If you are in town by February 28, met us at the Piedra Lisa trailhead at 2pm for a hike, and a time to get to know one another. Click on this link under Piedra Lisa: http://www.cabq.gov/openspace/trailmaps.html to download and print. From town, go east on I-40, exit north on Tramway, drive till Candelaria and turn right (east) to the end, then turn right again (south)-the parking lot will be evident on the left hand side.

For the first week, we will be doing some didactics, and some fun environmental lab sessions. Be prepared to be cold, or to get hot-the first week will cover temperature extremes, as well as resuscitation and improvisation labs. The weekend will be the survival weekend, so dress warmly!

Snow camping at altitude in Taos will be the big event the second week-worry not-you WILL do well in the snow-we will show you how. If for some reason any of you do get too cold, a nice warm Mongolian tent (yurt) will be nearby. The third week commences with a mountain search and rescue lab, and a climbing lab, with some sportsmedicine intermingled. Then we will be going to Grand Gulch in Southern Utah (we pick this spot because we can take this multiple day backpack without much snow-usually)! Those of you who participate in match day will be able to do so.

The last week will entail a diving amd marine medicine session, as well as some international medicine topics. We are considering participating in a disaster medicine session in Southern New Mexico in White Sands, where the Bataan Death March marathon will take place. Outdoor event medicine is an important part of wilderness and austere medicine, and a great primer to expedition, event, or disaster medicine. However, we may not be able to do both the Grand Gulch and the Bataan Death March because of the Match Day, which is something that seems to restrict our freedom, but are required to observe. At any rate, this month, guaranteed, will be one of the best rotations you will have ever experienced.

Although our activities will not be competitive, they may be physically demanding. Please begin to undertake some physical conditioning. We allow people to choose activities commensurate with physical abilities, allowing everybody to participate in a given activity, regardless of ability-so enjoy! However, if you have health problems or are over 40, please have a medical evaluation before the course.

Finally, if you haven’t paid tuition, please do so now. Otherwise, we will be unable to plan, since we will have no budget to obtain needed materials.

In the event that you cannot get hold of me in February, it is because I will have no e-mail in Haiti, and so will ask you to kindly contact Jan at JSchmidt@salud.unm.edu in my absence. Of course, I really do not have any idea if I will go or not, but we shall see.

See you soon,

Dario

Wilderness Medicine Course Planning

2009-09-29T09:41:00.000-07:00

March 2010 promises to be the best UNM Wilderness class ever, with excursions to New Mexico deserts, snow covered mountains, and canyons. Check back to this site for frequent updates.

Joe Alcock MD

Highlights

2009-04-10T20:10:00.000-07:00

Attached is a link to my final project: highlights from the course.

http://picasaweb.google.com/lh/photo/7lUBNkBa9d6e81pKpp4bvg?authkey=Gv1sRgCKfok7HM8Mvw8QE&feat=directlink

It was a pleasure to work with and learn from such excellent physicians and physicians-to-be.

See you on the trails,

Jordan

Hyper-Bueno Rotation

2009-03-29T20:05:00.000-07:00

Hey team, as reality hit today about moving across the country and starting a real job soon, I just wanted to say that I had a blast surviving the wild with all of you. The "epicity" was off the hook and a great way to end four long years of medical school. I'm excited to see where the future takes each of you in your careers, life, etc. (guess that means I better join facebook and have my wife teach me how to use it). As I reflect on the month it's apparent that we are a fortunate group of folks:
1. Learned some awesome medicine in nature's amphitheater
2. Made 20 great new friends (doubled Pat and Dave's census...ha ha)
3. Got credit towards becoming a DOCTOR for hiking, biking, backpacking, climbing, snowshoeing, navigating, jumping in rivers, etc.
4. Had a lot of great laughs and made some amazing memories
5. Didn't die falling off a snowy cliff during the final exam OR meeting a backcountry rattler OR picking up a fire salamander (which I was really tempted to do, leave-no-trace!)

Good times....I'm gonna go catch some dinner with a squirrel pole. I'll try and attach my slideshow to the blog. If anyone finds my pant legs or wants to hang out in Portland, ME gimme a holler (505) 270-5314. Peace out, Mike

Black & White Cookie Recipe

2009-03-29T08:40:00.000-07:00

Hi all,
It was a great month and I hope to see many of you in the future. Since the black and whit cookies were my final project, I decided to share the recipe, just in case anyone wanted to make a few for themselves.
Lars

Black & White Cookies
Cookies
3C Flour
Scant ¾ Tsp salt
¼ tsp baking soda
1 1/3 C Sugar
2/3 C butter (slightly softened)
½ C white shortening
2 large eggs
2 ½ tsp vanilla
2 tsp white corn syrup
Scant ¾ tsp lemon extract
1/3 C sour cream

Fondant
¼ C light corn syrup
5 C powdered sugar
¾ tsp vanilla
2 oz unsweetened chocolate

Combine flour and baking soda in a separate bowl
Beat sugar, butter, shortening in another bowl
Add eggs, vanilla, corn syrup – mix well
Beat in ½ flour mixture
Add sour cream – mix until just blended
Add remainder of flour mixture

Let stand 5 minutes

Using a 1/4 C of dough at a time, make dough into balls and then pat them down with your hands on a cookies sheet

Bake at 350 degrees for 11-14 minutes (done when edge is light brown)
Let cool completely.

Fondant
Bring ½ C water and corn syrup to boil
Remove from heat and add powdered sugar, stir until blended and mixture is thick but can be spread
Chop chocolate and keep in separate bowl
To chocolate add 2/3 C fondant until chocolate melts, then another ½ C fondant
Ice cookies with fondant

Reflection

2009-03-29T08:10:00.000-07:00

Hey all,
I hope everyone had a day or two to rest up before your journey continues. A few days of reflection on the course has given me the opportunity to focus on what exactly I feel the main learning experiences of this course are. First off let me say that this class was one of, if not the best, class that I have seen thus far.

After 4 years of medical school you all know medicine relatively well. With a little refining of the patient assessment and gaining some emergency medicine and rescue experience you all were set to go. The essential element was not medicine…

The traits and skills that everyone brought to the course and built upon, or gained throughout the course, was impressive and hopefully life changing. The temporary transformation that this course brings on will carry over into other aspects of your life. The situations that everyone encountered, scenarios or genuine life, gave you all the opportunity to truly test your body and mind. To find out if you’ve really, “got it.” Whether you were happy with the results or not the journey is not over. You all will continue with your medical journey and be incredibly successful. I encourage you to seek out your next voyage in the hills and find that strength, clarity and confidence can be found there.

Thank you for making the month incredible and stay in touch.

-Jason

A good article for those interested…
http://www.gymjones.com/knowledge.php?id=5

2009-03-27T23:48:00.000-07:00

So I was looking through some of the pictures from grand gulch tonight when I saw the one of the salamander that the long hike group found. I could have sworn that I remembered the black and yellow spots from somewhere.

This is a fire salamander. They are fairly common and can live up to 40 years. They can excrete a very toxic poison when threatened. From glands located behind the head and along the flanks the poison can cause Hyperventilation, HTN, and muscle spasms. Having said this, the poison rarely if ever (that i could find) effects humans.

Its been a fun month with you dudes.

Final Party and Creative Project Presentations...

2009-03-27T14:17:00.000-07:00

Hey guys,
Map to my house posted below. Please feel free to bring friends/family or some random guy off the street... Kicks off at 6:30pm. There is limited parking around my house but plenty at the park across the street.

From Tramway and Paseo Del Note head North. Turn Right, east, onto Cedar Hill. Take the second left onto Cedar Hill Ct. 727-12. See you all there, call 505-249-0170 if you get lost.

Jason

View Larger Map

Into the Gulch of Death, the 20 hours, and the 3 Incomparables

2009-03-26T17:16:00.000-07:00

It is terribly unfair to characterize the Grand Gulch of Utah’s Cedar Mesa as the Gulch of Death. It was, after all, a source of life to uncounted generations of Anasazi people in presumably wetter times. It was also a treasure of other-worldliness for us who backpacked there during the wilderness medicine course, not only in its geological presentation but also in the art and architecture left for us by those who once called it home.

I call it the Gulch of Death because death, after all, is the final helplessness, and it was in the Grand Gulch that I came to a point at which I truly felt helpless. The hike began as hikes usually do, with buoyant walking, bearing a quite manageable load. It rapidly became obvious to me, however, that I was not up to the task of keeping the same pace as the others in my group. I was a slow hiker years ago even when younger and fitter, and now am fatter and indisputably middle-aged. I was told that a brisk pace was necessary to reach a particular distance goal that day.

Now it does no good to kick a lame horse, and it did no good to urge me to speed on. I certainly tried to increase speed, but this was at a cost of safety, as I then tended to stumble and once almost twisted my ankle. I had chosen what had been presented to me as the “short hike group” of our three divisions because I knew myself. I reasonably believed I could complete a long hike based upon my experience, but at my accustomed pace. I did not sit out the Grand Gulch trip because, earlier in our course, I had little difficulty in completing the orienteering hike during the survival weekend and the snowshoe hike up the mountain during the Taos weekend, where I had been advised that “it’s the journey, not the destination” and to hike at my own pace.

I pressed on as fast as I could. We made our first camp by nightfall. We arose Sunday morning and set off. All of us enjoyed the Green Mask painted in amazingly still-vibrant hue by a long-departed Anasazi artist high on a cliff face, as well as other paintings and ruins along the way.

After stopping for lunch I realized how tired I felt. When we resumed the hike, I found that I could barely place one foot in front of the other, plodding at a speed that could hardly be called walking. The group divided up my pack and its contents. Even without a burden to carry, I found it hard to walk. I was short of breath and could feel my pulse racing. I sometimes felt mild, diffuse pain in my left chest and left upper back as I walked. I did not feel overheated, but my companions wet my shirt down out of concern for me. We walked to a cool spot where I could lie on a tarp on a rock.

Like most people, I prefer to be self-reliant and contributory, and I did not like it that others had to carry my pack. No one complained, and everyone was gracious, but I still did not like it. Nevertheless, reality was obvious to me. I simply could not do what I wanted to do. I could not will my way through it. I could not will strength to my body nor will my racing pulse to slow like some legendary Yogi from the Indian subcontinent. I realized that, had I been alone, I would possibly not have made it out.

After a time, I walked to where others had made our camp and pitched a tent for me. I rested supine in the tent with a headache and nausea. Shortly after consuming some electrolyte solution kindly prepared for me, I projectile vomited. I subsequently received intramuscular Phenergan and oral Benadryl. I slept a few hours, which was less then expected, and the nausea was gone for good.

The next day, I slowly walked and climbed out of the Grand Gulch with a near-empty pack. Upon our return to the ranger station, I received a bolus of intravenous saline. We returned to Albuquerque.

Shortly after I returned to where I was staying, the incomparable Dr. Joe Alcock called me to discuss his concern that I had experienced a cardiac event. He picked me up and accompanied me to the UNM Emergency Department. I was there 20 hours. After I made it past the waiting room, EKGs, and initial labs, the incomparable Dr. Diane Rimple had arrived and was my attending through the night. The cardiologists saw me in the morning, I had a stress test and echocardiograms, and by Tuesday evening the incomparable Dr. Daryl Macias had come on as my attending and discharged me.

The upshot was that the cardiologists detected no obvious or severe heart disease. I attribute my misadventure to over-exertion and dehydration, although my own perception would have been that I was hydrating adequately.

I still feel tired but not at all like I did in the gulch.

A few things to think about:
1. Foreknowledge is hard to come by. When we hike with friends or family of known ability, both they and we know to some degree what we’re all getting into. In a situation like our Wilderness Medicine class, we don’t possess that knowledge and must acknowledge ahead of time that we will all have to adjust. In reality, because beating a lame horse more won’t make her win the Kentucky Derby, the group will usually have to adjust to the less-able members.

2. It might be helpful if, prior to departure, everyone in a group communicates about the plan. I never saw a map or participated in any detailed discussion about what we were going to do. I usually had no idea where I was. I was just tagging along.

3. There is a strong argument for a group staying together. At one point, I heard a whistle and called out in that direction. It turns out that four of us, all at the end of the caravan, were walking on three divergent paths. Also, I am perhaps the worst person on this side of the galaxy to choose the correct path at any given fork. I am probably the Tracker Tom Brown in the Bizarro World, if any of you have read old Superman comic books and get my drift.

4. It’s a great comfort when your colleagues show that they are really decent human beings when you are relatively helpless. It shows the true character that we all hope to find in a physician or EMS rescuer. The actions of the members of our little “short hike” group bode well for our collective future.

5. Pack lighter and drink more (water, that is, not Patron Tequila).

That’s it. I’m glad I’m alive to write this, and I am glad to have met you all. God grant you a happy future.

Party Time!

2009-03-26T15:25:00.000-07:00

Hey Everybody,

I have taken on the duty of trying to coordinate the food/drinks for tomorrow night's final shin-dig, to take place at Jason's house. We all saw the grouchy-ness that ensues when deprived of dinner, so it would be great if everyone could pitch in in some way.

As it stands:

I am bringing the fixings for frito pies- my final project, couldn't let the out-of-towners leave without trying a NM staple.
Chang- is cooking up something bound to be delicious for her final project as well.
Chris- has agreed to have his momma fix us some enchiladas.
Anna- homemade ice cream

We are still going to need more main dishes, side dishes, desserts and drinks.
Think it over...We can talk about it tomorrow morning.

Jayme

Eco-Rescue Challenge Final Exam!

2009-03-26T10:22:00.000-07:00

Get ready for the Primal Quest of Rescue! This coming Friday the 27^th we will be meeting at the Sandia Peak Tramway at 8:30am to begin your final exam. Please do not be late, as the tram will leave at 9am with or without you and that would just be embarrassing….

Once on top of the Sandia Crest we will break into our 4 rescue strike teams, listed below, and your first scenario will be given. Medical equipment will be provided for you. Please being your RESCUE ORIENTED day pack and be prepared for a long day on the mountain. If for some reason the tram shuts down, most likely due to wind, we will be hiking 8 miles down the La Luz trail. Check the weather…. http://www.wunderground.com/cgi-bin/findweather/getForecast?query=87122&wuSelect=WEATHER It should be interesting. Below is a list of skills that will be assessed throughout the day. The Strike Team that is most proficient in the skill sets based off of the instructors recommendations will be awarded the "Golden Carabiner" at the party.

O and also, a camera guy from local fox show called New Mexico Wild will be accompanying us on the final exam…. As if you needed more pressure J

Movement over terrain

Land Navigation

Patient Packaging

Improvised Patient Transport

Improvised Splinting

ACLS

Hypothermia Treatment

Survival Skills

Teamwork

Communication

Group Leadership Dynamics

Stress Tolerance

If you own a harness and a helmet please bring it with you. For the rest of the class harnesses will be provided for you. Strike Teams listed below:

Strike Team 1 Strike Team 2

TL: Katie TL: Anna

Justin Hoops

Mike Pat

Chang Fernando

Jason

Strike Team 3 Strike Team 4

TL: Owen TL: Lars

Chris Tim

Jayme Desiree

Dave Evan

Rob

If any questions or concerns arise feel free to call. Map and directions below. See you all on Friday!

-Jason

505-249-0170

View Larger Map

Elena Gallegos Wilderness Journal Club

2009-03-25T22:23:00.000-07:00

Tomorrow will be a fun filled time, which includes a journal club review by those below. While we have lived the dream this month with rich outdoor experiences, we are mindful that, while wilderness medicine is not always evidence based, we are trying to unearth nuggets of evidence in this field, so that at least, if faced with real life situations, we can be a bit more authoritative (or pretend to be)!

The List:

Dan Hoopes: Cycling Sportsmedicine article from JBJS
Evan Tobin and Mike Roehlk: Adventure Race injuries (under "Ortho and Sports" in Trauma-Sports Med folder
Rob Shoots and Tim Madden: Backcountry Ultrasound in Resuscitation folder
Lars Peterson, Justin Kan and Chris Loucks: Airline Emergencies and Fever after Travel (under "Casual Travelers" in Infectious Disease folder)
Chang Rim and Fernando Monreal: Worsening Breath Hold Dive Hypoxia (under "For Diving Pros" in Marine folder)

We will discuss many topics that will be pertinent to the final exam. The fun begins at 1pm, under the covered BBQ area of Elena Gallegos: go to the gate and turn left, following the road till you find a large covered open roof area. If lost, call Jason. BTW: you are free to barbeque!

Aquarium

2009-03-25T14:02:00.000-07:00

We meet at the Albuquerque Biopark at 4:30pm.
Directions are here: Scroll down this link for mapquest map
We are going to do interactive marine envenomations, followed by brief lecture, followed by real live dive scenarios!

Dinner will be at the Japanese Kitchen at 8:30pm, restaurant is located at:
6521 Americas Pkwy, Albuquerque, NM 87110-5358
Click here for detailed directions
We will be at the sushi bar, NOT the main restaurant. They are actually in two separate adjacent buildings.

See you tonight!

Joe

2009-03-25T06:27:00.001-07:00

Case #1

Sandia Downhill Bomber
19 year old extreme downhill mountain biker collides with a tree, has a brief loss of consciousness. First Aid team attends to him; He recovers consciousness, his helmet is removed and his spine is immobilized. He complains of lip numbness and facial pain. 1st responder notices a loose tooth in his mouth and tries to retrieve it. The biker’s entire palate moves freely as he taps the tooth. His palate seems to be detached from the rest of his face.

Diagnosis: Le Fort Injury.
An Austrian report suggests that facial injuries, including Le Fort Fractures are common among extreme mountain bikers.
Le Fort 1: Maxilla is separated from pterygoid plate and nasal septum.
Le Fort 2 Maxilla and nose moves but not eyes
Le Fort 3 Craniofacial disjunction. Facial Skeleton separates from skull.

During transport biker becomes unconscious again, develops a widely dilated and fixed R pupil.

Diagnosis: Epidural hematoma pushes temporal lobe over tentorium, trapping CN III, and putting pressure on the midbrain. Uncal herniation. Compression of CN III is responsible for pupil.

Discussion points:
Overall mountain bikers have 40% decreased incidence of head and face injury compared to roadies. Helmet use is more frequent. Absence of cars. Downhill bikers often wear full face (motorcycle style) helmets. Despite these, head and face injuries still can occur. More on this later…

Case 2
Roadie Helmetless
Road biker doing her afternoon commute home is struck by a station wagon that failed to stop at a stop sign. She is found 25 yards from her bike, unconscious and unhelmeted. There is clear fluid oozing from the left ear and nose. A large bruise is noted behind the ears and under the eyes. A large laceration over the forehead reveals an underlying step-off of the bone. She is pulseless.

Dx: Depressed skull fracture Basilar skull fracture. Traumatic arrest. Unlikely to recover.

Road vs. Mountain bike Injury Pattern.

MTB have 40% - 60% decreased incidence of head/face/dental injuries than roadies. Decreased traffic and increased helmet use.

Rivera (1997) Seattle study. Surveyed bicycle injuries prospectively between 1992 and 1994. Study involved 7 ED’s and 3390 injured bicyclists.
Only 4% of these were mountain bikers.
73% of MTBers were between 20 and 39 years of age.
86% were male
Helmet use: 80.3% MTB vs. 49.5% on road. (Perception of risk and Difficulty changing habits) Injury cases – 29% head injured pts helmeted vs 56% of non-head injury pts helmeted.

Head and face injuries: MTB decreased risk compared to those incurred by roadies.
Severe Injuries (dislocations,concussion,fractures): 4% of MTB injured patients vs 7% of road injured. Hospitalized: MTB 6% vs 9% of road injuries.

Safer with helmets, safer off road!

In other surveys: Head injuries complicate 22-47% of injured bicyclists. Usu MVC. Head injuries account for 60% of deaths.

JAMA study: Helmets provide 4-fold protective effect against head injury. 85% effective against head injury and 88% effective against brain injury.
Helmet type: doesn’t matter. Hard shell, thin shell (most), no shell are all equally effective. All must meet ANSI, Snell requirements. Fit is probably the most important consideration when buying a helmet.
Helmets reduce risk of nose and upper face injury by 65%.
CA helmet legislation has resulted in 18% reduction in head injury for<18 yrs.

Case 3
“Slickrock Handlebar”

40 year old 1st time mountain biker rents a bike in Moab Utah. 10 minutes into the ride at slickrock, he falls off a rock ledge and lands directly on the bar-end attached to his handlebars. He develops guarding of his abdominal muscles and complains of upper abdominal pain. He does not want to be moved.

Diagnosis: Liver injury vs. Splenic injury vs. bowel injury. In this case: sub-capsular liver hematoma. These have been associated with the use of bar-ends. Many can be managed non-operatively. Of intra-abdominal injuries secondary to handlebars: spleen > liver. Spleen injuries are generally managed non-operatively, as are sub-capsular liver injuries.

Handlebar injuries.
Israeli Study of children. Handlebar mark in only 15% of children admitted for handlebar injuries. 30% had ruptures of spleen or liver. 5 of these 25 were operated on. Small bowel injuries also can occur this way when bowel is trapped between the spine and the handle bar.
Case 4
Extremity in Extremis

26 yo F bicyclist falls over the handlebars on a rocky descent. Notices brief numbness and paresthesias of R hand and cannot move R arm. L hand is becoming progressively more swollen and painful. Her companions notice a squared off R shoulder and numbness over R deltoid.

Diagnosis: R shoulder anterior dislocation. Axillary nerve injury. Consider also ulnar nerve injury. Brachial plexus injury.

Hand Exam shows snuffbox tenderness.

Most common injury involves going over handlebars. Upper extremity injury is most frequent. Abrasions, followed by contusions and sprains, then fractures and dislocations.

Attempt splinting of hand if possible and Consider reduction of shoulder. Scapular manipulation/ traction.

For hand consider splinting with a Sam Splint. If shoulder is reduced use safety pins to splint the shoulder.

Get patient to a place where XR can be performed.
Case 5
Endurance Race Wipeout
22 yo M triathlete participates in 24 hour mountain bike ride. The weather is hot, he is rehydrating with evian water and the occasional powerbar. 10 hours into the race he is getting drowsy, and beginning to have transient visual hallucinations. Is it just because it is 11:00 pm? Begins to feel weak. Then falls onto the sandstone and has a brief seizure.

Diagnosis: Hyponatremia. Fluid replacement without sufficient salt to match sweat losses. This entity has killed marathoners and triathletes every year with the advent of extreme endurance sports. Prevention with salty foods is important. Fritos might be the most important thing in your pack. Hyponatremia is one of the most common diseases to afflict visitors to the Grand Canyon

Case 6
Cactus Encounter

First time mountain biker from Oklahoma visits New Mexico and barrels down a steep foothills path, he is unhelmeted but luckily doesn’t strike his head as he tumbles over his bike into a staghorn cactus and prickly pear. He also has a deep abrasion from a sharp rock he acquainted himself with a nanosecond before kissing the cactus.

You can usually grab the end of a big thorn with needle-nose pliers. Splinter forceps (tiny sharp tweezers) are ideal.

If there are multiple small thorns in a fairly small area, try removing them with glue. Spread a generous coating of patch glue over the entire area. Wait until it dries, then peel it off. It will usually pull the thorns (and your body hairs) out as it comes away from the skin. Of course duct tape will probably work for small thorns too. If thorns remain in the skin they may provoke an inflammatory response or cause infection and may end up causing a granuloma.
Case 7
Heatstroke

Scenario:
You're sweating like a pig in the Durango sunshine, trying to figure out the Colorado trail. Dang that CamelBak is heavy on the uphills! So you dump out some water. Getting kind of dizzy. Don't stop, because the significant other will be waiting. Odd -- you're getting goosebumps despite the heat, but at least you're not sweating so much any more. Which fork do you take here? Your eyes blur and its impossible to figure out this old map. Boy, this heat is making you dizzy. Better sit down for a minute. Whoops, kind of fell down there.

Description:
Heatstroke occurs when your heat-regulation system fails. Often sweating stops and there are signs of excess adrenaline such as goosebumps. The body temperature climbs and begins to interfere with thinking. Symptoms of heat exhaustion usually precede the confusion that marks the beginning of heatstroke. Finally, consciousness is lost and brain damage (and death) can occur rapidly.

When has a biker passed the line between heat exhaustion and heat stroke? To oversimplify: if the brain isn't working perfectly (confusion, dizziness even when lying down, etc) you've crossed the line from dangerous to deadly.

Immediate care:
Immediate cooling can be lifesaving. (Often, the victim can no longer sweat, so the temperature just keeps rising. You can't just "wait it out.") Get the person out of the sun immediately. Remove extra clothing. Spread arms and legs to increase evaporative surface. Have them lie down, while keeping as much skin open to the air as possible. Wet your biking shirt, then drag it loosely over exposed skin, moving from one area to another. Keep the cloth loose and very wet, letting it pass through the air to cool between wipes. If there's a cool but shallow stream nearby, consider moving the victim so their back and legs are in the water. If you're close to a camper where ice is available, put ice in the groin, armpit, and under the back. If the victim remains confused or becomes unconscious, send someone out for help.

Case 8. “Numb Perineum”.

You are on an all day ride on the boundary trail in Taos, at mile 20, your partner begin to complain of numbness of her ring and little finger.

Dx: ulner nerve compression (ulnar tunnel syndrome or cyclists palsy). Ulnar neuropathy is much more common than median nerve palsy in cyclists.

Tx: change gloves, change handle bar position. Of note road and mtn bikers get these symptoms in roughly the same proportions. Although road bikes offer more hand positions, rides are often longer.

At mile 22, you (male) note a numbness in a sensitive area. Bilateral pudendal nerve compression. {Impotence is no more common among competitive cyclists than among other athletes}.

Change saddle, Change into more padded shorts.

Mountain Biking

2009-03-24T13:08:00.001-07:00

Folks, we are going to split up into two groups: You can ride with me in the bosque or you can ride with Diane Rimple in the foothills. The bosque ride is a fun, winding singletrack ride through cottonwood trees in flat terrain down by the river. You can go fast or slow on this one. You will see Canada geese and maybe sandhill cranes, possibly porcupines, while whizzing by on your bike. The foothills ride will be slightly longer, with moderate climbs and descents in rocky terrain. You will see the occasional coyote, the Albuquerque jogger, and feral housecats. We have taken classes to both places in previous years and you will get your money's worth no matter which location you decide. There is a didactic component to this, so be prepared to learn something about biking injuries!

Bosque with Joe: Go to the Alameda Trailhead at 9:00am. Directions: take I-25 north to Alameda, go left. Just before you cross the river, turn left into the parking lot. Contact me if you need help with your bike, etc. See below.

Foothills with Diane: Go to the parking lot at the top of Indian School at 9:00am. Take I-40 west to Tramway. Go left (north) on tramway. Indian School is the 4th stoplight. Go right until you reach the trailhead.

We will need to get a head count, so leave a message with me @ 280-5181 or Jason to let us know what you are up to!

We will ride until lunchtime and there will be scenarios along the way. Be certain to bring a well maintained bike. We don't need mechanical breakdowns on the trail.

At 4:30pm we will meet at the biopark aquarium parking lot for diving emergencies and marine envenomation demonstrations!

Good Luck!!!!

NEXT UP... BIKING/AQUARIUM

2009-03-23T21:40:00.000-07:00

Enjoy your well earned day off on tuesday! And congratulations to everybody for teamwork, successful navigation, and trail-side wound care, not to mention impressive hikes from everybody!

Bike rentals for those that need em:
Northeast Cyclery on Menaul. There should be a discount for UNM Wilderness Med Students.
Map and Phone number for Bike Shop

See you on Wednesday am at 9:00am at the Alameda Trailhead. Check back for directions and details tomorrow.

Joe

Grand Gulch!

2009-03-16T09:55:00.000-07:00

Folks,
At 10:00 am 3/20/09 - Meet at UNM Continuing Ed.
Barring an armed rebellion (a distinct possibility), or natural disaster - we are planning on leaving for the Grand Gulch on Thursday noon.

The first night (friday) that we spend in the area will be at the Valley of the Gods. This will be car camping. Following this (saturday, sunday, maybe monday nights) we will be in the grand gulch canyon backpacking.

Our decision:
We are going to split into three groups, each leaving at different trailheads. The three trailheads are Kane Gulch ranger station, Bullet Canyon trail, and Collins Canyon trailheads. We will have the opportunity to do some incredible hikes!

Your decision:
You must decide which group you will hike with. We are looking at groups of about 7-8 students with 1 faculty each. At some point we can look over a map and decide the route each group will take.

Options:
This map gives a good overview of the area but without trails labeled.

The distances between trailheads are here.

One long hike option is this:
Kane to Collins is 38 miles:
http://www.usatf.org/routes/view.asp?rID=198462

But I think that option is tough to do with our schedule. So, most groups will cover 8-12 miles a day and end up at the same trailhead that they started at.

Some things that are not allowed in the canyon are: building fires, taking or damaging artifacts, damaging vegetation and defacing rocks. (We are allowed to have fires at Valley of the Gods).

Leave no trace!

My equipment list: (yours may vary)
pack
pack cover (garbage bag)
flashlight
blade
whistle
map
compass
(gps)
toiletries
foot care (moleskin)
tp - wet wipes
sunscreen
sunglasses
water filter
stove, firestarter
plastic spoon,fork,knife
fuel
water bottle
waterproof shell
waterproof pants or poncho (or umbrella)
waterproof shoes or good boots
teva sandals
tent, or bivy, or tarp
tent footprint (garbage bag or tarp)
sleeping pad
sleeping bag 20 deg minimum
long underwear/fleece pants
synthetic long-sleeve shirt
fleece sweatshirt
gloves

My food list:
snacks: nuts, trailmix, granola bars, jerky
breakfast: instant oatmeal, hot chocolate, coffee, tea, sugar
lunch: rice cakes with peanut butter and jelly
dinner: instant soup, top ramen, cup o' noodles, instant mashed potatoes
drinks: koolaid, tea, emergenC
dessert: girl scout cookies!

Remember: the lighter the better - for enjoyment of the hike, fewer blisters, and speed.

Bring the lightest warmest clothes, leave the canned peaches at home. I sometimes put just enough sunscreen, or toothpaste in a ziploc. Bring ricecakes instead of bread. Split the load - not everyone needs a water filter and a separate tent, stove and cookware. Do you really need to bring jeans and 4 changes of t-shirts and underwear? Well....maybe the rest of us will appreciate it but your feet will not!

JA

Firearm Day-March 17, 2009

2009-03-15T22:25:00.000-07:00

We are gonna make your day on Tuesday, March 17 for some firearm safety and shooting! We will meet at Starbucks on the corner of Central and Tramway Blvd, in the Four Hills Shopping Center where the theater is. Meeting time is 0830 in the morning. Take the Interstate 40 east, and exit Tramway, turning right. Starbucks is on the southwest corner of the intersection. From here, we will be driving out to the New Mexico Big Horn Gun Club in Edgewood. We will arrive about 9 am, and leave in time to get you to the afternoon activities at the EMS Academy.

What to bring: safety glasses or goggles (clear or yellow amber ideal; sunglasses ok). We will provide earplugs, unless you wish to bring your own ear protection. If you have a firearm, you may bring it as well. Bring something to drink, and snacks if desired. Camo optional! Scenarios? Can't say at this time...ask Bob Quinn; I am just a facilitator. Questions? Call my cell number.

Hasta la vista, baby.

Dario

Helicopter Operations SF, NM

2009-03-15T16:29:00.000-07:00

Tomorrow we will be meeting at the NM National Guard hanger in Santa Fe at 9am. Plan on leaving ABQ by 7:45 to make it to the hanger by 9. It looks like it will mostly be inside lectures and scenarios, but as always come prepared to be active.

If you have any questions feel free to call: 505-249-0170

-Jason

Note: Click on "view larger map" below to see the correct arrow on HUEY RD, which is right of the arrow shown in the map below.

View Larger Map

Pics from the Yurt and Hostel

2009-03-14T17:38:00.001-07:00

Embudo Mountain Rescue Day!!!

2009-03-12T12:09:00.000-07:00

SATURDAY MARCH 14th 8am

The Embido SAR day is coming up this weekend. I hope everyone is excited as it is going to be an action packed day. When we gather in the parking lot we will divide into strike teams and support teams. Whether you are in a strike team or a support team everyone will have the opportunity to provide patient care. As soon as the teams are in the parking lot at Embudo at 8am you will be given a scenario and a brief overview/introduction of the equipment and staff for the day. Teams will be provided with radios for day. Keep in mind that communication is key in a rescue situation, not only for relaying medical patient information to base, but also for dispatching adequate resources to the rescue site... And yes you will need a lot of resources during this scenario. Last Hint: Review how to manage Mass Casualty Incidents.

See you all there - Jason

ITEMS TO BRING:

Day Pack

Adequate Clothing

Water/Lunch

Harness/Helmet if you have it

You will be provided with your FASTPACKS and 2 ALS kits

Map Link Below. See you all on the 14th at 8am! We should be wrapping up around 3pm.

From Tramway and Indian School Head East on Indian School until it dead ends at the trail head parking lot।

http://maps.google.com/maps?f=s&utm_campaign=en&utm_source=en-ha-na-us-google-gm&utm_medium=ha&utm_term=map

Survival Photos

2009-03-09T09:09:00.000-07:00

Hi all,
Some photos from our first camping trip.

Pictures from Hypothermia Lab

2009-03-09T09:04:00.000-07:00

Some pictures from burying people alive in snow and heating them up again.

Paparazzi!

2009-03-04T19:23:00.001-08:00

Hey everybody! I hope everyone received the invitation to view pictures at my picassa site. If not, please let me know since the album's privacy setting is high and you'll need an invitation to view it. I'm not that great a photographer but I compensate by taking a lot of shots so I'll continue to take a bunch throughout the course and keep posting them to the same album. Enjoy! :)
- Chang

Give me that pen!

2009-03-03T19:08:00.000-08:00

While the improvised IV bag needle was good, this might be a little bit better, though pricey:

http://www.airstat.org/

Patient Assessment

2009-03-02T08:10:00.000-08:00

SOAP NOTE.

S: Setting, Safety, Mechanism, Number

O: Organ Systems

A: "(S)AMPLE" history

P:Plan, Anticipated problems.

SAMPLE = Secondary Survey, Allergies, Medications, Pertinent History, Last Meal, Events.

Prepare for the 10th Wilderness Medicine Course!

2009-01-03T11:18:00.000-08:00

Welcome to all of you planning to participate in our tenth course at the University of New Mexico! The 2009 New Year is providing us here with lots of snow for great skiing in Northern New Mexico and Southern Colorado, and nice sunny days to even go for a great mountain bike ride. I have been practicing survival skills as well-last week drove from Taos to Silverton and got benighted in a snowdrift, but it was all good! We hope you are also preparing for a fantastic course in March!

We have some new classes for you, always geared toward personal and group preparation. You see, true wilderness medicine is more preventative medicine...you really want to avoid doing ACLS in the field, for instance! With our wilderness and international emergency medicine fellowship looming next year, our excitement for the March course (which will be a part of the fellowship) is bigger than ever. In the meanwhile, if you are not on an exercise plan, start now! If you get the chance to be outdoors in the next couple of months, do it! And keep up to date on the events relevant to wilderness and austere medicine-the news and popular press is doing a good job of that (see our regular Mountain and Marine Medicine blogs for some of those press releases). On behalf of the faculty here, we can't wait to meet you. So, have a safe New Year, a prosperous New Year, and a well prepared New Year! If you're in the area, say "Hi" to us at the Ouray Ice Festival (Jan 10-14, 2009).

Dario

Feeling Mushy

2008-03-28T13:41:00.000-07:00

So I'm feeling a little nostalgic and thought I would share the final entry of my journal. Darryl, Joe - I promise to send it to you by the end of the weekend! Writing is not my forte but hopefully the sentiment is there:

I am currently in Boulder, CO realizing that I am talking non-stop about the rotation. I am about to embark on a four-day journey to Palo Alto, CA while car camping/hiking along the way. Driving six to eight hours a day can make you pretty nostalgic.

As I drive along I-70 through Utah, I look at the weathered rock around me hoping to catch glimpses of the familiar landscapes of Valley of the Gods or Grand Gulch. It’s beautiful, but it’s not the same. I never fully appreciated the landscapes that the US has to offer. I didn’t know about Albuquerque; I was completely mistaken about New Mexico; and I couldn’t fully appreciate that the southwest is more than just desert. I’ve always chosen to travel to foreign countries just to see and experience something new. And while that’s an incredible experience in itself, I’m surprised and embarrassed to have been so ignorant of what was in our “backyard.” I have just passed through Arches National Park. Finally, I know what crypto is. I also know that I prefer backcountry camping as opposed to crowded national parks during spring break. I don’t know how to not make this sound cheesy, but I am about to make an analogy between weathered rock/natural arches and people/experiences we have. I look at some of these breathtaking terrains and I am astounded by what I see. How is it that an enormous rock came to be perched upon such a fragile-appearing base? How is it still standing? Then I realize that each balanced rock is the result of water sweeping along its sides, rain running between its crevices, and wind beating against its surface. Forty years from now when I am old and decrepit, I hope to have that same outlook and understanding. I hope to stand elegantly and proudly displaying my weathered self (not in a exhibitionistic way). I hope to recall the time I spent on this rotation in Albuquerque, NM and remember the experiences I’ve had and the people who have shaped and sculpted a part of me.

Thank you to all of you who have made this rotation such a memorable experience. Best of luck and warm wishes all in all you do.

-kristina

Another Photo Album

2008-03-26T15:01:00.000-07:00

Hi Folks,
While glad to be back in Philly, compiling this album made me terribly nostalgic.
Here it is: http://picasaweb.google.com/mthomer1
Enjoy!
Maggie

Ya Know That Feeling...

2008-03-23T20:33:00.000-07:00

Well it came... Just thought I would share the latest rescue with you all. Call came in Sunday night around 7pm for 6 females (ages: 42, 16, 16, 17, 17, 14) who took the Embudo trail (SAR day trail) up around 12 pm and encountered snow then lost the trail. They had a hard time getting out of it and became dehydrated and hypothermic along the way. They were all wearing sweats, had ran out of food and water, did not have anything to start a fire and no light source. They call 911 who advised them to stay put until rescue arrived. I quickly "obtained" their cell phone number and advised them to head down the mountain carefully toward Albuquerque and got a good idea of where they were at. I knew that they were in either Embudo or Embudito canyon, which is 2 canyons to the North of Embudo. I sent a team up Embudo and I headed up Embudito. Approximentaly 2 miles up Embudito canyon I gained voice contact with the party and a few minutes later was in contact with the group. As soon as I started to assess the first patient I see one vomiting heavily out of the corner of my eye. Priorities switched to that patient. She was cold and a little out of it. Last oral intake was 4 hours ago and she had apparently fallen a few times while heading down the trail, however no trauma noted on head to toe, no pertinent history. Hot chocolate was brewed for all and a warm IV established for the vomiter. Approx. 20 minutes on scene and we started down trail with the group. Took about an hour to get down. Good short rescue. You can see how things could have gotten much worse if more patients were vomiting ect... We were also lucky that we could hike them down.

Anyway.... Thanks again for the great card and gift. Hope to see you all soon.

-Jason

Another Video Journal

2008-03-23T19:13:00.000-07:00

This video/photo journal is pretty weak in comparison to Whitney and Allison's... but figured I should post it to pass the course.

It can also be seen/downloaded here in a larger size.

-Dave Z

spinach feta pasta

2008-03-23T15:26:00.000-07:00

Hi all,
per request, here's the pasta recipe from last night... guess I should have made a double batch.
1 package family size Buitoni (or other) 3 cheese tortellini
1 bag baby spinach
2 lemons/~3/4 cup lemon juice
2-4 cloves garlic/~1tbsp+ minced garlic
a couple forkfulls of capers
small container of crumbled feta
olive oil

Cook pasta according to directions
combine lemon juice, capers,and garlic
Add 3/4 to most of the bag of spinach when there's 1-2 minutes left
Drain pasta and spinach
Add a little olive oil so the pasta doesn't stick together
add the lemon/garlic/caper mixture
add the feta
mix well

Alternatively, you can add the spinach to the hot, drained pasta with everything else and then cover the pot and let it sit a few minutes to steam

Thanks for a great month- hopefully some of our paths will cross again
Take care,
Alli

Grand Gulch

2008-03-23T11:24:00.000-07:00

Here is our grand gulch video. Sorry it didn't get included on the DVD. Still don't know how that happened. Thanks again for a fun month. Hope everybody had safe travels.

Whitney

Eco Resus and Thank You All!

2008-03-22T17:48:00.001-07:00

What a tremendous month! Over the time we had together, we learned, lived, laughed, and loved (well, I dunno about the last one, but some loved more than others)! Eating crickets, MRE's, sleeping in Grand Gulch without sleeping bags, being airlifted, and of course, deploying, were all part and parcel. Our guest videographer, Paul "Pablito" Romo, one of the most understated poets, says it all as hats were lost and patients were saved on the zipline. Follow Paul on his excursion, and good luck to all!
Darryl

Chill Night before the Big Day

2008-03-21T16:23:00.000-07:00

Hi Gang,

Just throwing it out there - staying in watching a movie at 1606 Las Lomas tonight (say 7:30/8:00-ish) if anyone is interested. I've got Gone Baby Gone, Into the Wild, and some 80's John Cusack ("Ken") movie. Please bring what you've got if these don't do it for you. I've got some peanut butter, pop tarts, and gorp...kidney beans, black beans, and gum.

I don't really know where I live except that it's across campus off University. Call Dave or Zev for directions. Call me if you don't have their number.

-Kristina

Photo Album

2008-03-20T18:37:00.000-07:00

Sorry I didn't put it up yesterday; my internet was on the fritz. If you go to Google, under "More" you will see photos. Picasa is a free download.
My album is:

UNM Wilderness Medicine

I don't know if you can add your own photos to it, but I am pretty sure it is easy to take photos off of the site.
Enjoy.

Zev

Party time

2008-03-20T15:39:00.000-07:00

Hey all. So we will discuss on Saturday what time the party will start... I'm guessing as soon as the exam is over... but I wanted to get directions out there. Thanks to everyone for bringing food, drinks ect.

Copper is the second intersection to the North from I-40 and Tramway. From Tramway and Copper head east. Take your first left onto Montie Alto, next left onto Grant. From there go straight and the road will fork, continue straight onto Vidal pl. Townhome on the right 13807 Vidal pl. Directions on the google map are from the tram.

View Larger Map

photos

2008-03-20T14:21:00.000-07:00

Hey all,

Here are some pics from this month to enjoy. I plan on doing a photo journal for my "creative" project. Feel free to use some of my photos if so desired.

http://picasaweb.google.com/julielaughner/UNMWildernessMedicine

match day celebration

2008-03-20T11:57:00.000-07:00

congrats all. Here's the party plan. Dinner at 7:30 at Tucanos Brazilian grill located at 110 central, go to www.tucanos.com. Sarah made reservations for 2 tables of 4 and there is bar seating. more Reservations can be made at 505-246-9900 if need be. Also there is a $5 off coupon in the city's visitor guide.

that's not all folks...pre-game somewhere downtown around 4-5. Any suggestions for somewhere with happy hour and outdoor seating? If so call me 412-551-3549.

Christiana suggested finishing the night with some booty shaking. Any suggestions. Call Christiana.

Party!

2008-03-19T15:50:00.000-07:00

So here is the list of people I have bringing different things for Saturday night. Everybody is bringing their own thing for the grill and alcohol of choice. Beyond that:
Dessert: Zev, Paul
Salad: Jen, Donny, Brian
Other Side: Jules, Connell, Jerell
Condiments: Mary
Non-Alcoholic Drinks: Allison, Whitney
Utensils/Plates: Maggie

Feel Free to Edit this list, add to it or whatever. Its just what I got down from our chat this afternoon!

Happy Match Day.

Friday Snake Demo!

2008-03-19T14:58:00.000-07:00

This friday you will have the unique opportunity to see multiple species of rattlesnakes up close and personal. This will be an interactive session with Eric Schaad, UNM PhD candidate, who can answer specific questions about venom characteristics and ecology of these snakes!

As we discussed, this will be an optional day, but unless you are going to be out of town, we encourage you to come to this last day before the Eco-Resus (Eco-Rescue) adventure!

We will start at 9:00 am at the UNM EMS academy which is in the north side of the building shared with the Center for Disaster Medicine (located by the airport at 2700 Yale SE).

Directions are here.

Schedule for 3/21/08:
9am-11am - Wilderness Veterinary Medicine
11am - 12:00noon - Medical Kits
1:00pm - 2:00pm - Snake demo
2:00pm - TBA, Q&A about eco-resus, etc.

Good luck on the match!

Joe

Eco-Rescue Challenge

2008-03-18T07:26:00.000-07:00

Welcome back everyone. I hope Grand Gulch was fantastic. Now get ready for the Primal Quest of Rescue! This coming Saturday the 22nd we will be meeting at the Sandia Peak Tramway at 8:30am to begin your final exam. Please do not be late as the tram will leave at 9am wth or without you.

Once on top of the Sandia Crest we will break into our 4 rescue strike teams, listed below, and your first scenario will be given. Medical equipment will be provided for you. Please being your RESCUE ORIENTED day pack and be prepared for a long day on the mountain. If for some reason the tram shuts down, most likely due to wind, we will be hiking 8 miles down the La Luz trail. By now most of you know that I am pretty much always against hiking boots, but due to the snow and ice conditions on the crest I recommend boots for the day. Below is a list of skills that will be assessed throughout the day. The Strike Team that is most proficient in the skill sets will be awarded the "Golden Carabiner" at the party.

Movement over terrain

Land Navigation

Patient Packaging

Improvised Patient Transport

Improvised Splinting

ACLS

Hypothermia Treatment

Survival Skills

Teamwork

Communication

Group Leadership Dynamics

Stress Tolerance

If you own a harness and a belay device please bring it with you. For the rest of the class harnesses will be provided for you. Strike Teams listed below:

Strike Team 1 Strike Team 2

TL: Jake TL: Sara

Allie Brian

Whitney Paul

Connell Jules

Kristin Donny

Ken Dave

Strike Team 3 Strike Team 4

TL: Ortho Dave TL: Maggie

Ryan Jan

Allison Jarrell

Mary Tim

Zev Jen

Allen

If any questions or concerns arise feel free to call. Map and directions below. See you all on Saturday!

-Jason

505-249-0170

View Larger Map

Mountain Bike and Waterworld Extravaganza

2008-03-17T16:17:00.000-07:00

Welcome back from Grand Gulch! Tomorrow is the big day-March 18 at the Alameda Open Space-on Alameda over the Rio Grande! See this map link or paste the address on the Internet! Then a little rest, an aquarium night, to be chased down by a sushi delight.

TIMES: 11:00am AT ALAMEDA TRAILHEAD FOR BIKING! Please call Joe this evening before 10pm or tomorrow am between 8:00 - 9:30am if you need help transporting or picking up rental bikes (280-5181). See also the post below about mountain biking.
5:00pm AT THE ALBUQUERQUE BIOPARK.

ALAMEDA TRAILHEAD Link: http://maps.google.com/maps/mm?hl=en&ie=UTF8&ll=35.185594,-106.638107&spn=0.185753,0.294571&z=12
Use the scroll to zoom in or out. If the Rio Grande Alameda Open Space icon doesn't appear, look where Highway "528" intersects the big Rio Grande river. (Take the Alameda exit from I25 - go west, lake a left right before it crosses the river).

The Management

Climbing at Soccorro

2008-03-13T06:22:00.000-07:00

While off to Grand Gulch, check out the climbing day, featuring Super Jake!

Bike and Aquarium Day

2008-03-12T22:51:00.000-07:00

We also will have a big day AFTER we get back from Utah!

We will need to assemble a list of people that need bikes. I have reserved 10 mountain bikes from the Northeast Cyclery
http://www.mapquest.com/mq/8-t*CO
Their phone is 299-1210.
The bikes are different sizes so bike renters will have to get together with me tomorrow pm. The price is $19.00 including tax, (payable to me), and bikes may be picked up the morning of 3/18/08 or the day before.

The UNM outdoor store also rents bicycles (you must have a lobo card, sorry out-of-towners)
2 Bike Mike also advertises rentals but is kind of far away and I have not called them.
I can help people transport some bikes if need be.

If you are bringing your own or a borrowed bike, be sure it is in good condition - each year we have flat tires and broken chains! You must have a helmet - included with NE cyclery (and most other) rentals.

Following the mountain biking (11:00 am; directions here; we are meeting at Alameda right before it crosses the river - labeled as 1 on the map on this link, we will meet at the Albuquerque Biopark aquarium at 5:00pm. (Yes it will be a long day!)
Click here for link to the aquarium plus directions

We will do some scenarios and lectures at the Biopark aquarium. Afterwards we have traditionally gone out for sushi.....

PS. I have added some additional info about grand gulch to my post below.

JA

Grand Gulch Vans/Trails

2008-03-12T22:10:00.000-07:00

Howdy!=) O.k., here are the lists

Van 1#: Leaving Sunday Starting from Collins and going to Government >14.5 plus miles

1.) Connell

2.) Allison

3.) Allie

4.) Ken

5.) Dave

6.) Allen

7.) Paul

8.) Open as of now

Van 2#: Leaving Monday Starting from Kane and hiking to Collins, ~38 miles

1.) Whitney

2.) Donny

3.) Jen

4.) Mary

5.) Jake

6.) Jarrell

Van 3#: Leaving Monday Starting from Gov. and hiking to Kane, ~ 29 miles

1.) Zev

2.) Kristin

3.) Tim

4.) Ryan

5.) Sarah

6.) Maggie

7.) Jules

8.) Dave

9.) Brian

See you all in tomorrow, and yeah, we can totally adjust things as needed=) Night!

{Thanks Sarah for putting the lists together. This will be a great adventure - we will cover more territory than previous groups have done! The third group might exceed the limits of the BLM for a group, tho, someone should consider switching to a different group. By the way, I am planning on hiking from Kane to Collins!
See you tomorrow,
Joe}

SWAT

2008-03-12T14:39:00.000-07:00

SCARED DOCTOR: Whose is bigger?

TERRORIST?

AWW YEAH!!

Brownie Recipe

2008-03-11T20:37:00.000-07:00

Several people asked for my brownie recipe, so here it is. Pretty simple and straightforward. Enjoy!

Zev

Chocolate Chewy Scotch Bars
1 cup chocolate chips
14 oz. sweetened condensed milk
2 Tbsp. butter
1 cup margarine
2 eggs
2 1/4 cup brown sugar
2 cups flour
1 tsp. salt
1 tsp. vanilla
1/2 cup chopped walnuts

Melt chocolate chips, milk, and butter in a small bowl. Mix together, and set aside. Melt margarine in a large bowl. Add eggs and brown sugar, and mix well. Add flower, salt, vanilla, and nuts. Mix well. Pour ½ the brown sugar mix into an ungreased brownie tray. Pour the chocolate mix on top. Drizzle the remaining brown sugar mix over the top. Swirl with the tip of a knife. Bake at 350° for 30-35 minutes. Allow to cool, cut, and enjoy.

GUN SAFETY DAY!

2008-03-11T15:54:00.001-07:00

This Wednesday the 12th we will be having our gun safety day. We will be meeting at the UNM Continuing Education building at 8:45am. We will then carpool to the firearms range. Apparently parking is limited. Classroom instruction at the range will be from 9am to approximentaly 11am then each student will have to opportunity to fire 30 rounds. Some things to bring and NOT to bring...

To Bring:

Outdoor attire

Brimmed hat

Sunglasses or glasses with plastic lenses

Shoes, no sandals

Not to bring:

Under no circumstances can you bring your own firearm or ammo

We will wrap up around 1ish and will not be eating lunch at the range.

Good climbing today. See you all tomorrow at 8:45.

-Jason

Embudo Recap

2008-03-09T09:46:00.000-07:00

What an excellent scenario on Saturday!! Thanks to the patients, volunteers and low flying aircraft :) Here is a video to recap the day -- bear with me, first video I've made, enjoy!
-- Allison

Helicopter Operations Day!

2008-03-09T08:15:00.000-07:00

Hello all. Again great job at the Mountain Rescue day on Saturday. On Monday we will be meeting at the NM National Guard hanger in Santa Fe at 9am. Plan on leaving ABQ by 7:45 to make it to the hanger by 9. It looks like it will mostly be inside lectures and scenarios, but as always come prepared to be active.

If you have any questions feel free to call: 505-249-0170

See you all on Monday!

-Jason

Note: Click on "view larger map" below to see the correct arrow on HUEY RD, which is right of the arrow shown in the map below.

View Larger Map

Taos Video Recap and Search and Rescue Saturday!

2008-03-07T20:12:00.000-08:00

Wow! what an amazing week thus far! Kudos to all of you in the class, as well as to all the instructors participating in Taos. After I left you all, I went up and enjoyed the pow-pow at Huntzinger's Bowl and El Funko. Today it's time to do the wash and thaw out, for our Embudo Search and Rescue Day tomorrow will be excellent. Read Jason's posting below for info!
A bientot,
Dario

Embudo Mountain Rescue Day!

2008-03-04T07:58:00.000-08:00

SATURDAY MARCH 8th 9am

The Embido SAR day is coming up this weekend. I hope everyone is excited as it is going to be an action packed day. While at taos this week we will briefly discuss SAR operations and then pre-plan our 2 Strike Teams and 1 Support Team for the day. Whether you are in a strike team or a support team everyone will have the opportunity to provide patient care. As soon as the teams are in the parking lot at Embudo at 9am you will be given a scenario and a brief overview/introduction of the equipment and staff for the day. Teams will be provided with radios for day. Keep in mind that communication is key in a rescue situation, not only for relaying medical patient information to base, but also for dispatching adequate resources to the rescue site... And yes you will need a lot of resources during this scenario. Last Hint: Review how to manage Mass Casualty Incidents.

ITEMS TO BRING:

Day Pack

Adequate Clothing

Water/Lunch

Harness/Helmet if you have it

You will be provided with your FASTPACKS and 2 ALS kits

Map Link Below. See you all on the 8th at 9am!

From Tramway and Indian School Head East on Indian School until it dead ends at the trail head parking lot।

http://maps.google.com/maps?f=s&utm_campaign=en&utm_source=en-ha-na-us-google-gm&utm_medium=ha&utm_term=map

Solar Injury and Sunscreen Preview

2008-03-03T20:17:00.000-08:00

Solar Injury (Part 1) See the handout section on the right to view the complete document.

1) my dermatologist tells me I should never be exposed to the sun. Is solar radiation all bad?
Clearly no. Without infrared radiation - we would freeze to death. Without light, we would all starve, by viture of having no plants to eat. Finally, without UV radiation causing Vitamin D production we would get rickets and increased levels of cancers.

2)What are the three relevant kinds of Ultraviolet radiation (UVR) of importance to humans?
UVR comes in 3 flavors. The first UVC, has the shortest wavelengths, and therefore the greatest energy, measuring 200 - 290 nanometers. UVC is of importance only where the protective ozone layer has been destroyed, e.g. arctic regions and extreme southern Chile and Argentina. Elsewhere, UVC is entirely absorbed in the stratosphere by ozone and oxygen.

UVB measures (290-320nm) and is responsible for Vitamin D production from 7-dehydroxyxholesterol, vias the skin, liver and kidney. UVB is also responsible for tanning, burning and skin cancers, though not melanoma.

UVA has longer wavelengths (320 - 400), and contributes to photoaging, tanning, burning, and some skin cancers. UVA also triggers phototoxicity of certain pharmaceuticals.

3) What environmental features most affect the amount of UVA and UVB that reaches the skin?

Time of day: 65% between 10a and 2p, but with daylight savings all bets are off!
Season is important. June has 100x more UVR than December
Latitude: 3% decrease with every degree of latitude from equator. Albuquerque 35 degrees N, Taos is 36.
UVA varies less with daytime and latitude changes - scatters less than shorter wavelength UVB.

Surface features: water reflects small amount of UVR. Snow reflects much more. (85%).

Clouds - attenuate UV radiation by 20-80% - generally 40%. Better absorber of IR radiation (heat).

Altitude: 10% increase with every 1000 feet elevation. Wind exacerbates solar damage - erythema- of skin. Moisture increases dermal absorption of UVR.

Pollution increases absorption of UVR through particulates and ozone.

Bottom line: Taos Ski Valley in March is a site of plenty of UVR! So slather up with sunscreen and don't forget those sunglasses! (I speak from personal experience)....

To read more:
Part 1 and Part 2 of the handout references are permanently posted in the "Handout" sections.

Joe Alcock

Buca di Beppo-Arranging Rides and Food Groups

2008-03-03T10:29:00.000-08:00

Hello!=)
Ok! There's a lot of confusion regarding rides to Taos, so in order to clear it up and enjoy fine Italian fare, we're going to meet at Buca di Beppo tonight at 7 pm (below is the link as well as a map). We'll discuss rides there and back, times, food groups for those who don't have any, etc. In addition, those who are local or who have cars, there currently is a shortage of vehicles, witnessed by the fact that we barely had enough to get everyone to and from Cabezon with gear. So, if those who are riding with others but have a car, could you please consider letting others borrow your vehicle? If this is not a possibility, then we can look into renting a vehicle for 4 days, but this will be a bummer considering it will only be driven for 6 hrs total and sitting for the rest of the time~3 days. For those of you who have rides, can you please contact me, or have a group person ccontact me so we can make SURE that we are not leaving anyone, for both there and back!!
Marti428@msu.edu
517.803.0473
Reservations: Sarah or Wilderness Medicine

Link Buca di Beppo: http://www.bucadibeppo.com/locations/location.aspx?location=3301

Phone number for directions: 505.872.2822

Meetup & Dinner Monday Night

2008-03-03T09:35:00.000-08:00

Per Ryan:
Let's meet up at Buca di Beppo for dinner at 6:30pm. It's located at 6520 Americas Parkway N.E. off of I-40 at the Louisiana Blvd Exit, just west of the corner of Louisiana Blvd on Americas Parkway.

Rides to Taos

2008-03-02T21:42:00.000-08:00

By taking a look at the Cabezon rides and by going with what I've heard around the group, carpools to Taos are shaping up. Here's what I could gather, but there are a lot of guesses. Drivers, please fill in the blanks. I know that Ken is looking for a ride and possibly Jen.

Dave & Bryon (different schedule)
Jan (solo due to upcoming child)
Jake (leave _?_, return _?_): Allen?
Dave (leave Tues, return _?_): Kristina, Zev
Allison (leave early Tues, return Thur, maybe Fri): Whitney, Conal, Maggie
Ryan (leave _?_, return_?_): Sarah, Tim, Jurrel, Jules...?

Alli = ?
Don = ?

Make corrections/additions by copying and pasting the above list with your changes in a comment post. Later changes should be make from the list in the most recent comment post.

Thanks! ~Maggie

FOOD!

2008-03-02T20:56:00.000-08:00

Because I hate to not deliver on promises made around the campfire, and tomorrow might be a good day to take advantage of some local spots below are a few of the favorite local places to eat. These are just some of my personal favs or local must visits and I'm sure others have their own but here are a couple to get started with...

Mexican:
Los Cuates (3 locations, 2 on Lomas just up from campus)
El Pinto (4th street)

Breakfast Burritos:
Dos Hermanos- lots of locations, huge delicious burritos
Hannah and Nates (Coors just north of Montano near starbucks and keva juice)-- Breakfast or Lunch

Other good spots:
The Range- 2 locations in town
Dion's- if you are looking for a quick slice of pizza or salad
Frontier- try a cinnamon roll (Central)
Saggios- lots of good sandwiches, calzones, salads, soccer games on TV (across from Frontier)

So this might get you guys started. Call with questions or directions

Taos!

2008-03-02T19:39:00.000-08:00

UNM Wilderness Medicine Students:

Tuesday night: youth hostel - Abominable Snowmansion - meet for evening lectures. I will start at 6:00 pm! (you might want to grab some dinner beforehand). You would be smart to arrive at the Snowmansion early to stake a claim on a the bunk of your choice. Of course what you do on Tuesday during the day is up to you - we would recommend skiing, since Taos conditions are good!

Wednesday: am lectures at the hostel after breakfast (there is a little grocery store nearby if you forget to bring oatmeal/cereal or Frontier burrito for breakfast!

Wednesday day: then we will travel to Bull of the Woods yurt
In case you are curious, there is an outhouse near the yurt. Probably a good idea to bring hand sanitizer. Not this!
You will need to figure our car-groups and food groups.
Wednesday night: Journal club in the yurt.
Thursday: Avalanche safety at Bull of the Woods
Friday: free day!

Gear:
You will need snowshoes or backcountry skis (with skins) - skis only if you are very skilled; it is a steep climb! Contact Darryl if you are having trouble getting snowshoes. I recommend bringing ski poles in addition to snowshoes.

You will need: (more or less the same stuff you had to stay warm at Cabezon today). But because the climb is steep - pay attention to the weight of your pack - don't bring unnecessary stuff.

Warm, layered, synthetics, down layer, shell. Waterproof gloves, gaiters are helpful. Ski goggles in case of bad weather may come in handy.
Backpack to carry gear

Snow campers will need a pad, sleeping bag, tarp. (bivy sack and tents are optional).
Yurt sleepers will not need a pad, e.g. thermarest.
You will not need to carry much water. The yurt has a wood stove - and we will melt snow.
Do not need cookware. Some of us will bring small camp stoves for individual drinks, etc.

Bring a backcountry snow shovel and avalanche transceiver if you have one! And don't forget to bring sunscreen, extra socks, and ear plugs!

If you think you may be prone to altitude sickness, obtain a prescription for diamox! Call Darryl or me if you have questions.

JA

Mild to Moderate Hypothermia!

2008-03-02T17:07:00.001-08:00

Note: Horizontal snowflakes in Darryl's compass demo! Click on the photo for detail. I did not use photoshop!

2008-02-29T20:54:00.001-08:00

This is what I like to call the "snugglee burritto" with a quote of the day: "I don't remember where you are from!"

1st Journal Club

2008-02-29T15:55:00.000-08:00

High Altitude: The role of Acetazolamide by Dave and Tim
High Altitude: the role of Viagra by Maggie and Kristina
Current Mgmt of Frost Bite by Zev and Jarrell
Current Mgmt of Drugs with and in Hypothermia by Jake and Ali
Current Mgmt of Drugs with and in Hyperthermia by Connel and Ken
Drowning by Ryan and Sarah

Articles due to Dr Macias by Tues March 4th

Rides to Cabezon

2008-02-29T15:52:00.000-08:00

Dave: Connel, Kim and Maggie
Jan: Brain, Jennifer and Kristina
Jake: Zev, Dave and Allen
Darryl: Joe and Ali
Allison: Mary, Whitney and Don
Ryan: Sarah, Tim, Jurrel and Jules

Cabezon Survival Weekend!

2008-02-29T14:12:00.000-08:00

Tomorrow am, we meet at the UNM Continuing Ed building Parking Lot bright and early.

Remember - first, this is going to be a lot of fun!

Second - somebody should bring firewood.

Third - we expect some gourmet camp cookery! Hope you chose a good food group.

Remember to bring a small daypack and canteen or camelbak, a flint and steel and compass and signal mirror if you have one (otherwise they will be provided).

Don't forget your sunscreen and sunglasses. Bring raingear and cold weather gear just in case! We have seen first class blizzards out there (probably not this weekend....)

Park in the back of the building (space permitting) Close up map

7:30 am sharp.

Be safe,

Joe Alcock

Best Comment of the Day

2008-02-27T21:09:00.000-08:00

Ankle Dislocation Demonstration

2008-02-27T17:51:00.000-08:00

This is a video clip of Darryl Macias MD explaining technique to reduce an ankle dislocation for students in the UNM elective.

JA

2008-02-27T17:46:00.000-08:00

Tomorrow am: Meet at Sandia Ski Area Lodge at 9:00 am.

Scroll down for Sandia Day lab post for directions and gear list!

I will post a gear list for Cabezon plus directions tomorrow.

JA

Wilderness Medicine Course Lecture

2008-02-26T14:55:00.001-08:00

A successful first day of lecture (one of only a handful of classroom days this year) for the Wilderness Medicine Course.

Tomorrow we meet at 8:00 am on the 3rd floor of the Domenici Center for patient transport and improvisation skills sessions.

Wilderness Patient Assessment

2008-02-25T15:30:00.000-08:00

This is a preview of tomorrow's UNM Wilderness Medicine lecture: Patient Assessment. We will start by explaining the general approach to wilderness medicine patients: The Scene size-up. The scene size-up has three components: First - Check the scene safety - Is it safe for rescuers to approach and attend to victims. Second - Assess the mechanism of injury - Consider what injury patterns might arise from such a mechanism. Third - Find how many victims are involved - the number of injured persons has large consequences for the rescue effort.

Organize your thoughts (and your report) with the SOAP note setting.

But lets change the SOAP note from its traditional format. Those who are familiar with hospital and clinic use of SOAP notes will understand this acronym as Subjective, Objective, Assessment, and Plan. But who knows what is subjective in the wilderness anyway? I have never liked this, so we are going to change it!

Our new scheme:

"S" stands for Setting, Scene size up and scene Safety.
"O" stands for major Organ system functioning. (ABCDEs)
"A" is the "ample" history and secondary survey.
"P" will remain "plan", but will include plans for contingencies and anticipated problems.

I hope this will be an easier way to understand the Wilderness SOAP note.

We will discuss this in more detail soon!

Joe Alcock MD

Sandia Ski area extravaganza 2/28/08

2008-02-25T14:10:00.000-08:00

The Wilderness Medicine Course is visiting the Sandia Ski area, and will meet at the ski lodge at opening time this Thursday. Directions to the Sandia Ski area from Albuquerque are: I40 East to Tijeras. Take route 14 north to Sandia Park. Follow the signs to the Sandia Ski area and park at the lodge for lectures on hypothermia and survival in the snow! We will discuss carpool options tomorrow.

Students who will be joining us should look at this gear list:

Outdoor snow gear - ski wear - sunglasses/screen -swimsuit for some!
Daypack
Ski area: Alpine/Telemark or Snowboards
Backcountry: X-country skis or Snowshoes
Bring or buy lunch/drinks
You may rent cross-country skis/snowshoes at REI - (505) 247-1191
Other gear at Sportz Outdoor (505) 837-9400
Ski Systems (505) 296-9111
UNM outdoor shop 277-8182

JA

Wilderness Medicine Elective

2008-02-25T14:01:00.001-08:00

After brief introductions, Jan Gilmore led the UNM Medical School Wilderness Medicine students on a brief hike in the Albuquerque foothills.

Tomorrow students will be presented with Introduction to Wilderness Medicine, Patient Assessment, Leadership, and Gear lectures at room 2112 in the Domenici center. Click on the map for directions.

See you soon!

Greetings from Darryl Macias

2008-02-24T19:16:00.001-08:00

Hello from Albuquerque to all taking the March class!
We are excited to have you come out at the end of February. Things are on track for another OUTSTANDING course-so get ready to learn, live, and laugh! Although I am honing my survival skills a bit (practicing with a bow and drill for firestarting), I have been "checking" out the snow for you as well. The backcountry skiing and snowshoeing is really good this year, and the weather is mild after several weeks of pretty cold weather. Dress properly...we are all meeting at the Copper open space for orientation at 1pm on Feb 25. You should have received a map. Registration will be done first (we will also do a little "accounting" work). Then, on a nice hike. Give us a jingle at 505-272-5062, or email me at dmacias@salud.unm.edu for questions. If you have anything that you would like to learn other than what is on the WIIM website, let us know. And tell your friends and family not to get too jealous while you embark on this fun educational event...
Cheers, aloha, namaste, and hasta...Darryl (Dario)

First Day for Wilderness Medicine Course

2008-02-24T18:54:00.000-08:00

Welcome to the UNM Wilderness Medicine Course. We will be meeting at the Albuquerque Open Space at the easternmost end of Copper Ave NE at 1:00 pm. Students will meet Karen Lucero, our administrative assistant and will receive syllabi and additional information. Dress warmly, and bring hiking shoes, water and a snack. We will go on a brief excursion after the administrative paperwork is done.

Questions, call Karen Lucero at 272-5062.

Check out this link for videocasts!

2008-02-23T09:48:00.000-08:00

Mountain & Marine Medicine Videos!

http://web.mac.com/dmacias5/iWeb/Site/Podcast/Podcast.html

Visit this blog for lecture handouts

2008-02-21T21:15:00.000-08:00

This is a handout for a scenario-based lecture during the UNM Wilderness Medicine Course

We will cover bicycling injuries when we go on a mountain biking excursion this month. Cases will be presented involving both road cyclists and mountain bikers.

A brief overview follows.

Injuries come in three categories:

1) Acute trauma

2) Overuse injuries

3) Environmental hazards.

I. Trauma

Mountain biking may have a few subgroups that qualify as extreme sport. As extreme sports become more common, it is important to note that practitioners rarely have medical insurance.

Bicycle Injuries are becoming more common in adults. Safety campaigns are directed mostly at children. In Massachussetts, the incidence of accidents was stable for kids in late 90’s but rose by 30% for adults. 51% were unhelmeted, accounting for 75% of closed head injury. 16% had a positive serum alcohol.

California Cycling Club: Reports a 41% yearly injury rate. Of these, most are minor, 26% required medical care. Only 1% required hospitalization. Extremity injuries accounted for 90% injuries. Head and neck trauma occurred in 12%. Victims were helmeted in 88%. Equipment failure accounted for 7% of injuries.

Downhill mountain bike injuries: common mechanism is going over the handlebars. Among racers, women more at risk than men. Injuries to torso and upper extremities. One report of fatality from diaphragmatic rupture.

Road vs. Mountain bike Injury Pattern.

Mountain bikers have a 40% - 60% decreased incidence of head/face/dental injuries than roadies. Mountain bikers are also less likely to be hospitalized, less likely to have severe injuries. These findings are because of decreased traffic on mountain trails and increased helmet use among mountain bikers.

So it is safer with helmets and safer off road!

A JAMA study showed that helmets provide 4-fold protective effect against head injury. Helmets are 85% effective against head injury and 88% effective against brain injury.

Helmet type does not matter. Hard shell, thin shell (most), and no shell helmets are all equally effective. All must meet ANSI, Snell requirements. Fit is probably the most important consideration when buying a helmet.

Helmets reduce risk of nose and upper face injury by 65%. California helmet legislation has resulted in 18% reduction in head injury for<18 yrs.

II. Overuse injuries.

1. De Quervain’s Disease. Overuse injury of thumb tendon. Repetitive shifting. Pain on inside of wrist and thumb movement.

2. Patellofemoral pain. Overworking the quadriceps. Using too high gears. Hill training.

3. Low Back Pain. Very Common. Fit of bicycle is important.

4. Ulnar tunnel syndrome. Bilateral ulnar distribution numbness. Treat with rest splinting, and NSAIDs.

5. Cyclists palsy. Distal ulnar nerve sensory and motor dysfunction. 92% IN A SERIES OF 25 cyclists completeing 600 km ride. No significant difference on mtn vs road handlebars for motor symptoms, Sensory sx more common in mtn bike group. Gloves, bicycle fit, changing hand positions also important.

6. Scrotal abnormalities. Microlithiasis, Spermatocele. Hydrocele, Scrotoliths, Varicoceles. More common in Biker group.

7. Bilateral Pudendal nerve injury secondary to excessive biking has been reported. ED may develop. However, Bicyclists have no more ED than runners and less ED than the general pop, reflecting healthier subpopulation. Authors recommend comfortable saddles and rear suspension on bikes.

Possible benefit. Mountain bikers have increased bone density and protection from osteoporosis compared to road cyclists.

III. Environmental Injuries

1. Hypothermia. This is rarer than hyperthermia, but can occur with rapidly changing weather conditions.

2. Hyperthermia. A real risk in the desert

3. Hyponatremia. Low serum sodium occurs when salt loss through sweating is accomanied by hypotonic fluid intake - like drinking water without salt-containing foods.

4. Lightning Injury. A real risk in summer afternoons. Lightning is the subject of another lecture.

5. Cactus injury

6. Animal encounters. Bites will be covered separately. Look for upcoming posts!

UNM Wilderness Medicine - Welcome!

2008-02-21T14:53:00.000-08:00

Welcome to the UNM Wilderness Medicine Blog! This weblog will be updated daily during the UNM Wilderness Medicine Course. Check for updates, news, directions to events, and other extremely useful information for wilderness medicine course!!!