Raw Medicine

We're joined by Dr. Michelle Curry, the new EMS medical director of the U.S. Forest Service (USFS). As of this episode, the USFS EMS program is just now coming into its own, with a uniform set of policies, Local Emergency Medical Advisor (LEMA) physicians appointed for each USDA Region, patient care protocols, and a national credentialing system. However, there are some big differences between the USFS EMS program and that of the National Park Service, to which it is often compared.

On Episode 13, we explored the role of WFR's and challenged some aspects of the way they're educated and regulated (or not). In this episode, Tod Schimelpfenig (recently retired Director of Curriculum at NOLS WMI) and David "DJ" Johnson (Medical Director of WMA International) join us to share their thoughts on some of those points. The conversation is frank but friendly, and outstanding!

WFR (Wilderness First Responder) is arguably the nucleus of wilderness medicine education. But what does it really represent- first aid, Basic Life Support, or some kind of hybrid? Where did this curriculum originate, and is it still appropriate in today's highly regulated world of patient care? Veteran WFR instructor Corey Winstead joins us to help put WFR in context and consider some provocative questions about the future of wilderness medical education.

We talk with Justin "Padj" Padgett, co-founder of Landmark Learning- about the nature of excellence and its nexus with wilderness medicine practice and teaching. Padj has spent his professional life thinking about and researching excellence, and is renowned throughout the outdoor industry for imbuing it into the Landmark method.

SARS-CoV-2 is a novel virus at the time of this episode, but there are already some lessons that can be applied to SAR responses involving known or suspected COVID-19 patients. We discuss respiratory protection for responders, airway management and resuscitation strategies, modifications to response protocols, and personal protection/decontamination considerations. 

Trauma care experts Sgt. Max Dodge, TP-C and Maj. Andrew Fisher, PA-C, join us to talk about backcountry bleeding: how to control it, what to do next, and why many of the common teaching points surrounding bleeding control have been taken out of context and misapplied. Max and Andrew also talk about their work with the National Stop The Bleed campaign, and the importance of educating lay people to be initial responders. 

The conventional assumption is that wilderness medicine training requires extensive hands-on practice, but what's a student to do when they want to learn the craft but can't attend a course in person? Can wilderness medical training be done online, and if so, is it valid? What's the balance that should be struck between skills training and didacticism in a body of knowledge that emphasizes resource constraints? We talk with Teal Harbin, a seasoned austere medical provider and founder of Base Medical, the company she founded to bring wilderness medical education to people who can't attend traditional in-person courses. 

Wilderness medicine is exciting and inspiring, but it can also imperil our emotional well-being in big ways. We talk with mental health expert Brenton Queen, who works with responders in his capacity as a licensed counselor specializing in coaching, conflict, and stress.

They way you were taught to recognize heat stroke is probably wrong, and the way you were taught to treat it is probably wrong, too. Forget the IV fluids, toss aside the cold packs, and hunker down for a stay & play scene. We're joined by Tod Schimelpfenig from NOLS Wilderness Medicine and emergency/sports medicine expert Tim Durkin, DO to talk about all of this, and why Orange Man (you've seen him) must die.  For the resources referenced in this episode, see the show notes at www.RAWMedicine.org

Nurses Bryan Simon and Linda Laskowski-Jones talk with us about the role of nurses in the wilderness medicine: the unique skills they bring to austere environments, the experiences they've had at the intersection of wilderness and bedside care, and how nurses interested in wilderness medicine can take the plunge.  

Do you really have to be concerned about throwing a hypothermic patient into V-Fib? What does the treatment of blood clots and frostbite have in common? And how does Lenny Kravitz fit into all of this. We have the answers in part two of our riff on hypothermia!

Seth and David sit down with Will Smith, M.D. to discuss being a medical director in the RAW medicine world. A combat physician, EMS medical director for fire departments, SAR teams, national forests and parks (and, in fact, the entire National Park Service), Dr. Smith still maintains his Paramedic credentials and routinely responds in the field.

Does core temperature really matter? Do hot packs work? Is there a role for warm IV fluid? In this episode (Part 1 of an intended two-part series), Seth and David get into hypothermia care: what works, what doesn't, and why.

In this episode, we explore the defining characteristics of RAW medicine, including the philosophical, practical, and regulatory dynamics of providing care off the grid.  Check out the article Seth and David reference here: https://www.ncbi.nlm.nih.gov/pubmed/28657809