EMS On The Mountain (Sean and Mike)

Sean and Mike talked about the cool technology that could be available for backcountry EMS, now they're bringing you the ugly side of not having the right technology, and Mike may have gone a little 'full mike' talking about being a good provider.

Sean and Mike talk through a common question they get, "How do I get a job doing Wilderness EMS." And as a special bonus Mike goes full Mike and pontificates about things that most people probably won't find that interesting. Just kidding! His thoughts are amazing!

Well it turns out Mike got to play patient..... so.... we talk about it.

Sean and Mike sit down with Liz Hall, the Emergency Manager for Great Smoky Mountains National Park to talk about Wilderness EMS and Search and Rescue there, and how you potentially CAN get paid to do Wilderness EMS!!

In this episode of EMS on the Mountain, Sean and Mike discuss first aid kit planning for the lay responder. They provide advice on how to build or evaluate a first aid kit for day hiker backpackers, as well as how to apply the same knowledge outside of the wilderness to a home or car first aid kit. The considerations discussed include volume (how many people is it for?), activity (what are you doing?), and training level (what is your skill/training level?). Topics covered also include bleeding control, minor injuries, general illnesses such as diarrhea and coughs.

Sean and Mike dive a bit into other aspects of being a good wilderness rescue professional, and talk about rope skills in this one.

Sean and Mike talk about the pathway for the podcast and ask for help! Tell us what you want to hear about:

theshow@emsonthemountain.com

Sean and Mike go deep on the treatment of mild to moderate hypothermia and talk about some of the science behind raising a patient's core temperature.

Sean and Mike go off the reservation on this one. The best way to experience this one.... is listen....

In this episode Mike and Sean discuss the importance of choosing an appropriate backpack for wilderness EMS. They emphasize that durability and size should be considered when selecting a pack, as well as personal preferences and mission sets. They also mention that purpose-built kits are often better than those found in outdoor recreation stores. They examine the need for durable, expedition-grade packs that can carry medical supplies, personal items and vertical equipment. 

https://app.redcircle.com/shows/510201b1-3ffc-4c03-a187-c91d04263e54/donations

Today’s episode features our guest, Mr. Tod Schimelpfenig

Tod is the retired Curriculum Director for NOLS Wilderness Medicine, where he still teaches classes regularly. In this episode we talk a lot bout the Wilderness First Responder certification and what their role is within the larger wilderness medicine context, as well as where things started and where they are now.

Sean and Mike talk through the components of a basic mission plan to make sure you're ready when the unfortunate strikes.

Sean and Mike talk through thing to think through when building a plan for a basic medical clinic, and how Paramedics fit into the mix.

This week we are speaking with Moose Mutlow (see Bio below). Most of our discussion revolves around how to engage and work with the family members of those individuals we are seeking to find and rescue, we also talk about provider resiliency and mental health, topics not always discussed on the wilderness side of emergency response.

Moose has nearly 4 decades of traditional and alternative education experience around the globe. He has course directed 58-day Outward Bound instructor trainings in Appalachia, been a deputy headmaster in the Kalahari Desert, managed a beach concession on the Mediterranean, slogged through Australian rain forests with middle school students, juggled as a street performer in too many cities to mention, has more than 2000 days of field instruction in a wilderness setting, spent four months as the Interim Head for an elite ski academy, and returned to Outward Bound to instruct a canoe program for Veterans on the Gulf of Mexico.

Since 2002 Moose has been a member and senior trainer of Yosemite Search and Rescue, working as a technician and within Incident Command, at one of the busiest SAR operations in the world. He is a Rescue 3 Agency Instructor and a Lead Family Liaison Officer trainer for NPS.

Sean and Mike sit down and talk about tools they use to stay up to date on the latest in pre-hospital medicine.

Podcasts we menton:

Push Dose EMS

Alert Medic1

The Resus Room

EMCrit

Prolonged Field Care

The World's Okayest Medic

The FlightbridgeED Podcast

Coffee Break HEMS

MCHD Paramedic Podcast

EMS 20/20

COROM Cast

Sean and Mike follow up Episode 39 and talk through the details needed to build a basic medical response plan.

Look at that, We're poets, and we don't even know it!

Sean and Mike talk about their plans for the podcast headed into 2024.

Mike may have also softened a bit on the ongoing discussion around degrees for Paramedics.

In this episode of EMS on the Mountain, Sean and Mike discuss first aid kit planning for the lay responder. They provide advice on how to build or evaluate a first aid kit for day hiker backpackers, as well as how to apply the same knowledge outside of the wilderness to a home or car first aid kit. The considerations discussed include volume (how many people is it for?), activity (what are you doing?), and training level (what is your skill/training level?). Topics covered also include bleeding control, minor injuries, general illnesses such as diarrhea and coughs.

Sean and Mike address the variables and minor differences in a load out kit for an ALS provider against the baseline BLS kit from Episode 13

Sean and Mike dig into the unique aspects of managing pain for patients for an extended period of time in the Wilderness.

Sean and Mike talk through their experience siting the beta offering of the Wilderness Paramedic - Certified (WP-C) Exam from the International Board of Specialty Certifications.

IBSC WP-C

Sean and Mike share a story about the repercussions of eating wild plants

Sean and Mike talk through EMS Billing, how it works, and the implications on managing the finances of a Wilderness EMS program.

Sean and Mike talk about how resource availability between an urban or rural system varies from a wilderness system and what that means for patient care. 

The first FROM THE MOUNTAIN Episode! Sean and Mike sit down while on duty in the mountains and discuss an encounter they had with a patient experiencing trouble breathing. They talk through the challenges of treating someone that isn't really that deep into the woods and outline how quickly things can become much more difficult when you're off the hard pack roads.

This is the first episode in a series we call "From the Mountain" where we deliver short episodes recorded in down time while at our duty station in the mountains.

Sean and Mike sit down and talk through technology available for wilderness and austere medical care, along with the pros and cons of taking that equipment with you into the wilderness.

Sorry Gang!

Sean and Mike dive into an overview of various bits of personal equipment needed to operate in a vertical rescue environment.

On this episode Sean and Mike discuss the details of long term extended care while carrying someone out of the backcountry using people as the main source of power.

Find us on Social Media:
Locals Wilderness EMS Community
Facebook
Instagram
Twitter

Sean and Mike talk through how to treat a relatively unique wilderness medical emergency, snake bites. Believe it or not, they are sober in this episode!

This week we are once again coming to you "from the mountain", in this show we discuss one of our favorite calls, what went well, what could have been better, and what we may have done differently.

Mike and Sean dive into the topic that keeps coming up.... Does the industry need a master's degree driven position like a Paramedic Practitioner?

As we approach Winter why not talk about Hyperthermia!! Why not start preparing for heat injuries early? Though, they can happen anywhere at any time.

All of us that have been in the EMS game long enough end up mentoring new providers, either as the 'senior provider' or more formally as a preceptor. Sean and Mike talk through their experiences in helping other providers succeed.

Sean and Mike talk through what you should and should not pack when making the transition to performing EMS out of a backpack instead of an ambulance.

Let's try this again!

Mike fell down and went boom, Sean and Mike take about the experience of being a patient.

Sean and Mike double down and discuss an article by Dr. Seth Hawkins, MD, NREMT and Dr. Tyler Prince, MD, NRP from the Wilderness Medical Society Magazine titled "The Definition of Wilderness Medicine & Wilderness EMS" 

Sean and Mike discuss the unique challenges of advanced airway management in the wilderness setting.

Sean and Mike bring you another episode From the Mountain. This time they discuss a patent with a dislocated knee, outlining the challenges of getting an immobile patient out of the woods.

Sean and Mike discuss the Nine Essentials.

Today, Mike and Sean talk about what goes into being a good WEMS provider. Just like the differences between urban and austere medicine, there are differences in the individuals who provide this type of care. They talk about some of the key attributes needed, both mentally and physically, as well as some of the additional skills required to function in a WEMS environment. Lastly, they discuss whether this specific area of specialization is for everyone.

Sean and Mike close out the hypothermia series with a discussion of rewarming mild and moderately hypothermic patients in austere environments.

Sean and Mike go deep on medication use for pain in the back country and what you need to understand about their use for patients you're going to treat for more than 30 minutes.

Nothing earth shattering in this one, Mike and Sean share some thoughts on documenting patient care in a wilderness or austere setting when use of traditional ePCR software is not an option. The discussion centers on a few general guidelines for selecting your preferred tool for documentation, as well as a few things to consider when you need to document your patients' care in the wilderness and for extended periods of time.

Sean and Mike talk about 2025 and beyond!

This episode is a curt discussion of the less than stellar things Sean and Mike have seen in their time providing wilderness medicine. This episode may not be for the faint of heart, or those that write policy.

Jason Tartalone NRP, FAWM, FEWM, WP-C -

Jason Tartalone is a 12 year veteran of the U.S. Army where he served as a Combat Medic and Flight Paramedic. During his service and throughout his career has spent considerable time in Afghanistan and other austere environments. Jason has been involved in wilderness search and rescue for the past 20 years and has been an active EMS provider for 17 years. Jason is a Fellow in the Academy of Wilderness medicine and has completed a Fellowship of Wilderness and Extreme Medicine from World Extreme Medicine. During his fellowship he specialized in mountain medicine, austere rescue operations, and high altitude medicine.

Sean and Mike are joined by David Fifer, NRP, FAWM. David is one of the hosts of The Remote, Austere, and Wilderness Medicine Podcast. He has been a long-time advocate for the Paramedic profession and a leading advocate for the training and recognition of the unique aspects of wilderness medicine. The three discuss the origins of the International Board of Specialty Certification upcoming Wilderness Paramedic Certification exam and his personal experience with providing care and preparing for the mission of EMS in wilderness environments.

https://rawmedicine.org/

https://redstarmedical.org/

https://www.ibscertifications.org/

Support the Podcast

Sean and Mike sit down and review the paper "Wilderness Medical Society Clinical Practice Guidelines for Medical Direction of Search and Rescue Teams"

Link to the paper;

https://tinyurl.com/38a26ycm

Sean and Mike sit down and chat with Jason from Sergeant Rescue and Training about pros and cons on a number of topics related to redundancy in high angle systems.

https://sergeantrescue.com/podcast

Sean and Mike come to you from FAST24. FAST is an annual Critical care flight and transport summit put on by the awesome team at FlightbridgeED. Sean and Mike discuss their experience and talk about the criticality of continuing your education through self study and events like this.

https://flightbridgeed.com

https://flightbridgeed.com/fast24-schedule/

Next year's Conference:

https://flightbridgeed.com/fast25/

Applying the military principles of Prolonged Field Care to the civilian WEMS environment. Mike and Sean discuss PFC, what it is, and how it can and should be translated to WEMS care. They also discuss some planning and a brief introduction to desired WEMS equipment considerations in support of prolonged patient care

Sean and Mike talk through tele-consults from the wilderness, and how to ensure success by selling the situation.

Sean and Mike dig deep into Hypothermia, what is going on when we get cold, and key treatment methods.

Wilderness Medical Society Clinical Practice Guidelines for the Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia: 2019 Update

Mountain Emergency Medicine

Sean and Mike discuss the differences between Wilderness First Responder programs and how they compare to professional EMS Response roles and responsibilities.

Find us on Social Media:
Locals Wilderness EMS Community
Facebook
Instagram
Twitter

So, you think the environment gets a say in environmental emergencies? How about in every emergency? When your Due is the wilderness the environment always has a say in your care decisions. Sean and Mike discuss the unique aspects to keep in mind and how the environment always gets a say. 

Sean and Mike sit down and talk about various tools, protocols and skills and how, or if, they apply to care in the austere and wilderness environments.

Sean and Mike discuss what kind of physical and mental preparation one should consider when working in a wilderness setting.

Sean and Mike get honest about the common misconception that a couple of sticks and a length of paracord is all you need to perform wilderness medicine.

Sean and Mike discuss the DHS Austere Emergency Medical Support (AEMS) Field Guide and how it maps back to wilderness environments. They discuss the similarities between wilderness and austere care and how these considerations can quickly become something providers in an urban or suburban EMS system may need to take into account.

Find us on Social Media:
Locals Wilderness EMS Community
Facebook
Instagram
Twitter

The Episode that never was

In this episode of EMS on the Mountain, Sean and Mike kick off a multi-part discussion of what they carry, and what personal equipment they are using. This episode covers mission specific personal equipment, gear and clothing that works for them an how to think about having the right personal gear while still leaving room for rescue and team equipment. 

Sean and Mike take a bit of a detour and discuss the Advanced EMT level of care and how the AEMT level of training fits into a wilderness EMS Response.

Sean and Mike introduce themselves and discuss:

• Out experience in the field
• What is Wilderness and Auster Care
• Contact times for patients is very different
• Where we work and how it’s different

Find us on Social Media:
Locals Wilderness EMS Community
Facebook
Instagram
Twitter