OUTDOOR EMERGENCY CARE
This summer I decided to plan for my next level of outdoor emergency care and I was faced with the choice of taking a WFR (Wilderness First Responder) course or OEC course (Outdoor Emergency Care). Because I have always been interested in volunteering in a ski patrol I opted for OEC – it also seemed that the training was similar in nature to WFR. OEC is the National Ski Patrol mandated course, meaning that all NSP ski patrollers need to be OEC certified (some are EMTs which is kind of the same).
After looking for a class on the NSP site I found that the patrol I wanted to join in Mammoth did offer a class in Burbank and it seemed very convenient except that I was going to be out of town for too many classes ( running UTMB for instance ) and I wasn’t sure I could commit to two nights a week (and teaching also two nights a week). So I settled on two weeks intensive in Squaw Valley in November – I found the class through the NSP web site. I got in touch with the instructor and he had a web site set up and directed us, students, to read the OEC book on our own, some 1300 pages of emergency medicine instruction. I read the book twice over the summer until I became confident taking the exams and scoring about 94% on my own (we had access to a number of past exams). It was a lot of medical information to digest but I loved it, there’s so much to know about the human body and trauma.
Then the end of October came and it was time to drive up to Tahoe and take the intensive class. And intensive it was! From 8 am to 5 pm every day non-stop for 16 days including the final exams and a midterm. The Squaw location got canceled so the class was located at the beautiful Northstar fire station (much thanks to the Northstar firemen for letting us use their facilities). A classmate who had a condo in Alpine was kind enough to offer me to stay with him and every day we made the 40-minute drive to Northstar, picking up another student or the instructor along the way in Squaw in order to carpool (through the funny town of Truckee. I loved the gold rush vibe the area still has).
It’s hard for me to tell whether it was a good class or not because I have very few points of reference in that area of instruction. Considering that I passed the exams I could say that it was effective (93% at the written exam – it would have been more useful to take the written at the beginning of the intensive to get it out of the way – I also saw that some other patrols allow for a take-home exam). The instruction was based mostly on drilling us in conducting a standard patient assessment and the resulting decision-making for what type of urgent care and/or packaging a patient needs. Since it was effective I don’t regret my decision to take that course and I did learn a lot.
Another positive aspect of this particular course was the students. I had very helpful and friendly classmates and this proved very precious when it became tough in the second week. I’m used to rough and tough things, I have had military training but here I have to say that at some point I just about had it (ski patrol is volunteer work!). The main instructor was sometimes acting in an unfair fashion (also using a loud whistle to have us stop certain activities). No doubt he was acting in our best interest and was taking the job very seriously want us to pass the exam (also let’s be reminded that he was volunteering two weeks of his time which is quite remarkable).
The most positive learning I experienced was the “flow” – a specific guide to assessing patients. It’s very effective and although it differs somehow from what is explained in the book it’s very effective and keeps rescuers on track in the heat of the moment especially when trauma might be mixed with a medical condition (asthma, diabetes), crummy environmental conditions or an altered mental state. Lots of acronyms and mnemonics had to be learned and it really helps.
What was also very positive in this experience was the involvement of many patrollers from the area. They also were volunteering their time and it was obvious that they were passionate about what they were doing and cared a lot about providing us with the best instruction possible. They were also very likable and they had a great sense of humor!
Thanks to this great training the final practical exam was stressful but also a lot of fun. The volunteer patrollers who were judging the exam or crewing for the candidates were very encouraging and very positive about our performance – while remaining professional everyone was having a good time. With the exception of one scenario, the last one I had to take. Every scenario entailed having fictitious patients and providing the right assessment as well as the right emergency treatment. For my last scenario, I was told that the cannula delivering oxygen to my fake patient should be ignored and that I should take it easy when palpating his abdomen because his spleen was enlarged. Fine, I’m game! But it was dicey because at some point the patient tried to fake asthma and it was getting confusing with the cannula (especially that the didn’t know how to fake asthma and didn’t have any problem breathing when whining as I was bandaging his hand… clearly that group of patrollers were there to fail us. Or try to, considering how unpleasant and negative they were). I believe the scenario was canceled for everyone.
At the end of the day, I’m glad I took the course but I think I still have to go through WFR (and possibly EMT) training because OEC is a little light on the backcountry and wilderness side of things. It’s mostly geared toward people patrolling in a ski resort. It’s an advance on the WFA I was holding but insufficient for what I do. I’m content to join the ski patrol though as it’s a fun way to meet outdoor/ski minded people in the area and I’ve made a lot of friends already. I’m also enrolling for other NSP sanctioned classes such as MTR (Mountain Travel and Rescue) and Avalanche 2 (despite the fact that I’ve done that stuff already).