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Medical Response in the Wilderness Environment
As written by Leslie Terrell, EMT-P
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I began my career in 1982 as a paramedic in Fort Worth Texas. In
1989, I moved to Medford where I started volunteering for Jackson
County SAR. I then moved to Bend and joined the Deschutes County SAR
unit and have been involved with Search and Rescue for about 8 years.
Being involved with SAR has given me a different perspective on
practicing field medicine. This took my experiences as a paramedic to a
new level.
Deschutes County SAR provides initial medical response to a large
portion of the 1,365,370 acres of US Government land in the county. The
diversity of terrain and recreational activities attract large numbers
of tourists to the area. The county received 4.8 million visitors in
1999. This diversity also creates a challenge for those who respond to
emergencies in the wilderness areas. It is a great learning environment
for many who are just getting into the field of SAR and the wilderness
environment. Deschutes County terrain ranges from elevations of 9,000+
feet to high desert areas that are flat. Deschutes County is also home
to Smith Rock, one of the premier rock climbing locations in the county.
It is this diverse geography of the county, and the types of recreation
available, that provides the responders their greatest challenges to
meet the needs of not only the patients but also the responders
themselves.
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Not having a lot of experience in the wilderness environment, I had
a steep learning curve in the beginning. Bend has wonderful
opportunities for operation in many different terrain types and
temperature ranges. When I walk out the door, I have to be thinking
about where I am going, what the weather is going to be like, and how
long I may be gone. I also need to have enough supplies to support
myself for 24 hours and the medical equipment required to support a
patient. Being faced with carrying all that on my back, I quickly
adapted from having everything but the kitchen sink with me to utilizing
what I have for multiple functions.
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Besides medical knowledge, you need to learn about the environment
you are working in. Since I have been here, I have learned more about
land navigation, outdoor survival, working in snow, avalanche conditions,
and many other outdoor related topics. Being raised in the south,
sleeping in a snow cave was not something I had ever imagined. There is
also the physical condition challenge. A leisurely outing in the
backcountry is quite different than a quick response to reach a patient
in need. Once you arrive, you have to perform those things that you
would normally do for your patient in an ambulance or ER setting.
Performing tasks like IV access or even taking a pulse on a patient are
quite different when your heart is pounding from a two or three mile
hike uphill with a 35 to 40 pound pack, and it is almost always uphill
to get to the patient.
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On the medical treatment side you have to think about your patient.
How long have they been out there? How prepared were they? What affect
will the weather have on their condition? This creates the biggest
challenge we face here; having the right equipment for the job and
getting it to the patient. All this requires creativity and flexibility
on the part of the medical team.
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The SAR environment requires that you learn new skills and push
yourself in ways you may not be accustomed. It is a challenging and
rewarding environment to work in. I have had the opportunity to do many
things and see some beautiful sights along the way.
Leslie Terrell, EMT-P
Deschutes County Search and Rescue
Oregon certified since 1989
Photos courtesy of Deschutes County Rescue
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