Maine is stunningly gorgeous. A few years ago when Joe and I visited Acadia National Park, we were amazed by the scenery. During my five-day Wilderness First Responder course, I was floored once again by the fog, the water, the trees, the weather, the everything!
The course was held on Gay Island, off the coast of Friendship, ME (In the map below, look in lower right corner).
About a mile long and a half-mile wide, Gay Island has no roads, no stores, no nothing — just docks for private land owners. It was really incredible to be slightly “cut off” from the world in a physical sense. I still got okay service on my phone, which meant I could post photos and check in with Joe, but it was really nice to be just a little distanced from “civilization” in such a stunning place.
The course was held within and around the lodge in the image below. About 12 of us stayed in rooms in the lodge, and the other 7 people camped nearby. There was a private beach area, a patch of flat grass where delicious blueberries covered the ground, and woods areas.
The view of the ocean from the cabin:
The view from the ocean when fog started rolling in. On several days, the fog would sock us in, and we wouldn’t be able to see across to the other islands:
The tides on Gay Island were really interesting. The tide went out about 30-40 feet (if not more?) and it went in and out FAST. Probably within 30 minutes. Sometimes, when people hopped in to swim after dinner, they’d forget about the tides and within 10-15 minutes, their clothes and shoes would be getting soaked. All the seaweed below was covered by water later in the day.
There were snails everywhere. EVERYWHERE! It was awesome and, in cases like this massive snail graveyard below, a little disturbing:
So that’s what we were surrounded by during the course — pretty, right? We all felt very lucky to be surrounded by such beauty the entire time we were there, though we all also wished we had more time to enjoy it! Other than a few 10-15 minute breaks and breaks for lunch and dinner, we were head down working almost the whole time.
Breakfast was generally served around 7:30 a.m. with “class” starting at 8 a.m. A general schedule would be that we’d have “lecture” from about 8 a.m. to 11/12. We’d all been required to read the Wilderness Medicine textbook prior to arriving at the course, so these lectures were part reiterating what we’d learned, as well as providing real-life accounts of rescues. Jon Tierney, who was our lead instructor, shared so many stories with us. Jon has been involved with wilderness rescue and medicine for years and years and his experience was invaluable. The number of examples he gave provided us with a more practical view of how to handle issues in the field. And his wealth of experience meant that when we asked questions, we could trust his answers.
After morning lecture, we’d generally have an hour-long practical lesson where we would either learn a skill (like splinting techniques, rapid patient assessments, litter carrying, improvised carrying mechanisms and patient packaging) or have a small “scenario” in which we would act as patients or rescuers. Jon and the supporting instructor, firefighter and paramedic Cameron Balog, would guide us in learning these skills, and in scenarios would work to make the patient problems as real as possible.
We’d have an hour lunch break and then around 1:30 we’d start up with lecture again. Around 4 p.m., we’d break out and do a full-blown two-hour-ish scenario. During the scenarios, the class would generally break into four groups – two groups of patients and two groups of rescuers – and Jon and Cameron would create parallel “accidents” in which 2-4 people were injured. If you were the rescuer, you’d come across the scene and then implement what you’d been learning.
You’d start with assessing the scene safety (making sure no other members of the rescue team or public became patients) how the patient was injured, and the number of patients.
You’d do primary assessments, checking the patients for severe bleeding, a pulse, if they are breathing and their consciousness level. Sometimes, care started right then. If the “patient” was severely bleeding, you’d put pressure on the wound or perhaps use a tourniquet for awhile while you continued your assessment. If the “patient” wasn’t breathing and there was no pulse, they’d get CPR. If they had been stung by a bee and their throat was closing up, they’d get epinephrine. It was stressed during these scenarios the importance to triage patients — learning to put aside the open fracture on one screaming patient to deal with the unconscious pulseless patient instead, and to not get tunnel vision on your patient if someone else needed help more urgently — this was SO hard to do for s lot of us. At this point, you would start to assess whether the patients’ problems were serious or not serious, urgent or not urgent.
Then you’d do a further assessment of the patient – a physical exam, check their vital signs, and, if they were conscious, their history. With all this information, the serious/not serious, urgent/not urgent categories would be revisited. You’d continue to monitor the vitals of the patient and if they changed, revisit the categories again.
If anything was urgent — something that could not be handled in the field — the patient required a rescue and would either need to be carried out or removed by helicopter. You’d have to handle organizing this rescue.
After the scenario, we’d come back to the cabin and do a little recap of what went wrong/right. Then we’d have another 2 hours of lecture or so. And then, around 8:30/9 p.m., we’d be done. They were crazy days!
In addition to being able to ask Jon questions, one of the best and most helpful parts of the class was learning about the logistics of a rescue. Over time, it became easier to categorize problems as serious or not serious, urgent or not urgent. But once you categorized something as urgent, you actually had to get the patient out of there, and there were lots of logistics to think about. Is the only way to get the patient out to carry them down in a litter? Okay, then you need about 30-40 people to come help you. Who do you call to get those people? What do you need to tell them? How long will it take? Will you need more water or food for the rescuers if it’s a long rescue? Can a paramedic meet you on the way down to provide any medications or additional care? Or are conditions favorable for a helicopter rescue? Is there a landing area? Great, then you need to start working through the emergency response system to request a helicopter, which takes time. But maybe a medical helicopter can’t land and you can’t carry the patient out either. Then you might be able to call for an extraction team to come and pick the patient up on the end of a rope.
During the scenarios, Jon often acted as the initial rescue contact. He made it a point to try to help us understand how tough it can be to get the right people on the scene. If you called 911 and didn’t describe the fact that you were in the wilderness 4 miles from the trailhead, they might send an ambulance to the trailhead and then realize that wasn’t good enough and you’d have to start all over again. He stressed that it was up to us to help make sure the right resources were dispatched. He helped us learn how to talk on the radio, when to call for a helicopter, how to ask for one and what information you needed once you did (like patient weight, a landing zone, and your coordinates). He did a great job of being SUPER annoying on the radio to show us what kinds of things can happen — either radio transmissions not going through, people talking over one another, how plans can change and go wrong and you have to adjust, how misunderstandings can develop.
We also learned that just because you want a rescue doesn’t mean you’re going to get one. The first step in any rescue process is the scene safety check. If it would be dangerous to send a helicopter to the area (maybe because of bad weather), or incredibly risky for a rescue team to reach a patient, you might not be able to get help. Or you might have to be the help, providing whatever help and improvised transport you can as quickly as you can without becoming another patient yourself.
I think throughout the class we all came to realize that rescue is complicated and there are a lot of moving pieces and a lot of things you can’t control. You have to be able to improvise, to know what information is important to relay, to understand the process and to provide the correct support and care to the patients in the meantime.
Now that the class is over, I miss all the wonderful and dedicated people who also took time out of their lives to learn so many new skills and who made my time in the class so much more valuable and interesting. I miss Jon and Cameron’s awesome teaching and so appreciate their ability to make the course interesting, engaging and practical.
Throughout the course my confidence grew. It’s still scary to think about coming across an emergency in the wilderness and it’s hard to know that in some wilderness accidents, you might not be able to save the patient. But I feel really good about having concrete things I can do to help improve the odds, and I think that this class will continue to pay dividends throughout my life and my time outdoors. It’s also very exciting to now have this in my pocket!: