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reconbeef
Nov 30, 2004, 4:21 PM
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In reply to: I mean if u are dumb and can't remember if its 3, 30, or .3 you should write it down. Or even better buy a 3/10cc syringe.
Yea, that's easy to say in front of the computer with a cup of coffee and your bunny slippers (ok, that's what I'm wearing), but it's another ball game out in the sunny world. And again, people have different levels of training and experience.
But if you have joe dirtbag raft guide (I love to pick on the boaters) who took his WFR over 2 years ago, and it's all kinda hazy and he's looking at a dying client and an amp of epi....
The beauty of the epi-pen is that it is totally fool proof. There is one way to screw it up; reverse directions. And I've seen that done, a woman I work with put it through her thumb. I had to moniter her BP (highish) for an hour and she was fine. She said it hurt like hell though. But there is no measuring, not drawing up, no trying to remember if you are going to give the wrong dosage of one of the most powerful cardiac drugs out there.
In reply to: everyone seemed to throw there 2 cents worth in so i did...and thats why I also said "That may not work for YOU but thats what I carry"
No, no, I think it's intresting you bring this up. This is THE debate about epi in the outback, and it's a hot one. I think it's funny we spent so much time arguing style points, because this is the real bone of contention. Do you stick with the auto injector or do you give some 19 year old english lit major a needle and the big daddy of dangerous medicines and say, go gettem tiger! (You can see where I stand).
-James
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addoil
Nov 30, 2004, 7:42 PM
Post #77 of 108
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In reply to: Thanks a lot guys. This has to be one of the better threads of late.
i hate this thread.
reno is a mod. gave wrong info. covered his ass with the 'meet this criterea" crap. and bullied the buig who was correct.
don't the only contraindication in a life or death situation is whether or not other people will get hurt.
what he should have wrote is this. do it: but if you are not sure that the case is life threatening for what ever reason then realize that there are potential dangers.
at best he never fully answered the question at worst he acted like a typical abusive mod never owning up to a simple mistake
maybe some people should just suck it the feck up and say yes i didnt mean what i wrote exactly i should have written it better. istead of covering tracks by acting all condisending. epi is IM. there is not always time to think. that is why people train. to hard wire info. the only time you need to think is when there are multiple options. thats when contraindications come intop effect.
and please people stop taking advice from EMTs. Reno is probably are extraordinarily well trained one. but still EMT's do not need much training. anyone worth his salt know that contraindications are a blanket statement.
PEOPLE WHO KNOW DONT THINK THEY JUST DO....and dont even bother responding. your ego is way out of control.
hell i live in Tajikistan i can see a boen head from here
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mtn_eagle
Nov 30, 2004, 11:12 PM
Post #78 of 108
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In reply to: In reply to: Thanks a lot guys. This has to be one of the better threads of late. i hate this thread.
I agree.
This is a very complex issue that is best be left to experts with deeper, more fundamental knowledge of the topic. There's a whole lot more to anaphylaxis than epi and benadryl. Give me an hour and a blackboard and we could probably scratch the surface. As I stated in my first post, see an allergist if you want the best advice.
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reno
Nov 30, 2004, 11:33 PM
Post #79 of 108
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In reply to: In reply to: i hate this thread. I agree.
I'm terribly sorry you both feel this way.
mtn_eagle, I agree with your comment about an allergist. In fact, I am fairly certain I mentioned something about an immunologist in one of my posts.
addoil, I'm not sure what you've posted that contributed to this thread. You've not offered your input on the medical treatment side at all, actually. Please, if you think I gave bad advice, then I invite you to point out the bad advice (where did I go wrong,) and post your correct advice.
Also, be certain to share your medical credentials, as you must obviously be a physician of some sort.
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epic_ed
Dec 1, 2004, 12:27 AM
Post #80 of 108
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In reply to: In reply to: Thanks a lot guys. This has to be one of the better threads of late. i hate this thread. reno is a mod. gave wrong info. covered his ass with the 'meet this criterea" crap. and bullied the buig who was correct.
Please explain where he was wrong. It has been debated to death about whether he included too much info, but it's never been disputed that he gave the wrong advice.
As for being a mod -- we're allow to have opinions and we make mistakes from time to time just like you. I'm not sure what kind of freakin omniscient savior you're expecting to have as a moderator around here, but it ain't gonna happen. Feel free to step up to the plate and volunteer if you think you can do a better job. We'd love to share the work load with you, and they'll probably pay you double what their paying me.
As for bullying -- again, show me an example of how Reno bullied anyone. His tone was clearly the more cordial and level headed between the two of 'em.
Ed
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reconbeef
Dec 1, 2004, 12:53 AM
Post #81 of 108
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In reply to: This is a very complex issue that is best be left to experts with deeper, more fundamental knowledge of the topic. There's a whole lot more to anaphylaxis than epi and benadryl
But the problem is in a wilderness setting, that's all you have, and sometimes you're lucky to have that. I am not a physician (but I get yelled at by them sometimes), but I've put some time in in backcountry rescue and it makes the back an ambulance seem like a level one trauma center.
I guess what really bothers me about this whole thread is the level of overcomplication. There are a lot of really smart medical people who climb who have been weighing in, but I'm not sure it helps the poor bastard who origionally posted:
In reply to: In reply to: I jab the first epi-pen into my thigh. That's good for about 15 minutes. We start heading down, and I feel the anaphylactic shock symptoms arising again. So I use up the second epi-pen, which is pretty much the limit of what you should take. So, now, am I screwed, or will the double doses of adrenaline be enough for me to get me out of there? For arguments' sake, I also have some Benadryl with me.
This is a pretty simple question, assuming anaphylactic shock. You've got the benadryl, got the epi, and I think the importance of the benadryl as the end solution (rather than the temporary soluiton that the epi-pen offers) has been well addressed.
I railed on this topic in the wilderness first aid post about a month ago. You are dealing with a very limited scope of options. Even from a liscensed perspective, as a medic on a mountain rescue team, I get to do all sorts of crazy s*it on rescue situations that would get me hung in the street because the wilderness protocals kick in. Doing medicine in the backcountry is closer to a nursing situation that it is to your typical EMT/Paramedic experience.
To sum up, I think that there is a wilderness specific frame of reference that a lot of really smart, really well trained people lack. And I know because before I started doing wilderness medicine, I lacked it too. So realize that your training and experience will not allways translate over to a wilderness scenario.
As a final note, get involved. I guarantee wherever you are, if you'e climbing, there is a SAR or mountain rescue team close to you. It's lots of fun, you get to play in the woods, and if you have a medical background you get to do some good stuff. Plus, if you join a technical team, you will learn more about rigging and ropes than you ever thought possible.
This is a good place to start:
http://www.nasar.org/nasar/links.php
Just trying to keep the thread positive.
-James
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karlbaba
Dec 1, 2004, 1:00 AM
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I think it's a huge mistake for anyone to claim that it's inappropriate for us to discuss how to treat ana in a wilderness setting. The vast majority of climbers aren't going to deeply investigate the minutia of this subject in an academic setting, so what happens when somebody gets stung by a bee 10 miles from the road?
Do I pull out a disclaimer form that says "Only medical doctors should be empowered to treat medical conditions that might be serious and life threatening. You are therefore advised to immediately proceed to a medical facility, or unable to do so, wait for qualified, on-duty personnel to reach you. In the event that these procedures fail, only an ordained clergy member is authorized to.......
Sheesh
Karl
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cjstudent
Dec 1, 2004, 1:07 AM
Post #83 of 108
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In reply to: In reply to: Thanks a lot guys. This has to be one of the better threads of late. and please people stop taking advice from EMTs. Reno is probably are extraordinarily well trained one. but still EMT's do not need much training. anyone worth his salt know that contraindications are a blanket statement. PEOPLE WHO KNOW DONT THINK THEY JUST DO....and dont even bother responding. your ego is way out of control.
Who are you? How about going back and reading alittle bit. I think Reno has given pretty good info, just as everyone else has. To me, reading this post it seems to be more of a conflict of getting a "second medical opinion". There are several qualified people who have responded to this thread. Reno for one isn't just an EMT, if you would read, he's a paramedic which (at least from my side of the country) is quiet a bit of training. So are some of the other responders, WFR instructors or paramedics.
And your last statement is a pile of shiz. People who know don't think they just do. ???? Yea if you lived by that idea, you would kill your patient for sure. Doctors know alot of shiz, and they think about possibilities, not just do stuff.
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cjstudent
Dec 1, 2004, 1:15 AM
Post #84 of 108
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In reply to: In reply to: I mean if u are dumb and can't remember if its 3, 30, or .3 you should write it down. Or even better buy a 3/10cc syringe. Yea, that's easy to say in front of the computer with a cup of coffee and your bunny slippers (ok, that's what I'm wearing), but it's another ball game out in the sunny world. And again, people have different levels of training and experience. But if you have joe dirtbag raft guide (I love to pick on the boaters) who took his WFR over 2 years ago, and it's all kinda hazy and he's looking at a dying client and an amp of epi.... The beauty of the epi-pen is that it is totally fool proof. There is one way to screw it up; reverse directions. And I've seen that done, a woman I work with put it through her thumb. I had to moniter her BP (highish) for an hour and she was fine. She said it hurt like hell though. But there is no measuring, not drawing up, no trying to remember if you are going to give the wrong dosage of one of the most powerful cardiac drugs out there. In reply to: everyone seemed to throw there 2 cents worth in so i did...and thats why I also said "That may not work for YOU but thats what I carry" No, no, I think it's intresting you bring this up. This is THE debate about epi in the outback, and it's a hot one. I think it's funny we spent so much time arguing style points, because this is the real bone of contention. Do you stick with the auto injector or do you give some 19 year old english lit major a needle and the big daddy of dangerous medicines and say, go gettem tiger! (You can see where I stand). -James
Ok I agree with you on alot of that. Maybe its just me, I am trying to be the guy who knows enough to be useful, but isn't a doctor. You know? For me I think the ampules are the way to go. I've been pretty interested in wilderness medicine every since my first day of WFR, and intend on getting my EMT within the year so i can be a WEMT. (and join our rescue squad) Thinking back to my WFR class, there are some people in there who need the epi pen with pictures. :D And as a WFR instructor i could see where u would be leary about teaching ampules. I would say, that for you, it would depend on your class and students. We went over both epi pens and ampules in my wfr class. i think most of the students in my class decided to go with the epi-pens over ampules. I'd like to think I'm someone who has their head screwed on straight and in the moment of an emergency would be calm and think back to training instead of "uhhh, dude, stab them with an epi pen"
and as far as in NC, i have a certification that says i can use epi on other people in the absence of a doctor. (or if the doc is there, if he tells me to do it) hopefully that would help me with some legality issues
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climbingnurse
Dec 1, 2004, 1:25 AM
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OK, first, a lot of people have been bashing Reno. I don't think any of them have the knowledge or experience that he does. (Please note that the nurses and doctors on the forum have not contradicted anything he said.) I don't think he said anything that was misleading and I am fairly certain he didn't say anything that was wrong. If I go into anaphylaxis, I want him there. Failing that, I'd be psyched to have someone nearby following his advice.
Anyway, a lot of people have mentioned the shortcomings of epi-pins. I see them having two major drawbacks: expense and short shelf-life. The obvious advantage is that they are virtually idiot proof. (Unless you put it through your thumb...) So anyway, the outdoor ed folks at my school recently came up with an alternative.
(Please don't read what I'm about to write if you are a safety nazi hell-bent on demonstrating your self-righteous indignation towards people who do things differently than you.)
We made anaphylaxis kits that consist of:
-3 0.3 mL syringes (with fixed needles)
-3 ampules containing 1 mg of epi in 1 mL of solution
-A bunch of benadryl
-3 alcohol swabs
-3 2" x2" gauze pads
-directions for use
AND (this is key) we started an annual training program that is mandatory for all guides. This class and the kits were designed by myself with the help of one of my professors who has more medical credentials than anyone should and is also a backpacker.
The 0.3 mL syringes are also key as it makes it pretty hard to overdose someone.
These kits cost about $20 (for at least three doses of Epi) and expire every 18 months instead of every 8 or whatever for Epi-pins.
Some final advice: Be very wary of people who give their opinions while trying to withold as much information as possible about their own backgrounds.
(And just to make sure everyone knows, as I stated in my first post in this thread, I am not a nurse yet. I still have one semester to go.)
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reconbeef
Dec 1, 2004, 1:46 AM
Post #86 of 108
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In reply to: AND (this is key) we started an annual training program that is mandatory for all guides.
This is TOTALLY the key. I agree that on the face of it, the ampules are the way to go, you can multi-dose, they are smaller, lighter, cheeper. And if your outting club/guide service/keg party has an instituted program for training and quality assurance, then it's a winner.
From a once every three years WFA or WFR class, it's a little dicier. I would love to make people re-cert their WFRs every year, but it's not economically possible. It used to be every two years, and then one of the big schools, to be different, switched to three years, so everyone had to grudgingly follow suit.
When I have taught the multi-dose epi, I make people do 5 to 10 wind sprints, and then do the draw up. Because you're going to be so freaked out, shaking, and trying to remember what the hell it was your instructor said. This is why, despite the cost of and pain in the ass of the epi-pen, they are the perfered alternative for most people/programs.
But good on you guys for taking the initative to up together a epi program, that's pretty progressive.
-James
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cbare
Dec 1, 2004, 2:01 AM
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I think this has been a worth wile forum. People from many clinical disiplins has weighed in and have given many unique options that people can put in their back country tool box. I am not shure what some people qualify as an expert in anaphylaxis. I suppose an immune specialist, but I don't think you need an advanced degree in medicine or biological science to have a solid working knowledge of this subject. I think a paramedic is certanly qualified to talk about anaphylaxis. Perhaps people are not aware of the extent of their training. In the USA most paramedics undergo a rigorous training program that consists of several hundred class and clinical lab hours, in addition they usually undergo a clinical rotation that exceeds 1000 hours. They rotate through ER, ambulance internship, womans health, surgery, intensive care, and pediatrics. In addition, they must have documented patient contacts and have proof of skills use. ie, must have several documented medications deliveries,(typically they can administer 50 or more meds) and special skills such as intubation. Finally they go through a grueling exam that puts them in stressful scenarios where they must demonstrate all of their skills by the book. ie, trauma management, medical management,(anaphylaxis is a commonly tested medical problem) advanced cardiac management, airway stations, iv stations and medication delivery, this is followed by a board style paper exam. All in all pretty complex training. Most paramedic programs are associate degree programs and require college level biology, anatomy and physiology, math, and english classes as prerequisits to the core medic program. Heck even an EMT Basic recieves over 100 hours of training and must pass a similar exam and complete a clinical rotation. This post is a deviation from the original thread but I know allot of people have a he's just an ambulance driver attitude and hopefully this will help people better understand paramedics. After all I think these forums are more about learning than a competition of the minds. Take care everybody , cbare.
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cbare
Dec 1, 2004, 2:03 AM
Post #88 of 108
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I think this has been a worth wile forum. People from many clinical disiplins has weighed in and have given many unique options that people can put in their back country tool box. I am not shure what some people qualify as an expert in anaphylaxis. I suppose an immune specialist, but I don't think you need an advanced degree in medicine or biological science to have a solid working knowledge of this subject. I think a paramedic is certanly qualified to talk about anaphylaxis. Perhaps people are not aware of the extent of their training. In the USA most paramedics undergo a rigorous training program that consists of several hundred class and clinical lab hours, in addition they usually undergo a clinical rotation that exceeds 1000 hours. They rotate through ER, ambulance internship, womans health, surgery, intensive care, and pediatrics. In addition, they must have documented patient contacts and have proof of skills use. ie, must have several documented medications deliveries,(typically they can administer 50 or more meds) and special skills such as intubation. Finally they go through a grueling exam that puts them in stressful scenarios where they must demonstrate all of their skills by the book. ie, trauma management, medical management,(anaphylaxis is a commonly tested medical problem) advanced cardiac management, airway stations, iv stations and medication delivery, this is followed by a board style paper exam. All in all pretty complex training. Most paramedic programs are associate degree programs and require college level biology, anatomy and physiology, math, and english classes as prerequisits to the core medic program. Heck even an EMT Basic recieves over 100 hours of training and must pass a similar exam and complete a clinical rotation. This post is a deviation from the original thread but I know allot of people have a he's just an ambulance driver attitude and hopefully this will help people better understand paramedics. After all I think these forums are more about learning than a competition of the minds. Take care everybody , cbare.
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epic_ed
Dec 1, 2004, 2:07 AM
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I don't know how anyone can say this hasn't been a good, informative thread. Personally, I've learned a lot and it's been one of the more appropriate, on-topic discussions we've had about wilderness medical crisis. Thanks to all of you who have contributed to the exchange of ideas.
Ed
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reno
Dec 1, 2004, 2:52 AM
Post #90 of 108
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In reply to: We made anaphylaxis kits that consist of: -3 0.3 mL syringes (with fixed needles) -3 ampules containing 1 mg of epi in 1 mL of solution -A bunch of benadryl -3 alcohol swabs -3 2" x2" gauze pads -directions for use AND (this is key) we started an annual training program that is mandatory for all guides.
I think this is one hell of a great idea, and in my opinion, it should be the national standard for wilderness training. If I can support it in any way... any way at all... please tell me.
Teach the right things, then teach them again every year, just to keep folks current.
As a medical professional, I applaud this approach. Bravo, sir. Bravo indeed.
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reno
Dec 1, 2004, 3:02 AM
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In reply to: When I have taught the multi-dose epi, I make people do 5 to 10 wind sprints, and then do the draw up. Because you're going to be so freaked out, shaking, and trying to remember what the hell it was your instructor said. This is why, despite the cost of and pain in the ass of the epi-pen, they are the perfered alternative for most people/programs.
James:
I like this! Can I borrow that idea? :twisted:
I once hit on the idea, while training tactical medics, to light a string of firecrackers behind them when they were trying to start an IV line. Sure, it caused a lot of blown veins at first, but darned if they weren't the best in the state with an IV needle after I was done. :)
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reconbeef
Dec 1, 2004, 3:24 AM
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In reply to: it should be the national standard for wilderness training
And therein lies the rub. There IS no national standard for wilderness training, and this is somthing that everyone on this thread (well everyone in general, but I'm realistic) should realize. If you take an American Red Cross first aid course or American Heart Association CPR course in Maine, it will be the exact same course that you would get in Nevada. It is a national standard, to which all other courses are held. No (to my knowledge) CPR courses are being offered that don't confirm to the AHA guidelines.
Not so with wilderness medicine. As I said, there is no national certifying body. Reno, you could hang out a shingle tommorow and open Reno's wilderness medicine boutique and start teaching you students trepanation and to cric anyone who got stung with a bee. And you could do it. At least until some guy shows up at your door with a hole in his head and his neck wanting a few words.
Case in point, there is a guy in DC who runs a (fairly lucrative) wilderness first aid school that doesn't have the first damn idea what he's doing, and it's caused some real problems. I can't believe the guy hasn't been sued, but he keeps on doing his thing. This is why I advise people to a) take a class from one of the big three or barring that b) make sure you know who it is that is teaching your class.
The closest we have in the States to a 'standard setter' is the Wilderness Medical Society (www.wms.org). The publish a set of wilderness guidelines (which is well worth having) but do not endorse a standard, and most likely never will. So it's sort of everyone for themselves. The cirricula of the big three schools are pretty much the same, except for a few style points, but they are in agreement on the big issues (holes in head: bad).
So this is why you won't get a standard. And, to repeat something I've said here before, multi-dose epi is a bad idea for 90% of those taking these classes and performing medicine in the outback. Climbingnurse is in an institution that has decided to put time and money towards maintaing this standard (with an MD to oversee it). But most people coming to get their cert aren't. They show up once every three years to recert, and man, some of them are just there to punch the clock and get their card. You can tell they are going to forget everything the next day.
While having their drawbacks, Epi-Pens are the safest option for lay providers. I'm actually waiting for the first camper to die after being coded out by too much epi and see how long these amp programs stay around. I just think there's too much to go wrong, and epi-pens work great. They've saved thousands of lives. Can't argue with that.
-James
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reconbeef
Dec 1, 2004, 3:26 AM
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In reply to: I once hit on the idea, while training tactical medics, to light a string of firecrackers behind them when they were trying to start an IV line. Sure, it caused a lot of blown veins at first, but darned if they weren't the best in the state with an IV needle after I was done.
Now that's a good one. I always thought they should teach professional CPR courses in poorly lit public rest rooms. Seems like that's where you always end up doing it.
-James
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cjstudent
Dec 1, 2004, 3:34 AM
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In reply to: In reply to: it should be the national standard for wilderness training And therein lies the rub. There IS no national standard for wilderness training, and this is somthing that everyone on this thread (well everyone in general, but I'm realistic) should realize. If you take an American Red Cross first aid course or American Heart Association CPR course in Maine, it will be the exact same course that you would get in Nevada. It is a national standard, to which all other courses are held. No (to my knowledge) CPR courses are being offered that don't confirm to the AHA guidelines. Not so with wilderness medicine. As I said, there is no national certifying body. Reno, you could hang out a shingle tommorow and open Reno's wilderness medicine boutique and start teaching you students trepanation and to cric anyone who got stung with a bee. And you could do it. At least until some guy shows up at your door with a hole in his head and his neck wanting a few words. Case in point, there is a guy in DC who runs a (fairly lucrative) wilderness first aid school that doesn't have the first damn idea what he's doing, and it's caused some real problems. I can't believe the guy hasn't been sued, but he keeps on doing his thing. This is why I advise people to a) take a class from one of the big three or barring that b) make sure you know who it is that is teaching your class. The closest we have in the States to a 'standard setter' is the Wilderness Medical Society (www.wms.org). The publish a set of wilderness guidelines (which is well worth having) but do not endorse a standard, and most likely never will. So it's sort of everyone for themselves. The cirricula of the big three schools are pretty much the same, except for a few style points, but they are in agreement on the big issues (holes in head: bad). So this is why you won't get a standard. And, to repeat something I've said here before, multi-dose epi is a bad idea for 90% of those taking these classes and performing medicine in the outback. Climbingnurse is in an institution that has decided to put time and money towards maintaing this standard (with an MD to oversee it). But most people coming to get their cert aren't. They show up once every three years to recert, and man, some of them are just there to punch the clock and get their card. You can tell they are going to forget everything the next day. While having their drawbacks, Epi-Pens are the safest option for lay providers. I'm actually waiting for the first camper to die after being coded out by too much epi and see how long these amp programs stay around. I just think there's too much to go wrong, and epi-pens work great. They've saved thousands of lives. Can't argue with that. -James
I would also agree to say that, its very important that people get their WFR from one of the Big Three schools. WMA, WMI, or SOLO. Since also the closest thing you can get to a standard is found in those three schools. Not joe-schmoe's wilderness medicine "school"
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reno
Dec 1, 2004, 3:44 AM
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In reply to: I would also agree to say that, its very important that people get their WFR from one of the Big Three schools. WMA, WMI, or SOLO. Since also the closest thing you can get to a standard is found in those three schools. Not joe-schmoe's wilderness medicine "school"
Yep. I mention these schools in the I&A FAQ, which can be found HERE.
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climbingnurse
Dec 1, 2004, 12:53 PM
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In reply to: In reply to: Reno quotes keith's earlier post about the epi kits and mandatory training. I think this is one hell of a great idea, and in my opinion, it should be the national standard for wilderness training. If I can support it in any way... any way at all... please tell me. Teach the right things, then teach them again every year, just to keep folks current. As a medical professional, I applaud this approach. Bravo, sir. Bravo indeed.
I think this approach is most appropriate for school outing clubs. They make up a significant portion of the clientelle for the "big 3". It would be great if all outing clubs were encouraged to take this approach. It's not too hard to implement. Spread the word...
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climbingnurse
Dec 1, 2004, 12:55 PM
Post #97 of 108
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Registered: Oct 30, 2003
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In reply to: In reply to: When I have taught the multi-dose epi, I make people do 5 to 10 wind sprints, and then do the draw up. Because you're going to be so freaked out, shaking, and trying to remember what the hell it was your instructor said. This is why, despite the cost of and pain in the ass of the epi-pen, they are the perfered alternative for most people/programs. James: I like this! Can I borrow that idea? :twisted: I once hit on the idea, while training tactical medics, to light a string of firecrackers behind them when they were trying to start an IV line. Sure, it caused a lot of blown veins at first, but darned if they weren't the best in the state with an IV needle after I was done. :)
James, you are mean. Reno, you are evil.
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climbingnurse
Dec 1, 2004, 12:56 PM
Post #98 of 108
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In reply to: Case in point, there is a guy in DC who runs a (fairly lucrative) wilderness first aid school that doesn't have the first damn idea what he's doing, and it's caused some real problems.
Just wanted to state for the record that I'm not that guy. :shock:
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climbingnurse
Dec 1, 2004, 1:01 PM
Post #99 of 108
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In reply to: Climbingnurse is in an institution that has decided to put time and money towards maintaing this standard (with an MD to oversee it).
Keith's biggest pet peeve: People who assume that only a doctor could do this sort of thing. The person who helped me develop the kits and the training program is NOT an MD. She is a Family Nurse Practitioner (amongst other fancy initials including PhD).
I, for one, see this as being a much more appropriate role for a nurse than for a doctor. Nurses get more training in education and tend to be better at seeing the big picture in patient care settings.
I know you meant no harm, but you just inadvertently trampled on my career field.
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tgmd
Dec 1, 2004, 3:07 PM
Post #100 of 108
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Registered: Oct 8, 2004
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Interesting thread, at least from my perspective (Emergency physician). I respectfully disagree with climbing nurse about doctors. I enjoy wilderness settings and climbing, so I have some experience. I don't have the experience in the field as does Reno and others here. I can only treat the ones the medics save in the field. But, please, some of us doctors are pretty good at teaching and enjoy it. Some of us do get "the big picture" and understand the difficulties of wilderness field medicine. I don't believe that I am an exception. I have met a lot of very qualified professionals, doctors, nurses, and EMS personnel, at Wilderness Medicine Society meetings. I hope that your expeiences are more positive in the future.
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