Med Ship Inbound

View of Half Dome from the Snow Creek Trail

Hello ProRangers and Park People! My fourth week in Yosemite was very eventful as preparations were made for the annual ALS refresher and I responded to emergency calls on the valley ambulance. I started the week assisting one of the park paramedics who is in charge of putting together the annual ALS refresher. The refresher is a week long series of lectures and scenarios for paramedics and parkmedics that reinforces existing knowledge while providing new information and techniques to ensure that medical providers in the park are up to date with current protocols and procedures. Although I am not currently an ALS provider, the refresher provided an opportunity to learn a lot of valuable information and network with experienced healthcare providers. Attending the refresher reinforced the importance of continuing education within the emergency medical field and furthered my interest in pursuing parkmedic certification. In addition to preparing for and attending portions of the ALS refresher this week, I responded to a EMS call that involved applying some skills and knowledge discussed during the refresher. The call exemplified the need for clear communication, incident command, and teamwork while working on a seriously injured patient. I look forward to attending the remaining portion of the ALS refresher this week and learning new information!

One of the most important presentations at the ALS refresher focused on first responder resiliency. As a first responder, it is common to care for those in need. However, caring for others can come at a cost. While responding to emergency calls, first repsonders can suffer physical and or emotional pain. Although the effects of responding to emergency calls and caring for others differs among emergency responders, it is important to care for yourself and colleagues. The presentation focused on dismantling stigmas that prevent first responders from acknowledging the effects of their work and encouraged self care. I am grateful to have been a part of this discussion where I learned how to manage stress and work through traumatic situations early in my career.

In addition to attending lectures presented by a variety of medical professionals, I also participated in a wide array of skills based scenarios. The first scenario focused on bleeding control through the use of a tourniquet and hemostatic gauze. I was able to refine my ability to utilize a tourniquet to control major bleeding while learning how to pack a wound (chicken breast) with hemostatic gauze. Even with these basic bleeding control skills, it is important to practice and stay sharp. Unbeknownst to me, I would apply a tourniquet to a patient only an hour after this scenario!

Self application of a tourniquet inferior to the knee

Hemostatic Gauze used in puncture wounds

Packing a simulated wound with hemostatic gauze

After the bleeding control scenario, I joined a group of ALS providers for a pediatric cardiac arrest scenario. The scenario was a great team building exercise in a high stress environment. Working as a team exemplified the need for clear communication during a medical call. Although I have practiced cardiac arrest skills for adult patients in the past, I learned a lot of new information specific to pediatric patients.

Pediatric Cardiac Arrest Scenario 

In addition to attending portions of the ALS refresher this week, I responded to my first trauma call in the park that involved applying some skills and knowledge discussed during the refresher. After falling from 15 feet, a climber sustained a significant injury that resulted in the use of a tourniquet and lower extremity stabilization. The patient was ultimately flown out of the park on a med ship for more definitive care. While there is always room for improvement, I was amazed by the clear communication, teamwork and establishment of incident command early on during the call. Together, these skills ensured that the patient had the highest level of care possible.

PHI Med Ship landed in Ahwahnee meadow to transport the patient

Although this has been a busy work week, I have spent some of my time off reading, hiking and relaxing. This past weekend, I went on a rigorous hike up to Snow Creek that included some serious elevation gain and over 100 switchbacks! I also started reading a new book, "Off the Wall: Death in Yosemite" that documents all the known fatal mishaps in Yosemite. While gruesome at times, this book offers readers an inside look into search and rescue events in the park and cautions against making similar mistakes in the future. I look forward to the remainder of the ALS refresher and the opportunity to go on some ride alongs in the coming weeks.

Until next time,

ProRanger Caruso