Johnson City Press: Practicing medicine in the great outdoors, ETSU Quillen College of Medicine offers new Wilderness Medicine elective

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Practicing medicine in the great outdoors, ETSU Quillen College of Medicine offers new Wilderness Medicine elective

Contributed • Apr 12, 2019 at 3:50 PM

Medical emergencies do not always happen in close proximity to the sterile, well-equipped halls of a hospital or health care facility. Backwoods hiking accidents, natural disasters or other scenarios in the wilderness can require a physician to assess and care for a patient using limited resources and improvised techniques and equipment.

To get a firsthand glimpse of these situations, a group of fourth-year medical students at East Tennessee State University Quillen College of Medicine recently participated in a simulated medical rescue scenario at ETSU’s Valleybrook campus. The exercise was part of a newly-introduced Wilderness Medicine elective at Quillen College of Medicine.

“Wilderness medicine is the practice of medicine in an austere environment, where you do not have supplies and the technology available in an urban setting,” said Dr. Jeff Sanders, a Kingsport anesthesiologist based at Holston Valley Medical Center and the course director for the Wilderness Medicine elective at Quillen. “This type of medicine is often practiced in search-and-rescue operations.”

Last week, a Wings Air Rescue helicopter landed at the Valleybrook campus to simulate a patient rescue that could occur in a remote rescue operation. Wings generously donated time and equipment to allow the students to work with the helicopter at no cost. Students practiced patient packaging, loading and helicopter safety.

“I chose to take the Wilderness Medicine elective because I grew up here in East Tennessee doing a lot of hiking, backpacking, snowboarding and those kinds of things that I have continued throughout my life,” said Chelsea Miller, a fourth-year student at Quillen College of Medicine. “As a physician, I think it’s important to be prepared on these trips to take care of everyone else around me and to really know my environment and know what kind of resources I can use, even in the wilderness, to take care of people.”

Ben Nolt is going to Yale University for his residency in emergency medicine after he graduates from Quillen College of Medicine in May. He chose the Wilderness Medicine elective because of its similarities to emergency medicine.

“Emergency medicine is analogous to wilderness medicine in a lot of ways because we have to work with what we have,” Nolt said. “A lot of times the type of injuries are the same. Today we were talking about fracture reduction, dislocations and things like that. What happens out in the wilderness is what we deal with in the ER.”

Throughout the Wilderness Medicine elective, students learn the unique considerations in evaluating patients for spine and neurologic issues in outdoor settings, as well as protecting patients from the elements that can cause serious conditions such as hypothermia.

“The main goal of this course is to introduce the students to wilderness medicine and have them think about problems in a different way than they would every day when they go to work in a hospital,” Sanders said.

Sanders, who is a recreational outdoorsman and climber, was excited to coordinate the first Wilderness Medicine elective at Quillen. Others are helping him teach the course, including David Paine, Wings paramedic; Jeff Wadley, a search and rescue expert; Randy Montgomery, a local dentist and ski patroller; John Teilhet, orthopedic physician assistant; Dr. Jason Moore, Department of Family Medicine at Quillen; Chuck Perry, an engineer and climbing enthusiast from Abingdon; and the Wings flight crew consisting of Mitch Hathaway, Tim Cox and Andreas Grisotto.

“I came onboard this elective to teach wilderness orthopedics,” said John Teilhet. “I have a bachelor’s degree in outdoor education, so I have a long history in wilderness education. Since I became a physician assistant, this was the first opportunity I’ve had to marry my undergraduate [studies] and what I do as a career. It’s exciting for me to get back into wilderness medicine and use the last nine to 10 years of what I have been practicing in a hospital setting and how that relates to the wilderness setting.”

The helicopter evacuation simulation experience at Valleybrook was an integral part of the course. Last week, students also went backpacking together along the Appalachian Trail to practice scenarios that could occur in the wilderness. Students say the class has provided an invaluable opportunity to participate in hands-on training that is unlike what they have already learned in their previous medical classes.

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