Peru - tropical medicine ultrasound

As a part of my fellowship I'm participating in a tropical medicine ultrasound course offered by the mcg faculty.

We all met at Dr kuhn's house this morning and carpooled to the Atlanta airport. It's about a 6-7 hour flight to Lima. We are staying at Jose Antonio hotel in miraflores. We have Saturday to do a bit of exploring before the course starts Sunday morning.

About 4 hours after getting to Lima we are finally at the hotel. 3 bags were lost and the ultrasounds didn't make it through customs.

Atleast my room is nice!

High Angle Rescue Conference

October 17th, 2012

After spending the morning lecturing (Mike spoke about high altitude and his everest experience) and I spoke about cold injuries (which luckily I have no personal experience with) we headed out to do some high angle rescue demonstration with the residents.

Laughing or Screaming?

 Mike rappelled down and got his fingers stuck, so I rigged another rapell line, came down to him, attached him to my ATC via a cows tail (sewn sling) and managed to get his finger free. We then tandem rapped down my line.

 In the next iteration I rapped down to the stuck climber. I attached him to my ATC again. This time I had to rig a 3:1 to untension his rope to get him off of it. I did this with a prussik above him with a 3:1 with a foot loop for me to stand in.

Who will make it to the top first?

We enjoyed climbing the rest of the afternoon!

ACWM Training Event: climbing

Sat Oct 13th: Crowder's climbing



Deb celebrating on the way down

One of my goals as part of the Appalachian Center for Wilderness Medicine was to plan some more group activities. The first one of these was a day of climbing at Crowders. Deb and I had a great time. She did some awesome climbing - 5.11b sport lead :) I couldn't even follow up that on top rope... maybe one day!

Hopefully the next events will grab a bigger crowd - or Deb and I can just have fun :)

Me struggling up

Mtn Biking Around Pisgah



View from Black Mtn

October 4-6th -Mtn Biking:  Brevard NC

I had a couple of fall days off so headed up to Pisgah with Matt and some of his friends. (Most of mine bailed...) We camped at the Davidson River campground and got in a lot of miles on the mtn bikes.
Thursday evening we rode Black Mtn. I rode this trail numerous times in college and probably once or twice since then. I was really disappointed after lugging my bike uphill (both riding and hike a bike) for almost 3 hours - to find the trail was in such poor condition (washed out waterbars, huge ruts) that a lot of it wasn't rideable (for me atleast). The view was still great from the top!



Matt on NC slickrock

On Friday and Saturday we rode at Dupont State Park. The trails there have great flow - and plenty of climbing and descending to keep me very happy (and tired). It helped to have a semi-local (Allen) ride with us on Saturday - as he was a lot more familar with the fun trails!



Great couple of days riding. Can't wait to get up there again. Won't be long until all the leaves are changing!

Resident Wilderness Day

Wilderness Medicine Day Oct 3, 2012:

Mike and I spent a couple day out on the Savannah River and on the trails around FATs setting up a medical adventure course which entailed the residents navigation on both water and land to answer a series of wilderness medicine related questions. They finished up the day with a series of land based stations including litter building, fishhook removal, intubating under and dock and dragging heavy mannequins from the water for resuscitation!

Overall an awesome experience for all involved!!

Mike paddles through the shallow water of the Savannah River

View from my kayak

 

Crane enjoys nature

Augusta Half Ironman

Sunday Sept 30th

I spent the afternoon out at the Augusta Half Ironman medical tent. Luckily there were no serious injuries on my watch - mainly exhaustion, cramping and some blisters. Powerade and bandaids were my medicine of choice for most of my patients. It was inspiring to see such a large group of motivated athletes! The triathalon was sold out with 3,400 participants!

Fishhooks in the ED

Impaled by a Fish Hook! Fish hooks are great at snagging fish and fingers. There are a number of novel techniques for their removal. In this situation after performing a digital block (numbing up the whole finger) we used the needle cover technique which is described below from the FPnotebook website. In this case as the fishhook was embedded fairly superficially and only had one barb it was very effective. We also up dated the patient's tetantus and washed out the wound throughly after removal!

Technique: Needle Cover Technique http://www.fpnotebook.com/surgery/der/fshkrmvl.htm

1. Indications
   1. Large hooks with single barbs
   2. Barb superficially embedded
2. Images
   1. Needle Cover Technique
      1. 
3. Technique
   1. See Preparation above
   2. Advance 18 gauge needle along entrance of fishhook
      1. Insert parallel to shank
      2. Bevel pointing toward inside curve of hook
      3. Longer edge of needle matches end of hook angle
   3. Disengage barb by advancing fishhook
   4. Pull and twist hook so hook point enters needle lumen
   5. Back the needle and hook together out of the wound