All posts by SALA Remote Medics

SO MUCH TO LEARN!

Having been in EMS for a couple decades before coming into the remote medicine arena, I thought I had a pretty good handle on patient care. I did. What I was not aware of was all the other stuff I needed to learn. As I have mentioned before, my introduction to remote medicine was through a friend of mine who hired me to work in a remote area of a western state.

My introduction to seismic/ remote work started off well. Good pace, not too fast, not too slow. I felt prepared as I went to my first job site in nice, warm, sunny weather. I saw folks with some sunburn… nothing dangerous. Watched folks throughout the day in order to make sure they drank enough water. Again, not a bad gig. I saw my first heat rash. Easy to treat with a little Gold Bond powder. But, as I continued my work in more remote areas… like on the sea in the arctic circle, I quickly realized that while I was good at what I do as a Paramedic, I was not fully prepared to deal with the other stuff… athletes foot, common cold symptoms, the aches and pains of everyday life. I found that I had some time at work (how to fill the time at work will be addressed in another blog) on personal improvement projects.

When one works on an ambulance in an urban setting, it’s easy to do the minimum care that protocols require because sometimes that’s all the time you have before reaching the hospital and handing over care to the nurses and physicians. When one works more rural, say in a farming or ranching community, one is often able to do more as they tend to be further away from the hospital. However, when one works in an area that is far away from a hospital, maybe by hours or days, then one must be familiar with the steps that would normally taken to care for the patient if they were at a hospital much sooner.

In the case of a cold or athletes foot, it’s simply a matter of monitoring the patient and treating the symptoms with standard over-the-counter medicines, or making sure they are frequently changing their socks and using fungus cream. Then there are those times when the patient is sicker… vomiting, diarrhea that won’t stop, migraine headaches, or worse. Those are the times when having seen hundreds, if not thousands of patients over ones career can be extremely helpful as the astute paramedic has been learning from every patient encounter, realizing that paramedic school and the first few years of their career is the training ground.

Do I know everything about the patients I see? NO! Will I know everything about them before my career is over? NO!!! I do my best to stay current with accepted, standardized treatment for the illness’ that I expect to see. I spend part of my days at work reading medical literature online or by e-textbooks that I bring with me. I speak with my physician sponsor on a regular basis. When I am not in the field, I attend as many classes as I can in an effort to provide my patients with the best care possible.

There is so much to learn, everyday. I have always felt that. And I will continue to strive to for a high level of excellence.

By Scott Nelson, B.S., NRP, MICP

What…You Live on a Train in the Arctic?

That is usually the follow up question that I get when people ask me what it is like to be a remote paramedic in the arctic of Alaska during winter.  I bet as you are reading this, you are sitting there asking yourself the same question…So let me tell you a little about it.

Just like anywhere in the world, land is a precious item and it is one that we are all trying to preserve and protect. The North Slope of Alaska is no different, and despite anyone’s personal opinions, companies care about it as well. Therefore, during the winter months when the snow is falling and temperatures dip to negative 70 degrees at times, it allows for the best time for exploration without damaging the area.

To do this, companies build temporary camps that are known as sleigh camps, or cat-trains and we glide across the snow without disturbing the tundra below. It is amazing, because when summer hits and the snow melts, there is absolutely no sign that anyone has been on the land.  I know what you are saying right now, “You still have not explained what a sleigh camp, or a cat train is?”

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So here goes, a cat-train is a set of boxcars just like you would see on a normal train running on tracks, except this train sits on skis. Yes…skis just like you would use to ski down a mountain, just much bigger.  There are five boxcars per train, (or string) as we call them. These boxcars can have a multitude of different functions. Some of the cars have sleeping quarters where up to three people stay in them. Others have things like a diner, a kitchen, administration offices, computer labs, and a medical clinic, which is where you will find someone such as myself.

camp aerialNow, as I explained before there is only five box cars per string. Therefore, we must have multiple strings. In most camps, there are between five and eight strings that are lined up side-by-side when we are parked. This is where the term “sleigh camp” comes into play and at times there can be upwards of 150+ people living in this camp. These camps move every 3-5 days depending on the goal and the size of the project.

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So how do they move?  Well that is where the word “Cat-train” comes from. We use tractors to pull the strings when we decide to move. This could be as simple as moving a couple thousand yards to protect the tundra from long layovers and at other points we travel 10-20 miles in a day, except they only move at about 2 miles per hour. So needless to say, those can be long days.

It is probably one of the strangest things I have done in my career. I live on a train, that sits on skis, that moves across the snow every few days, and then we set up shop again. However, I will tell you that I am so glad that I was given an opportunity like this. There are people who dream of going to Alaska. Not only did I get to go to Alaska, but I got to do it unlike most and I got to do it in style!

By: Jason McLaughlin, B.S., NRP, MICP

The Privilege of Working

The privilege of working “Choose a job you love and you will never work a day in your life”. This quote has been attributed to Confucius. Pretty smart guy if you ask me. When I tell people what I do… work in remote medicine as a Paramedic in the arctic, the first question they ask is “How do I get a job like that?” Followed by “isn’t it cold there?” The answer to the first question, at least for me, is that I knew someone and he brought me up here at a time when I needed to see EMS through a different lens. More on that later. The answer to the second questions is… “Yes”. That is the easy one… IT IS THE ARCTIC AFTER ALL.

After working in Emergency Medical Services (EMS) for nearly two decades (at that time) in roles including; wheelchair vehicle driver, emergency medical technician on a transfer ambulance then to emergency medical technician on a first response 911 ambulance, promoting to paramedic,  then having the pleasure of becoming an Educator for an EMS training program and a Fire Department and finally becoming a Clinical Director for an ambulance service. I think it’s safe to say that I had seen many aspects of EMS, the good, the bad, and the ugly. I needed a change or I needed to get out of the business that I had loved for so long but began to despise.

I was able to find a short-term position with a remote medical service provider. The first remote job I picked up had me spending three weeks in an isolated spot in a western state. It was perfect! I was able to remind myself that there is more to EMS than just chasing one thing after another. I was being paid a decent wage, and I was able to checkout from technology (cellphones and internet access) as well as the grind of running emergent and non-emergent call after call for a while. It is amazing how that can clear one’s thoughts and change your perspective.

Over time, I found myself working in remote areas of Alaska, on the sea as well as on land. The coolest part? Most of my work in Alaska has been in the Arctic Circle. Yes, it IS cold there. I have had the opportunity to see the northern lights, whales, walrus, seabirds, foxes, caribou, musk ox, and wolves. I have observed people in one of the harshest environments on the planet and watched them thrive as human beings. I’ve learned about industrial areas that I had not previously been exposed too. I have met people from areas of the world I had not even conceptualized beyond reading National Geographic or watching the Discovery Channel and learned about their families, their homes, cultures, and values.

I left this job for a short-time to pursue an opportunity that was presented to me. That opportunity was a J-O-B. I felt as though I was showing up to work every day and forgot what it was like to be happy. I realized that I missed working in remote medicine and returned to a job I love. It is a privilege to find a job that is enticing and challenging but rewarding and yet still pays well.

I do not really feel like I go to a job anymore. It is not work at all; it is fun, interesting, and an adventure. As soon as one tour is over, I find that I cannot wait to return for my next.

By Scott Nelson, B.S., NRP, MICP