Duration: 1 month
Enrollment: 4th year medical students (up to 15 total). Contact Brenda Michael (bmichael@hsc.wvu.edu) for enrollment information and application for non-WVU students.

Objectives:
This course is designed to introduce 4th year medical students to the concepts of wilderness medicine and the treatment of environmental illness and injury. It will combine the standard ED rotation with focused wilderness medicine training. This should enhance the students’ experience during their ED rotation by allowing more direct discussion with ED faculty outside of the busy emergency department. In addition to the wilderness medicine objectives, a primary objective is to acquaint students with all aspects of emergency medicine. This includes interaction with prehospital personnel, the triage system, as well as care of patients of every age group with both major and minor problems. Emphasis is on a team approach to care and interdisciplinary communication.
Various teaching tools will be used throughout the course. Students will attend didactic sessions covering a range of WM topics (see list below). Practical skills workshops will reinforce the concepts taught in the classroom. An integral part of the course is the time spent outside in a practical field experience with simulated patient scenarios and demonstrations of wilderness rescue techniques. The students will participate in problem-based learning scenarios requiring teamwork and improvisation. Students will also work 10 shifts in the main Emergency Department, Fast Track, and with EMS. Students are expected to take histories, perform physical exams, formulate differential diagnoses, participate in treatment, and help arrange patient disposition. In addition, the students can expect to perform several procedures which may include suturing, splinting, pelvic exams, slit lamp exams, lumbar punctures, etc. Students will be exposed to emergencies in pediatrics, trauma, surgery, gynecology, neurology, and medicine. For didactic learning the students are offered a self-guided workbook for a cost of $20.00.

Examination Procedures and Evaluation Criteria:
Each student will be evaluated on clinical performance and participation in the scheduled workshop activities. Each will also be assigned a faculty mentor for the month. The student is expected to prepare a formal written history and physical on 2 or 3 patients they see in the Emergency Department and turn them in to their faculty mentor. Formal evaluations are given at the end of the month based on clinical performance, participation, and patient write-ups. There will also be a written examination at the conclusion of the course.

Prior to the start of the rotation contact Kim Menear on the 7th floor of HSC South, Room 7413, or call (304) 293-0294 to arrange a schedule. For any questions, please contact Jack Ditty at jditty@hsc.wvu.edu.

Preliminary schedule: (each student will do 10 shifts in ED, EMS, or Fast Track)
ED shifts are 8a-4, 2p-10, 8p-4, FT 2p-10, or EMS

1: Intro, Lectures 1p-4, Coopers Rock picnic 6pm
2: Lectures 8a-12, Splinting workshop 1p-3
3: ED conference 8a-12, Airway management workshop 1p-3
4: Lectures 8a-12, Medical kit preparation workshop 1p-3
5: ED shift or day off
6: ED shift or day off
7: ED shift or day off
8: ED shift or day off
9: ED shift or day off
10: ED conference
11: Appalachian Wilderness Medicine Conference
12: Appalachian Wilderness Medicine Conference
13: Appalachian Wilderness Medicine Conference
14: ED shift or day off
15: ED shift or day off
16: ED shift or day off
17: ED conference, ED shift or day off
18: trail maintenance workshop
19: ED shift or day off
20: ED shift or day off
21: ED shift or day off
22: Field practical TBD
23: Field practical TBD
24: Field practical TBD
25: Field practical TBD
26: ED shift or day off
27: ED shift or day off
28: ED shift or day off
29: ED shift or day off
30: ED conference, ED shift or day off
31: Exam

Practical Skills Workshops:

Splinting –Orthoglass, SAM splints, traction splints, improvised splints
Airway management –BVM and oral airways, LMA’s, RSI and ET intubation
Medical kit preparation –trip planning scenarios
Immobilization and evacuation –at AWMC with Doug McDonald and CREM
Cave rescue –at AWMC with Carl Werntz, Doug Moore
Swiftwater rescue –at AWMC with Charley Walbridge and Eric Nies

Didactic Lectures (* lecture at AWMC):

WM intro (8/1 1p -J. Ditty)
Head and spine trauma (8/1 2p –TBD)
Heat illness and lightning injury (8/1 3p –TBD)
Death in the wilderness (8/1 4p –J. Ditty)
International medicine and travel medicine (8/2 8a –TBD)
Marine envenomations and dive medicine (8/2 9a –R. Best)
Aeromedical transport (8/2 10a –TBD)
Drowning and hypothermia (8/2 11a –TBD)
Swiftwater medicine and waterborne illness (8/4 8a –J.Ditty)
First aid kits and trip planning (8/4 9a –M. Burriesci)
High altitude medicine, cold-related injuries (8/4 10a –J. Ditty)
Envenomations (insects and snakes) and anaphylaxis (8/4 11a –TBD)
ATV injuries*
Disaster medicine*
Jungle travel and survival*
Mountain biking injuries and orthopedics*
Poisonous plants of the Appalachians*
Mine rescue*
Hypothermia*
Appalachian infectious disease*
Wilderness resuscitation cases*