-: CWEMSE Day 26 :- [9/19/2024, posted late on 9/22/2024] Today’s Travel: 373 km Total Travel*: 11,955 km* Knot of the Day: VT prusik Max over 1 GRADUATION!! We have a tradition of holding our graduation ceremony a few days before actual graduation, since the final weekend is so jam-full of operations and adventures. So tonight, on Day 26 in the Poplar Creek Farm meadow, we celebrated the amazing accomplishments of our two Externs this year, MD-75 Laura Westneat (The University of North Carolina at Chapel Hill) and MD-76 Bret Naanep (University of Illinois Chicago). On hand to celebrate were the entire BRATT class as well as Extern Graduates MD-53 Chris Davis (EX13), MD-62 Wooten Jones via FaceTime (EX18), MD-68 Abigail Wehner (EX20), and MD-71 Kara Hatlevoll (EX22). Cake was delivered by Den Mother & Number 1 Volunteer Kelly Collings Hawkins. During the ceremony the Externs not only receive their plaques but also get to present the Golden Carabiner Award to the person who was most significant to their learning for the month. They presented it this month to Wooten Jones, our Associate Director for Coastal Operationsm who is responsible for the amazing experience that is the #CoastalModule. Congratulations to Wooten, who was also read an awesome original haiku written by the Externs for him: The Arch Wooten Jones Hunter of deer and disease We love your bald head Even more, congratulations to Laura and Bret—you have both excelled in this challenging rotation! Welcome to the ranks of Extern Graduates!! *total course travel distance to date for #MD1, #MD75, & #MD76, including by truck, motorboat, ambulance, firetruck, foot, helicopter, swimming, canoe, ferry, ocean rescue beach response truck, UTV & ATV, dune ambulance/response vehicle, electric vehicle (EV), litter travel, ascending and descending rope #CWEMSE2024 #cwemse #expeditionary #wildernessmedicine #wildernessEMS #essequamvideri #crewnotpassengers #medicalschool #emergencymedicine #hawkventures #yesthisismedschool #thisisanthropology #thisispublichealth #trainlikeyoufight #BRATT #BRATT2024 #WakeForest #technicalrescue #pilotmountainstatepark #poplarcreekfarm #poplarcreekflowerfarm #WakeForestWildMed #anchorbuilding #ropeskills #ropeskillsrigging #CWEMSEGraduation @HawkVenture @CWEMSE @UNC @EastCarolina

The Externs reppin’ the #CoastalModule during Day 4 of the #BRATT class on Pilot Mountain. #oceantomountains #CWEMSE2024 #NCoceantomountain #PIMO #PilotMountain #DareEMS #DareCountyEMS #WootenJonesMD #MD75 #MD76 #ChrisDavisMD #1718brewing #1718ocracoke #experientialeducation #essequamvideri #MD53 #MD62 @DareCountyEM

-: CWEMSE Day 13 :- [9/6/2024] Today’s Travel: 1,131 km Total Travel*: 7,613 km* Knot of the Day: overhand Externs #MD75 Laura Westneat and #MD76 Bret Naanep and Wake Forest Wilderness Medicine Fellow #MD68 Abbie Wehner (EX20) awoke against this morning at Jockey’s Ridge State Park at the conclusion of the #CoastalModule. They headed back west to Durham and a didactic session at Divers Alert Network. There they learned about the international work DAN does to prevent and manage diving injury and illness, toured the facility, and got to work with DAN international medical director Jim Chimiak. The remainder of the day was spent on stops in the Piedmont (including the Eno River!), completing precourse materials for the upcoming Landmark Learning Wilderness Swim Safety class tomorrow, and checking out the Morganton Historic Festival! Also there may have been another visit to Fonta Flora Brewery and Ono Poke Bowl, rapidly becoming the 2024 Externship hangout… *total course travel distance to date for #MD1, #MD75, & #MD76, including by truck, motorboat, ambulance, firetruck, foot, helicopter, swimming, canoe, ferry, ocean rescue beach response truck, UTV, dune ambulance/response vehicle #CWEMSE2024 #cwemse #expeditionary #wildernessmedicine #wildernessEMS #essequamvideri #crewnotpassengers #medicalschool #emergencymedicine #hawkventures #yesthisismedschool #ncparks #outerbanks #jockeysridgestatepark #dan #diversalertnetwork #divemedicine #SCUBA #scubadiving #enoriverstatepark #HistoricMorgantonFestival #onopokebowl #fontaflorabrewery @FontaFloraBrew @CWEMSE @HawkVenture

REPOSTED FROM @CWEMSE While in American EMS of the 20th century, helicopters were considered somewhat of a last resort option or were reserved for critical cases (with some regional exceptions), they were proliferating in rescue operations in Europe and Asia. At the turn of the century and into the 21st century, however, helicopters are becoming more and more ubiquitous in US rescue and field medical operations. In kind they are a growing part of our Externship training. Here, a MAMA - Mountain Area Medical Airlift @MissionHealthNC helicopter out of Asheville lands at Lake James State Park to orient them and UNC and Wake Forest University wildmed student interest group members to their operations. They have already worked with the Dare County EMS @DareCountyEM helicopter at the Outer Banks during the #coastalmodule and will spend an entire ride-along day with @MedCenterAir out of Charlotte. In the modern era, familiarity with military and civilian rotor wing platforms is a critical part of #WildernessEMS. #essequamvideri #helicopters #medtwitter @DavidMBaskin1 @NCparks @NCEmergency #thisispublichealth

-:@:-CWEMSE Day 12 Daily Travel (Total Travel): 666 km (10,150 km*) Knot of the Day: münter mule The Externs woke up this morning after repositioning west and made a visit to the Divers Alert Network world headquarters. After learning about dive medicine, resuscitation, and this famous diver resource—which was the formal end of the #coastalmodule—they made their way further west to Winston, where they stopped for resupply and a Zoom call with the remarkable Steve Smith, author of _Beneficial Risk_. Risk analysis and "safety" considerations have interwoven throughout this Externship month, and his book is required reading for them. They got to hear first-hand his provocative and compelling concepts of Safety 2 and his proposition that "safety is not the absence of risk but rather it is the presence of capacities". Great opportunity to speak to a true expert in this area. While they continued further west, Hawkins and the rest of the leadership team were getting two dozen UNC and Wake Forest medical students into canoes at Lake James State Park for our annual WFU-UNC WildMed Lake Day. The students paddled a little over 2km out to the paddle-up-only campsites on the Long Arm Peninsula just before sundown. The Externs followed them shortly thereafter, chased by the setting sun, and they are all settling down for the night under the warm September stars and surrounded by the lapping lake water. Esse quam videri! *total rotation travel distance to date, including by foot, climbing, rappelling, ascending, car, truck, ferry, UTV, helicopter, dune ambulance/response vehicle, canoe #CWEMSE2023 #cwemse #expeditionary #expeditionmedicine #wildernessmedicine #wildernessEMS #essequamvideri #crewnotpassengers #medicalschool #emergencymedicine #hawkventures #yesthisismedschool #WakeForestWildMed #wildmed #WEMS #UNCBlueRidge #WPCC #NCStateParks #MD73 #MD74 #LakeJamesStatePark #WFUWildMedLakeDay #safety2 #safetythird #DAN #diversalertnetwork @DiversAlert @NCparks

CWEMSE Day 11 Daily Travel (Total Travel): 2,484 km (9,484 km*) Knot of the Day: münter hitch We awoke this morning to 45 mph winds, sideways rain, and flooded roads. We repositioned last night into the Jockey’s Ridge auditorium (thx to the kind rangers there!) to avoid tents in a tropical storm. We were a bit spooked by the possibility of a “Night at the Museum” scenario with all the taxidermy animals (hence the picture with the stuffed raptor yesterday) but all was well as the storm raged outside our walls. After a breakfast celebration of WFU EMS Fellow Memu-Lye Kamara’s birthday, we ventured even further north. Today took us to the remote, furthest north tip of the Carolina Outer Banks. We visited Fire-Rescue-EMS stations at Corolla/Currituck/Carova, including the famous Station 7 only accessible by off-road dune vehicles which fields dune-adapted response vehicles in an area without roads and remote from any other medical care services. The Externs then moved away from the storm-surging Outer Banks—the portions of Rt 12 they had taken just the day before were flooding, as we had discussed as a risk—and repositioned further west, to wrap up the #coastalmodule tomorrow. *total rotation travel distance to date, including by foot, climbing, rappelling, ascending, car, truck, ferry, UTV, helicopter, dune ambulance/response vehicle #CWEMSE2023 #cwemse #expeditionary #expeditionmedicine #wildernessmedicine #wildernessEMS #essequamvideri #crewnotpassengers #medicalschool #emergencymedicine #hawkventures #yesthisismedschool #WakeForestWildMed #wildmed #WEMS #UNCBlueRidge #WPCC #NCStateParks #MD73 #MD74 #coastalmodule2023 #currituckems #corollafirerescue #nationalparkservice #thisispublichealth #HurricaneIdalia

I woke up yesterday morning on Ocracoke Island running the Carolina Wilderness EMS Externship #coastalmodule. I drove 800 km yesterday (plus a 90 minute ferry ride) simply to make my public health class last night with Dr. Apryl Alexander... and it was so worth it! Then this morning, before driving back to the coast, I had class with Samantha Haigler Nevins, which was equally worth the trip. Her class has made me aware of the #thisispublichealth movement out of the Association of Schools and Programs of Public Health. As y'all have surmised from my recent schooling endeavors, increasingly I think most of what I do in "medicine" is actually public health. I love the idea of the ASPPH "this is public health" movement! I'm going to begin tagging posts that I think are public health-based with this hashtag. Honestly, I think the challenge will be finding those times it does not apply rather than the reverse. As I prepare to make the 560 km drive back to the coast to reinsert into the #CWEMSE coastal module, I am poignantly aware (largely because Dr. Wooten Jones, our Associate Director for Coastal Operations, is an MPH and flavors our work with this perspective) that age-adjusted death rates are substantially greater in Eastern North Carolina than the rest of the state for virtually all major causes of death. If the 41-county Eastern North Carolina region were a state, it would be about twice the size of CT (where I grew up) and would rank 43rd worst state in the country for premature mortality. As a LEMA and medical director for numerous state and federal spaces in this region, this drives and underlies my work and justifies my crazy driving—because you have to be, at least episodically, physically in the communities you are serving. This is the way. This is esse quam videri. This is public health. #cwemse2023 #essequamvideri #appliedanthropology #roadwarrior #unccharlotte @CLT_CHHS @CLTPublicHealth @PublicHealth @DrAprylA @ASPPHtweets @NCparks @ncculture @NCEmergency @USFSRegion8 @CapeHatterasNPS @CapeLookoutNPS

CWEMSE Day 7 Daily Travel (Total Travel): 1,319 km (4,001 km*) Knot of the Day: alpine butterfly Our Externs and Wake Forest University EMS & Wilderness Medicine Fellows arrived this afternoon in Goose Creek State Park to begin our #coastalmodule. They were oriented to the upcoming week by our Coastal Associate Course Director #MD62 Wooten Jones (EX17), who also made us his famous shrimp and grits (wow). We learned about Goose Creek State Park and its EMS and #SAR coverage from Superintendent Joseph Martin and planned out our predawn departure for the Swan Quarter ferry to Ocracoke tomorrow. Our tents are pitched mere meters away from the Pamlico Sound and the salt air is filling our lungs and our souls. The coastal adventure begins! *total rotation travel distance to date, including by foot, climbing, rappelling, ascending, car, truck #CWEMSE2023 #cwemse #expeditionary #expeditionmedicine #wildernessmedicine #wildernessEMS #essequamvideri #crewnotpassengers #medicalschool #emergencymedicine #hawkventures #yesthisismedschool #WakeForestWildMed #wildmed #WEMS #UNCBlueRidge #WPCC #NCStateParks #MD73 #MD74 #coastalmodule2023 #stercorefactumquestus @NCparks @HawkVenture @WakeEMresidency @WakeForest @BrownUniversity @EmsWake @WakeWildMed

CWEMSE Day 6 Daily Travel (Total Travel): 95km (2,682 km*) Knot of the Day: water knot Day 6 is a recovery day between the 5 days of #BRATT we just completed yesterday and the 5 days of the #CoastalModule just about to begin tomorrow. The Externs get to sleep in a bed, enjoy hot showers, do laundry, and generally reset. Recovery days are also times to knock out some of the reading for the rotation. Our book list includes Hawkins's Wilderness EMS @WEMSText, Auerbach's Wilderness Medicine, Smith's Beneficial Risk, Dworkis's The Emergency Mind @TheEmergMind, and Van Tilburg's Mtn Rescue Doctor. *total rotation travel distance to date, including by foot, climbing, rappelling, ascending, car, truck #CWEMSE2023 #cwemse #expeditionary #expeditionmedicine #wildernessmedicine #wildernessEMS #essequamvideri #crewnotpassengers #medicalschool #emergencymedicine #hawkventures #yesthisismedschool #WakeForestWildMed #wildmed #WEMS #UNCBlueRidge #WPCC #NCStateParks #feedyourbrain #recovery #MD73 #MD74 @DavidMBaskin1 @WPCC_Pioneers @WakeWildMed @NCparks

#CWEMSE2022 Day #14 Our #wfuwildmedstudentlakeweekend ended w/ 2 mi paddle back to #LAJA to meet Dr. Chimiak of @DiversAlert. Then #MD71 #MD72 pivoted to #CoastalModule, launching for Goose Creek SP,Pamlico Sound,& #OBX portion of training w/ #MD62 Wooten Jones (EX18)! @NCparks