KU School of Medicine-Wichita

Embark 2014

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"I would recommend it to any medical student who enjoys being in the outdoors," Klein said. But the real takeaway for the students is similar to what the Scouts themselves experience: confidence in their abilities. "We were expected to know the things a resident would know," Klein said. "We were challenged for hours. I really enjoyed calling the shots, I guess," Klein added. "I didn't have to check with each and every person before doing everything. I had a lot of freedom. Because of that, I double-checked myself a lot. I solidified my knowledge and just learned a lot more." As a 17-year-old Eagle Scout from Derby, Roger Klein dove into the camping, hiking, and other adventures that make the 214-square-mile mountain wilderness at Philmont Scout Ranch world famous. On his return, as a fourth-year student at the KU School of Medicine–Wichita, Klein tried to make sure today's Boy Scouts got to enjoy it as much as he did. "Of course, when you're working in the Health Lodge, usually the kids who are there are having a bad day," Klein, now 26, said. "Since I knew how much fun it was to be out there, we made it our goal as much as possible to get the kids back out on the trail as soon as they were medically able." Hands-on … from blisters to bears Klein is one of two dozen KU medical students who volunteered for a monthlong rotation at the ranch in northern New Mexico this summer, part of a decades long partnership between the two institutions. KU medical school faculty members serve as attending physicians at the camp. Karen Drake, assistant director of student affairs, said the program is so popular with students that there is usually a waiting list to go. And it can make for some interesting tales. When KU students treated a Scout who'd been attacked by a bear, Drake said, "I heard about that for the next six months." Dr. Garold Minns, dean of the medical school, spent a week at the camp in August. "I looked forward to it, as I do every year," he said. "I'm pleased that our students also get so much fulfillment out of it." The medical students live in college dorm-like rooms and work out of what Klein calls a "very nice clinic" with a trauma room and wing with about 15 beds for patients requiring overnight care. With about 2,000 Scouts and adult volunteers using the ranch and engaged in fairly strenuous activities, the clinic stays busy. Many of the problems are routine – blisters, turned ankles, poison ivy, minor cuts. Others are more serious, such as adults suffering chest pains. "We get to kind of practice as residents would," Klein says. "It's just us and the attending doctors. We see the patients all by ourselves. A lot of times we just treat the patients on our own and send them on their way." Triage along the trail Because the ranch is so large, the medical students often communicate via radio with Scouts and volunteers, helping them take care of minor medical issues themselves. "They'll say, 'Hey, I've got this Scout who's got nausea, diarrhea, vomiting. Here's his vitals. What do you want us to do?'" Klein said. "We try to assess the patient and determine whether he needs to stay there and get treatment in the mountains, or if he needs to come down and get further evaluated. If that's the case, we figure out transpor- tation." In other instances the medical students travel to the scene themselves – by an ambulance fitted with off-road tires if they're lucky, otherwise on foot. "There are lots of places the roads are not close to," Klein said. That's what happened when Klein got called to the top of Tooth of Time mountain, the ranch's best-known peak. Initial reports were that a 15-year-old scout had fallen, hit his head, and suffered a seizure. Klein and a fellow student hiked 1 1 / 2 hours up the mountain, carrying medical gear on their backs. "He ended up being OK," Klein said. "We got him fluids and food. We kind of think that it was hypoglycemia and stress." Walking the Scout back down the mountain took another three hours. Klein was also called out to treat several cases of anaphylaxis, or severe allergic reaction, with epinephrine. One adult patient was brought in with what the students thought was dehydration. When he didn't respond to fluids, students realized he was actually suffering from hyponatremia, or extremely low sodium. "That's a pretty life-threatening situation we were able to be a part of treating,'' Klein said. Taken to a hospital, "He was back 24 hours later, a totally different person. We sent him back on the trail." Hard work … fun … confidence gained Despite working 70 to 80 hours a week, Klein said medical students have some time for hiking, horseback riding, shooting, and other camp activities. U Lacerations U Broken bones U Rashes U Headaches U Allergies U Dehydration O F F - R O A D M E D I C I N E Both of Roger Klein's trips to the Philmont Scout Ranch in New Mexico proved exciting, but for very different reasons. ''They probably get more out of it than they do any other elective during their fourth year. The attending physicians actually stand back and let the students run triage. It's an opportunity to practice wilderness medicine on an ER basis.'' 12

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