The new SOAP note app allows you to create highly accurate SOAP notes in ways that were not possible before. As patient care transfers from one level of care to the next, patient care data can now travel with the patient. SoapNoteApp enables you seamlessly transfer your SOAP notes from person to person. It tracks and secures all your notes. It includes a digitally signed change record so you can be confident your notes are safe. You can access your notes from anywhere at any time.

As well as clear simple screens that allow you enter data quickly and accurately, the new app has additional features such as streaming text, which allows you to keep a log with a time stamp, easy fill in boxes for vital signs with time stamp, an injury location screen that allows you to touch locations on a schematic of the body of the patient to more accurately highlight injury sites as you find them. The app also allows you to place a priority on specific injuries and treatments and then change those priorities as treatments are applied. The app records all of this data easily and allows you to go back and look more accurately and easily at events as they unfolded on scene. If you carry an iPad, iPhone, or Android this app can make your SOAP notes cleaner, more accurate, and easy to access digitally—check it out. SoapNoteApp

We hope that this message finds you in good health and ever eager to create and engage in new experiences.

Because the SOLO experience trains us with an eye cast for ‘emergency’, we never know when we may be called upon or in what capacity to be in service to others. With the current “Occupy” events that have been sweeping the nation and globe, there is a rising opportunity for those with SOLO wilderness medicine training to be put to use.  There are calls out in many cities across the US for on-site medical volunteers at these venues, so there may be good opportunity to strengthen your skills in a location near you.  Mind you – this post is NOT about politics.  It is about patient care an opportunity to respond to needed help to put our skills to work.  ‘Street medics’ in this context are volunteers with varying levels of first aid or professional certification who may or may not agree with the reason for protest but want to help others.

We often restrict our potential with the thought that our training in a ‘wilderness’ context limits us to that environment.  As events of natural disaster and mass casualty incidents teach us, urban environments can quickly present ‘wilderness’ challenges in access to definitive medical care and how care is administered.  Environmental obstacles can be diverse in an urban setting especially when it involves a mass of people.  Scene safety in an urban context presents itself much differently than in the back-country!  Experience and learn if your will and time allows.

If you want to see if there is an opportunity near you, you can click this map link and see the list of sites below the map and click again on a link for local information or try the Occupy Together website.
Some sites are more organized than others and may take time to assess the need -  so patience with communication may be necessary.  Take time to to tap into the local social media network to gauge the current ‘climate’ at the scene. Things happen on the protest grounds organically, much as they do in developing countries or disaster situations I have experienced.

A few points to keep in mind if you pursue:
- Keep politics out of medicine. Expectation is that of a good Samaritan and a good provider will create bridges of security / safety.
- Though the protests here in the US have been largely peaceful, there is always the potential for on-scene police or protester violence.  Be aware and prepared for a potential change in scene safety.  Take precautions. Do not incite violence but diffuse it if opportunity presents.  Scene safety first!  Nonviolent action is best action.
- Go prepared to take care of yourself above all. You cannot treat patients if you put yourself at risk.

Let me know if you have had any experiences worth relaying back to us.  We’d love to hear them.

Best wishes of health and safety!

–
Nickie Sekera
Assistant Director
SOLO

She was almost fifteen years old, and as the picture below shows, taken three days before her death in the SOLO shop, she was still in pretty good shape.

Saxon, still on the job three days before she died.

With little warning, age suddenly caught up with her and over a forty-eight hour period, her strength failed, her system failed, and she was gone. She passed away quietly in the living room of the cottage where she lived with Ted and Judy, surrounded by the people who loved her, and without suffering.

During the twelve years that she was with us, she had an impressive career. While at SOLO she participated in many of our Advanced Leadership and Emergency Care (ALEC) programs, numerous advanced WEMT Modules, Navigation courses, boat building courses, staff trainings, she was on the search committee for a time, and she was a regular proctor at EMT exams held at the New Hampshire campus in Conway. She attended numerous evening gatherings in the Roundhouse, where she met many students over the years.  In Addition she oversaw the complete renovation of the offices of TMC Books, the building of three sea kayaks, a 24 foot open pulling boat, a 16 foot sailing tender, the building of the boat shed, and the complete renovation of a 35’ Friendship Sloop. She had sailed the entire length of the coast of Maine from Kittery, into Canadian waters and back three times (the first time she needed more papers to cross the border than the boat did) and has been on cruises too numerous to count all along the coasts of Maine, New Hampshire, New Brunswick, and on Lake Champlain in Vermont. From 2003 on she was a regular at the annual Friendship Sloop Homecoming in Rockland. In 2005 she was the Boatyard Dog for the 2005 May issue of Maine Boats Homes and Harbors magazine. She was one of the main characters of the children’s book Merlin and the Black Star, and the SOLO Field Guide to Wilderness First Aid Afloat is dedicated to her.

Ever watchful.

She was such a ubiquitous figure on the SOLO campus that we all catch ourselves expecting her to appear around the corner, but we are so grateful that her end was swift, and grateful to have shared such a large life lived by such a small creature. We miss her a hundred times a day.

Saxon 1997-2011

Goodbye old friend.

Located in the heart of the Colorado Rocky Mountains, the Apex Mountain School has been offering SOLO courses continuously for five years.

photo from Apex Mountain School web site

Based in Vail, Colorado, Apex’s curriculum is taught by full-time SOLO instructors with real life experience in the field of backcountry medicine. The Apex/SOLO standard curriculum is offered for backcountry guides and enthusiasts alike, and both Wilderness First Responder and WFR recertification courses are provided.

The eight day Wilderness First Responder course and WFR recertification course are held at Camp Hale, Colorado. At just shy of 10,000 feet, Camp Hale was a training ground for the 10^th Mountain Division in preparation for high altitude mountain combat in the Alps during WWII. This amazing location neighbors forest service land, and free camping, mountain biking, hiking and climbing are just minutes away. 13,000 foot peaks and pristine rivers border this Vail location among some of the most beautiful mountains in the U.S..

The towns of Vail and Leadville are only a 20 minute drive for food and supplies, as well as additional activities including climbing, fly fishing, and more.

The upcoming Colorado Wilderness First Responder course is offered May 22-29, as well as June 12-19, and the WFR recertification course is offered May 21-22 and June 11-12, 2011. The Wilderness First Responder certification is active for three years, after which the standard WFR recertification course renews the credential.

For more information on Apex’s courses, you can visit http://apexmountainschool.com, contact Apex by email, or call (888) 686-7685. To register, visit http://apexmountainschool.com/wilderness-medicine.

December was a busy month for SOLO Nepal and Initiative Outdoor. In mid-December we ran a WFA course only to turn around and start a 5-day AWFA. Both courses were taught at the Kakani Center for International Training with the classroom set up on a mountaintop overlooking the Kathmandu Valley on one side and the Himalayas on the other side.

While most of the students in the AWFA work as guides, there were several other “outsiders.”  All but one of the students spoke varying degrees English, so the course was taught half in Nepali and half in English. As with the previous courses here, simplifying the medical terms was the biggest hurdle.

Despite these hurdles, the class had a great sense of humor. Every time a helicopter was called for an “evacuation,” the call was placed to Washington D.C. because all of the helicopters in Nepal were busy. We were assured that the response time from the States would be approximately 5 minutes.

Just as one would expect in an international course, these classes have been slightly amended to fit the situations most likely to be encountered in Nepal. More emphasis was placed on techniques and equipment relevant to the types of injuries and illnesses encountered in the Himalayas.  Cultural differences played an important part in how the material was presented and perceived.

Initiative Outdoor is currently advertising a WFR for late February and is gauging interest for more AWFA and WFA courses for the spring.

Pheri Betola,

Chandra Ale and Initiative Outdoor (SOLO Nepal)

The class was made up with a group of students based in Zambia going through what Overland Missions calls their AMT or Advanced Missions Training course.  The course is designed to prepare people to survive on their own, far off the beaten path for both medical missions as well as Christian based missions trips.  The class at the base this year was made up of people from both the US and Africa.

With the class being on the base we had plenty of space to play with and run various scenarios.  The problems that arose in Africa were unique in a lot of ways to the African environment.  The class was very worried about elephants as just before I arrived to the base a woman with a 10 month old child was attacked by a wounded elephant walking down the street. The woman had been ripped into three pieces and the child had broken her legs.   During the class we focused a lot on the problems that the class was likely to run into either out driving around or out in the villages they travel to on expedition.

medical teaching scenario

medical teaching scenario

medical teaching scenario

During the two weeks that I was at the base in Zambia it wasn’t necessarily all work.  I did have the opportunity to play a little bit.  On the first Sunday that I was on base we all went to the three star hotel about 15 minutes away where we went swimming and also were able to walk out onto the Victoria Falls during the dry season.  This gave me the chance to swim in the Zambezi River just above the falls.  That swim had to be cut short because of a crocodile seen just up river from the swimming hole.

On the following weekend I had the fortune of being able to go and walk with the lions at chief Mukunis’ wildlife preserve.  The amazing thing about walking with the lions is that they allow you to do it without any enclosure or safety measures, you truly get to walk with wild lions on their territory.  The experience was amazing.

During the final week of the course we were able to wrap up all of the WFR topics that a normal WFR course would get as well as add in some of the African animal talks and environmental differences.  The class’s final scenario was one of the most challenging scenarios that I have ever given a WFR class.  Their scenario was that an elephant had attacked a group of people on the base.  The class of 12 people had 7 patients with various injuries laid out around a giant baobab tree.  The patients had to be triaged by the class and they all needed treatment.  Their patients ranged in age from 4-60 years old.  One of the patients had a critical head and neck injury and had to be carried two miles back to the base on an improvised stretcher while the rest of the patients could be some variation of splinted or bandaged and walked back to the base.  The whole scenario was an amazing success and the class was able to learn a lot not only about triage and treatment but also about teamwork.

the big scenario

After that scenario was over the class headed into its final day, which was by far the longest day of class.  That final day consisted of a Third World Disease course that incorporated numerous third world diseases and parasites that the students had the potential to come across in their third world missions work.  The class was made up of two major parts.  The first part of the course was a lecture component that consisted of a powerpoint presentation that contained S/S and treatment for the numerous problems.  The second part of the course was a case-study portion where the students were given a case and given the chance to ask questions about the patient in order to attempt to diagnose and treat the patient for a disease of parasite.  The class once again achieved this goal with amazing speed and accuracy.

After the completion of the Third World Disease course the class was over and everybody was given their certifications.  The next morning I was leaving the beautiful base and a bunch of new friends behind to board a plane and start a long slow process of coming home to New Hampshire.  Even though I am back in the states and enjoying being back on the SOLO campus once again, I will not forget the experience and even more importantly the people from the amazing Overland Missions base in Zambia.

Josh MacMillan

SOLO Staff

Josh MacMillan, ace SOLO instructor, is just back from another trip teaching in Africa. This trip brought him to Zambia to teach a Wilderness First Responder course.

Despite scorching heat, the course went very well, and while there Josh got to visit a wildlife sanctuary where he got to play with cheetah cubs, lion cubs, and walk with grown lions.

You can watch a video of Josh among the Lions below:

If you have been to the main campus at SOLO, then you might have visited our small retail space on the first floor of the Main Building. Through the work of a number of people here on staff, we have finally set up an online version of the SOLO Store.

To check it out go to:http://stores.homestead.com/hstrial-CLewallen/StoreFront.bok

The SOLO store on campus

If you have questions, call Christine Wirling at 603-447-6711

We have recently returned from our combined course in Chitwan National Park. We held a WFA, along with an outdoor leadership program that totaled about six day’s. Perhaps there is no where in the country that the rain is heavier during monsoons than the Terai district and Chitwan NP. It was a challenge just to get there and back. On our commute we had 10 hour death defying bus rides, swollen river crossings by pole boat, land cruiser rides through frame deep mud (we did a great deal of pushing from time to time) and finally when the road disappeared we waded with our packs and gear through waist deep water while feeling for the road track under our chaco’s. I noticed that when I couldn’t see my feet under the water I couldn’t help think about the huge cobra population in the Terai. I quickly put that non constructive thought out of my mind! (I had been brushing up on my research to teach the Nepal version of bite’s and stings). I think it made the whole experience that much sweeter.

Taxi!

The Chitwan course had to be taught solely in Nepali. The course rosters were initially filled out in Nepali as well. I thought of turning them in to Jill (SOLO’s executive Director) just as they were however I value my Job too much so Chandra kindly translated them.

Chandra Teaching

Once again, I am humbled by the hunger to learn demonstrated by the student’s. It showed Chandra and I that these courses are very valuable and again very well received by the guiding and rescue community. The dedication to learning shown by the student’s was inspirational. In the end the perceived language barrier was no barrier at all as Chandra did most of the talking!

While thing’s wind down for me in Nepal this time they continue to wind up in the Initiative Outdoor office for the future. Although we were not able to run all the courses we had hoped, the one’s we did do went smashingly! The Nepal Winter course’s, SOLO included, are building as I write this. Chandra, his staff and I continue to plan for what lies ahead. I see more chapters in this worthwhile endeavor unfolding and I am sure I will set foot here again very soon.

I thank Chandra, his staff at Initiative Outdoor, his family & friends for welcoming me back and helping make my stay a complete blast!

Again, on behalf of Chandra, myself, and all the student’s we recently had the pleasure of teaching, We give our sincere thanks to Frank, Lee, Jill, Bill and all the rest of the SOLO staff that made this happen (you know who you are). Ted, Thanks for editing my scribble!

Gerry Brache

Namaste and Pheri Betola,

Gerry Brache & Chandra Ale, SOLO

PS: I had recently been volunteering at a local street dog rescue shelter here in Kathmandu. Soooo…., as it turns out I have a small, black, four legged, furry friend who will be moving from Nepal to Maine! I couldn’t help myself! Welcome Kalee.