Confined space rescue training, physically very demanding. I spent the whole week totally outside of my comfort zone. I’ve done a number of  “austere” medicine training programs over the years, but this one was by far the most realistic and the toughest.

While the medicine was based on what I already know and do, the perspective is quite different. Add prolonged extrication times to injuries found in any number of disaster scenarios and the entire dynamic of treating patients changes.  EMS is the perfect job for the ADD generation. Especially urban EMS. Thirty minutes or so of patient contact you you’re done. In this setting you could be spending hours with a patient that can’t be removed or moved for hours. Which just adds to the problems of treating them.

Interestingly one of the instructors had a perspective on rescuer safety that meshed nicely with my post I’ve Seen Some Things, Man. We didn’t create the disaster and while we have a lot of compassion for the victims and will do our best, we have to remember that getting ourselves killed is not going to help. It’s their emergency, not ours. Sounds harsh, I know, but it’s reality.

Before this class I never understood how physically and emotionally exhausting it could be to sift through the wreckage of a building trying to locate and rescue victims. In EMS we don’t see a lot of building collapses on an every day basis. And when we do, it’s ONE building and we have plenty of resources to help. In a case like the tornadoes in the south or earthquake anywhere, it’s hundreds of buildings and most of the local infrastructure gone or degraded. A completely different mind set is required.

Every muscle in my body is sore today. So is every muscle in my brain, but I’m a smarter medic than I was a week ago. I’m glad I went.