Trial by Fire, Water and Mud
Weather conditions can be a wildcard when holding any outdoor event. And on July 20, 2019, the elements added lessons to the already challenging rural disaster drill on the family farm of Kimberly Lansing, MD, PhD.
“Our farm was flooded the day before, so things were wet and muddy. On Saturday, there was a tornado warning in the north part of our county, and we had to take a break for a thunderstorm,” Lansing recalls. “We managed to get through the entire drill just before another thunderstorm dumped a bunch of rain on us again.”
At the farm in La Crosse County, Wisconsin, Lansing and a team of planners ran 26 medical students through realistic scenarios to help them learn what it takes for first responders to safely do their job as they rescue patients at accident scenes and transport them to emergency facilities.
The students are enrolled in the University of Wisconsin School of Medicine and Public Health’s (SMPH) Wisconsin Academy for Rural Medicine (WARM), which trains medical students who are committed to improving the health of rural communities, with the goal of easing the physician shortage in underserved areas. The students came together from their various training posts in rural hospitals and clinics throughout the state.
The La Crosse-based Gundersen Health System/Western Academic Campus of the SMPH is one such place. A family physician there, Lansing also is an SMPH clinical adjunct faculty member and the site director for WARM students, as well as the assistant director of curriculum and faculty development for the WARM Program.
On a typical weekend, Lansing enjoys the peaceful acres of her farm. But on the day of the disaster drill, she donned rain gear and ran around with a clipboard as she coordinated with several faculty members and emergency personnel to orchestrate mock disaster scenes throughout the landscape. Rather than peaceful, the farm looked like several types of accidents had occurred simultaneously.
First thing Saturday morning, GundersenAIR, the emergency medical helicopter for Gundersen Health System, landed, and its staff conducted a group training session for the medical students. Next, five rural fire departments guided the way as the trainees became mock paramedics to “rescue” medical simulation mannequins in the following situations:
- a motor vehicle accident involving a mother and child, where the students needed to extricate the victims and treat them for injuries
- a mock drowning accident, where they had to rescue a 6-year-old child from the bottom of a swimming pool and resuscitate the youth
- a tree-stand accident where the victim was hanging upside down for several hours from a harness, and the students needed to treat him for compartment syndrome
- a search-and-rescue operation involving a diabetic patient who was out walking in the woods, broke his ankle and developed hypoglycemia and hypothermia.
“This is a working farm, so there were animals, fields full of hay that we had not been able to cut due to lots of rain, and of course, droves of mosquitos,” says Lansing. “Students wear 30 to 40 pounds of turn-out gear and perform real duties, like cribbing tractors or cars, with the firefighters and paramedics.”
She continues, “The drill helps the students understand how much effort it takes to establish scene safety, perform early interventions and figure out the best way to transport an injured patient to that nice clean emergency department where people might be waiting and wondering ‘What’s taking them so long to get here?’”
During the drill, medical student Marissa Paulson, who had helped create the child-drowning scenario, told WXOW TV in La Crosse, “It’s one thing to read [in a textbook] about a child who might have drowned, but to walk upon the scene—even though we know it’s pretend—it gives you a different feeling, and you have to think in a different way.”
Lansing credits a huge team of people who made this opportunity a reality. Players include GundersenAIR paramedics; Integrated Center for Education staff; SMPH faculty members; Stoddard, Shelby, Westby, Viroqua and Campbell, Wisconsin, fire departments; and La Crosse Emergency Management personnel.
“We do the rural drill with different scenarios each year on our farm, and we also conduct an annual urban drill at various locations,” says Lansing, adding that faculty members incorporate student feedback when planning future sessions.
Because the University of Indiana is interested in conducting similar training, four of its students participated in this rural drill. Without a doubt, they returned home with memories of a wet but exciting day in Wisconsin.