Bright and early on a Sunday morning, twenty-five members of KCL Wilderness Medicine Society headed in to Guy’s Campus for a full day’s training on expedition medicine, led by Dr Amy Hughes (Medical Director of Expedition Medicine) and Dave Marshall (HEMS paramedic). We kicked off the day with a whizz-through of a wide range of tropical infections, from the common, such as malaria and dengue, to the lesser-known myiasis and lymphatic filariasis, with useful tips on identifying these infections and their treatment – the diploma in tropical medicine in a nutshell!
Dave then spoke on his ‘pet’ subject – the importance of saving the first clot in pelvic trauma. Showing us graphically how usual practice will almost inevitably cause the initial clot to dislodge, I’m sure he convinced everyone on the merits of using a scoop, rather than an extrication board when extracting casualties. Leading on from this, was a practical session with teams of students getting the chance to bundle Dr Hughes up, ready for extraction. We covered various scenarios that may be encountered on an expedition, including what to do when the active 70 year old gentleman in your team is complaining because his hip replacement has popped out!
Next up was a session on primary survey of casualties in the wilderness. While this at first seemed no different to what we do when we’re not in the ‘wilderness’ (some would argue that South East London is a wilderness in its own right!), when discussing the very high value of a simple cough, and what alternatives are available when it’s simply too loud to hear breath sounds through your stethoscope, it became clear that medical school doesn’t teach you everything! Most of the students got a chance to practice performing a quick primary survey on a tattooed casualty that went by the name of Dave…
We moved back to the AV room to hear about the phenomenal Namibia Ultramarathon that Dave worked as a medic for, and some of the cases he came across. This led on nicely to a talk on heat injuries by Dr Hughes, and the potential problems when treating such cases, such as the effectsof fluid replacement on sodium balance. This was on the verge of becoming a bit too academic for a Sunday afternoon, so we decided it was time for the team challenge…
We were split into two teams, given a rope and 10 minutes, and the task was to produce a stretcher that would allow us to extract that tattooed casualty from the wilderness. After much head-scratching, (and possibly use of some contraband iphones), both teams had produced something that vaguely resembled a stretcher. Dave very bravely agreed to test out each stretcher, and remarkably, both stretchers held strong to the finish line. Clearly KCL students are naturals when it comes to the wilderness. The winning stretcher had extra holds to facilitate a longer carry, and the team was very proud of their Expedition Medicine mousemat prizes!
Having ‘exerted’ ourselves far too much, we headed back up to round off the day with a talk on jungle expeditions, and all the beasties and creepy crawlies to avoid, followed by a very valuable list of do’s and don’ts, when putting medical kits together. Basic principle: DO take lots of bandages and pain killers; DON’T forget the pregnancy kits!!! We finished off with a brief overview of Dr Hughes’ story, as an exemplary illustration of the many opportunities available to students and junior doctors in expedition medicine.
All in all, a fantastic day, packed full of very useful information on expedition medicine. This was the first time we ran a day like this, and will definitely be building on it next year. KCL WMS would like to thank Dr Hughes and Dave Marshall, wish Dr Hughes all the best with MSF, and hope they will come back to KCL soon, to inspire another bunch of budding expedition medics!
Words by Neeraj Shah