Wilderness on the Water: MedWAR 2022

EMRA members met at Lake Chabot Regional Park near San Francisco on Oct. 4 to compete in MedWAR, the annual test of medical knowledge, wilderness skills, and endurance.

The sunny temperate climate of the West Coast was certainly a welcome relief compared to the blustery conditions during MedWAR 2021 in Boston. The roughly 11-mile course circled the lake, taking competitors from scenarios on the water to panoramic views of the City by the Bay.

What is MedWAR?
MedWAR, short for Medical Wilderness Adventure Race, is a competition concept developed in Augusta, Ga., and created by Drs. Michael Caudell and David Ledrick. Teams race through an orienteering course peppered with medical quizzes and proctored wilderness medicine simulation challenges. It’s a test of strength, endurance, adaptability, and medical knowledge — all rolled into one.

Since its inception in 2000, MedWAR has been adopted internationally, with versions hosted by multiple medical schools and residency programs. EMRA MedWAR debuted in 2016, led by the Wilderness Committee’s Carrie Jurkiewicz, MD, and Geoff Comp, DO, with faculty advisors Drs. Caudell, Taylor Haston, and Paul Auerbach, MD, MS. It has become one of EMRA’s most dynamic annual competitions.

Escape from Alcatraz
Before daybreak, more than 30 volunteers gathered their supplies and dispersed to six stations throughout the park. Once competitors arrived, EMRA Wilderness Committee Chair Katie Kammert, DO, reviewed race details and rules while everyone fueled up for the day. At 9 am, racers began their trek by “escaping Alcatraz” through a series of wilderness medicine matching cards and scrambled letters that eventually led them to tying the “King of Knots,” the bowline.

MedWAR Trio.jpeg

Circumnavigating Lake Chabot
After escaping the notorious, cold, shark-infested waters, teams encountered a diver in distress who was covered in jellyfish stings. Thankfully, there was a research team onboard that had an ultrasound graciously provided by Butterfly to diagnose a pneumothorax. From the Florida Keys, competitors climbed more than 1,000 feet where they embarked on a search-and-rescue mission from Denali basecamp. Teammates worked together to recover a climber suffering from High Altitude Cerebral Edema (HACE) and a femur fracture that required improvisational skills to make a splint and hypothermia wrap for transport.

MedWAR Rescue 1.jpeg

Their journey took them downhill to the swamps of Georgia and some drunken “noodlers” who found the wrong end of a cottonmouth. A representative from BTG (CroFab creator) was able to play the victim and help racers think of resources that might be available inside and outside their ED. Further down the trail, an explosion occurred at a local meth house resulting in a mass casualty and pandemonium. While trying to treat an opioid overdose and blast injuries, racers had to ameliorate the agitated delirium of actor Michael Nguyen, MD, in order to perform a lateral canthotomy for his retrobulbar hematoma. Wild boars of Zakopane, Poland, attacked local hikers, transpiring in one patient suffering from an evisceration and open chest wound while the other victim distracted rescuers with his screams about his problem “down there.” A priapism reduction in the wild was a first for MedWAR and certainly drew attention to the course. On the final stretch, racers returned to the beach where a surfer was found down after a lightning strike. A nearby shark wasn’t deterred from this opportunity, so the victim required a tourniquet and CPR to help the victim “hang ten” again.

Trekking For Tacos
With five minutes to spare, all teams finished the race and celebrated their success over tacos. Last year’s champions from Albany, Receptaculum Ignis, placed third, while Stanford, with three minutes to spare, took the victory from the Turkey Sandwich Titans of Riverside. The Spirit Award honoring Dr. Paul Auerbach went to Miles of Smiles from Rutgers Medical School for their enthusiasm and embodiment of wilderness medicine. Team members received an autographed copy of Dr. Auerbach’s book, Wilderness Medicine, courtesy of Elsevier. Acting awards went to Michael Nguyen, MD, and Drake Johnson, MS-3, from UCSF for both distracting racers yet also teaching them valuable procedure skills. Many thanks to Elsevier, Butterfly, BTG Specialty Pharmaceuticals, and Zanfel for their generous contributions that helped this race become a reality.

EMRA Wilderness Leaders
This event would not have been possible without the hardworking members of the Wilderness Committee: Chair Katie Kammert, DO; Chair-Elect Matt Basinger, MD; EMRA Board Liaison and Past Chair Yev Maksimenko, MD; Vice Chairs Kara Hatlevoll, DO, FAWM, Tyler Rigdon, MD, and Kaitlyn Votta, MD; and Assistant Vice Chairs Joseph Mueller, MD Candidate Class of 2023, Danusha Sanchez MD, MIS, PMP, NREMT, Sasha Selby, MD, and Sarah Spelsperg, PA-C, FAWM, FEWM, MD Candidate Class of 2023. Special thank you to Medical Director Lainey Yu, DO, MS, FAWM, and MedWAR faculty advisors Michael Caudell, MD, FACEP, and Taylor Haston, DO, FACEP. Finally, we greatly appreciate the staff at EMRA including Heather Deja, Candice Grantham, and Leah Stefanini.

MedWAR Group.jpeg

If you are interested in joining the committee for MedWAR at ACEP23 in Philadelphia this October, please email emrawildernessctte@emra.org, and join us for our planning meeting during CORD Academic Assembly 2023 in Las Vegas this March.

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