You are in a canoe with two friends crossing a lake when suddenly one of them loses consciousness and falls overboard, tipping the canoe and all of its contents into the water. You swim to evaluate and rescue your unconscious friend while your other companion swims to retrieve your gear from the water. The two of you pull your canoe, your supplies, and your friend to shore and then go through the steps of evaluating, stabilizing, and resuscitating her. Fortunately, her “loss of consciousness” was merely acting so that your skills as a wilderness medical provider could be challenged and evaluated. This is just one of many simulated challenges you will face as a participant in a Medical Wilderness Adventure Race, or MedWAR.
Practicing medicine in the wilderness poses unique challenges: a lack of material resources and trained providers, difficult communication, terrain and geography that require dexterity and planning to navigate, uncertain weather, and even hazardous conditions. Keeping a patient's insulin from freezing, managing a severe allergic reaction, or constructing a splint for a femur fracture can test even the most experienced of providers. Caring for sick and injured patients for an extended period of time in the wilderness demands creativity and ingenuity.
History of MedWAR
The concept behind MedWAR was born in 1999 when Mike Caudell, MD, FACEP, an emergency physician at Medical College of Georgia, was speaking with his colleague, David Ledrick, MD, about the possibility of incorporating medical scenarios into adventure races. Initially conceived as a new way to educate medical students and residents, the concept was eventually presented at SAEM as an Innovation in Education. One of the most convincing arguments was that the educational value of a MedWAR event was essentially limitless. Whether you were a medical student just getting your feet wet, a resident overseeing a scenario, or an attending physician who did not get regular exposure to wilderness medicine, there seemed to be no shortage of potential learning opportunities. The inaugural race was held in 2001 in Augusta, Georgia.
The MedWAR mission is to “provide medical students, residents, health care professionals, and wilderness enthusiasts with a practical, interactive, and enjoyable curriculum for learning, applying, and evaluating emergency medical knowledge, skills, and techniques in a wilderness setting.”
While MedWAR competitions allow participants to practice their medical skills in demanding and uncertain environments, they also challenge teams to work together with accuracy and efficiency. Teams of various sizes (usually 3-4 people) accumulate points based on patient assessment skills, treatments, and time to completion. At each checkpoint, teams compete on tasks – for example, manage and evacuate a patient who has hyperthermia, or find and treat a victim of an avalanche burial. The MedWAR can last up to 10 hours, testing a team's endurance, communication skills, preparedness, and ration of food and water supplies.
The events can be tailored for particular skill sets and environments. For example, Dr. Caudell said, “We can be in the middle of the desert and change things up to say, ”˜Well how would you handle this if you were at 18,000 feet?'”
EMRA MedWAR at ACEP16
This year, EMRA's Wilderness Medicine Division is teaming up with ACEP's Wilderness Medicine Section to host its own adventure competition in conjunction with ACEP's Scientific Assembly in Las Vegas.
The EMRA MedWAR will take place Oct. 19, in the desert terrain of Nevada. The goal is to offer an opportunity for hands-on wilderness medicine experience outside the confines of a lecture hall.
The footrace is open to all EMRA members. A lottery system will be used to select 10 teams of 3 people each. Online registration will open this summer at emra.org/events/medwar. Entrance fees are $75 per racer.
We hope to see you in Las Vegas!