Zucker School of Medicine first-years-in-training aid injured hiker
Beginning on day one of medical school, first-year medical students at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell train to become emergency medical technicians by working shifts on Northwell Health ambulances, responding to 911 calls, and helping people in distress. In fact, Zucker School of Medicine is among the first institutions nationwide to establish a curriculum that requires new students to become EMTs.
“If it weren’t for the early exposure to patient care and EMT training we received right at the start,” said first-year student Zarina Brune, “we wouldn’t have known what to do.”
Brune is referring to a weekend excursion on May 5 to Echo Lake in the Catskills, New York, where she and 17 classmates involved in a Zucker School of Medicine special interest group called wilderness medicine put their newly honed skills to test in the recovery and rescue of an injured hiker.
“After a four mile hike, we set up camp and ran various stations for a wilderness medicine event, which was the purpose of our visit to the lake, when suddenly a man came out of the wilderness and flagged us down for a help,” explained Kevin Richardson, a first-year student who served as co-leader of the group with Brune. “We were in the right place at the right time.”
Knowledge in action
A subspecialty of emergency medicine, wilderness medicine differs significantly from conventional approaches to care that are oriented toward the urban environment. Training involves instruction on how to manage a medical emergency when help is miles away and calling 911 isn’t an option, including how to handle situations that entail prolonged patient care, severe environments, and improvised equipment. Participation in the wilderness medicine group at the Zucker School of Medicine is voluntary.
“It is an area of medicine that teaches you to be flexible and to learn to think outside of the box,” said Brune, “exactly what we encountered at Echo Lake.”
The hiker in distress, 38-year-old Anthony Jones of Patchogue, Long Island, had slipped while walking on a down tree stretched across a stream. He fell nearly 10 feet to the ground and landed on a large rock. His left knee dislocated upon impact and he was bleeding—the muscle tissue exposed in the back of the leg.
“I was in shock initially and then came tremendous pain. Fortunately, I was with two friends—one ran for help while the other stayed behind with me,” said Jones who is an EMT at Stony Brook Hospital and a Coast Guard Reserve.
Medical students arrived on the scene with equipment grabbed quickly from their campsite. They assessed Jones’s condition and cleaned the wound. Given the location, late time of day, and predicted rain, the students decided that the only option would be for them to move Jones back to their campsite.
“We were miles from cell phone service to be able to call for help,” said Richardson. “There was no way for a vehicle to get into the area.”
The students went to work creating a makeshift splint and stretcher. It was decided that a small group would manage the patient while the rest of the students collect and prepare materials for the support mechanisms. Bandages and trekking poles were used to brace Jones’s leg while long, thick tree branches bundled together and connected to backpacks were used to form a rudimentary stretcher. Students dug foot holes along the side of the steep ravine to manually hoist Jones up from where he had fallen and onto the awaiting stretcher.
“It took several people to carry the stretcher. We had one person stationed at the patient’s head, one at the base, two on the right side, and four people on the injured side who were stabilizing his leg, waist, and shoulders because we did not know the complete extent of his injuries,” said Brune. “We learned in our EMT work that everyone needs to be on the same page and have a role,” continued Richardson. “For example, the person stationed at the head takes the lead by calling commands and keeping the lines of communication open.”
Students not working directly with Jones ran ahead to clear trails and pathways through the brush for safe travel. They also formed a human brace to help those manning the stretcher to cross several streams steadily. The journey back to camp took nearly three hours where paramedics were waiting.
“By this time we had to treat the patient for shock and cover him with a hypothermic blanket which we had on hand for the trip,” said Richardson. “We gave our report to the paramedics, but we weren’t done.”
Team approach to care
After transferring Jones to the stretcher brought by paramedics, the students stepped-in and spent an additional hour helping the paramedics to transport Jones out of the valley on foot to the main trail where he was eventually transferred to an ambulance. Jones spent four days in the hospital where he underwent surgery to fix his dislocated knee, tendons and ligaments. He may require further surgery depending on progress and will enter physical therapy.
For now, Jones is healing at home and spending time with his two children, ages four and 10, and his wife, a Northwell employee. He views the incident as life-changing and is grateful for “the angels” who helped him.
“I compare what these students did to what we do in the military. They were immediately able to establish leaders and followers. Everyone knew their part and got on point very fast,” said Jones, who recently returned from hurricane relief efforts for the Coast Guard in St. Thomas. “How they were able to organize and take control made a bad situation more comfortable for me, I knew it was going to be okay.”
Although unexpected, the students see the experience as the job they have been taught and prepared to do.
“In our training [at Zucker School of Medicine], we have been able to see and learn what people do under pressure,” explained Brune. “You can be book smart but practically speaking, reality is the best teacher.”
Special thanks and praise to all the first-year students involved in the Catskill rescue. For more information about the Zucker School of Medicine curriculum, including EMT training, visit medicine.hofstra.edu/education.