Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.See all posts »
Depending Upon Technology
To all medical students, residency graduates, or anyone else who moves from a highly supervised environment to one where you are on your own, welcome to the club. The whole point of learning how to be self-sufficient is to be able to go it alone when the need arises. What is most striking about wilderness medicine is the notion that one moves to a setting that is austere and resources (people, technology, supplies, communication, etc.) are frequently limited. This can be very unsettling for experienced practitioners, and is even more so for neophytes.
We live in an age of technological imperative. Doctors train in hospitals with large, complex intensive care units. The emergency department is equipped with all the latest gadgets, and specialists are on call 24 by 7 to help out when a difficult or puzzling situation arises. That is not the case in the wilderness, on the battlefield, or out at sea. Expectations change from perfection to doing enough to get the patient to a higher level of care, or just to make it through the hour, let alone the next day.
Think about it. Take your favorite medical instrument(s) and think about how you would practice if you didn't have access to it. Could you diagnose heart failure without a stethoscope and pulse oximeter? High altitude cerebral edema without a CT scan? Septic shock without a blood pressure monitor, central venous catheter, arterial blood gas measurements, and a battery of laboratory tests? I think the answer is "yes" if you were properly trained.
Technology is good. In fact, it is great. Patients are better off for the ability of health care professionals to apply all manner of diagnostic and interventional devices and techniques. However, I believe that at the same time we are all taught how to do things in the city, we should learn how we must sometimes do them in the country.
image courtesy of cdneverest2008.com
Tags: technology, improvisation, medical practice, wilderness medicine, outdoor medicine, healthline
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