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Unit 151: The first infirmary unit stationed in the backcountry

July 13, 2022 — Out in Philmont’s backcountry, it can sometimes take a few hours from an emergency call being placed until an Infirmary staff member could get to a patient. In medical emergencies, every minute counts.

Philmont is striving to reduce its response time. Director of Medical Services Nate Lay had the idea of having an infirmary unit stationed in the backcountry and put it to the test last year. The unit would respond to medical emergencies and encourage crews to stay on the trail when they have minor injuries.

The pilot program was a success, saving Philmont Infirmary up to an hour and a half of response time. This year, the 48-hour shift as Unit 151 stationed at Beaubien is an official part of the Philmont Infirmary Drivers’ rotation. Beaubien is a nice fit because it is centrally located in the South Country.

“They’re staying busy, responding to infirmary calls all over the south country,” Lay said. “It cuts off an hour of our response time to have trained medical people with medical equipment that much closer to someone in an emergency.”

The Infirmary would like to extend their backcountry units into the North Country in the future, once resources become available.

Philmont Infirmary driver Ashton Callahan discusses pain relief options for a patient with another driver, Christian Sanders, as staff members Justice Borchard and Will Maniscalco finish loading gear in the back of the Suburban at Lower Bonito at Philmont Scout Ranch in Cimarron, N.M., on July 7, 2022.

Ashton Callahan, a licensed Paramedic who works as an infirmary driver for Philmont, discusses the best route to take as he backs the infirmary vehicle out of the Beaubien parking lot. Callahan’s teammate, Christian Sanders (not pictured) is an EMT-basic. Sanders helped navigate to the patient’s coordinates with their GPS. Infirmary dispatched Unit 151 as Callahan and Sanders were returning to Beaubien from Black Mountain.

Though Unit 151 is stationed at Beaubien they typically are not there long, except to sleep. This time, Unit 151 was at Beaubien long enough to drop off personal gear, grab a pizza bagel and refill their water before they were back in the Suburban.

Christian Sanders kneels next to Unit 151’s blood pressure cuff, stethoscope and pulse oximeter, which is stored in an empty pill bottle for protection. These are tools Philmont Infirmary uses to evaluate a patient’s vitals when they first arrive to assess a patient.

Sanders and Ashton Callahan (not pictured) arrived at their new patient after a two-mile hike. The patient, a ranger, likely pulled a muscle in her back putting her in extreme pain. Her crew stayed with her until Unit 151 arrived. The patient rated her pain an eight on a one to ten scale. She was unable to stand up on her own.

Unit 151’s first assignment for their day was to reunite Peg Malley, advisor to crew 701-9-E1, with her crew. She is hiking down to Black Mountain Camp with Christian Sanders and Ashton Callahan (not pictured). Malley experienced severe altitude sickness while summiting Trail Peak with her crew a few days earlier. Infirmary called on Unit 151 to respond. Since Unit 151 is stationed at Beaubien, they were able to respond much faster than if a unit from basecamp responded.

Malley expressed her appreciation for Unit 151. “It cuts your response time down, it minimizes the risk to the patient and it calms the rest of the crew,” Malley said.

Will Maniscalco, Beaubien’s assistant camp director called upon to help Unit 151 with the medical rescue, helps Christian Sanders pull crutches out as Ashton Callahan sizes them for the patient. The crutches will help the patient hike out of the trail to the Suburban ambulance parked at Lower Bonito Meadow at Philmont Scout Ranch on July 7, 2022.

Ashton Callahan, the patient, Christian Sanders and Will Maniscalco slowly hike up the “Stairmaster” Trail towards the backcountry Suburban ambulance near Lower Bonito. Despite being in extreme pain, the patient has to hike up to the clearing. It would take significantly longer for a carry team to assemble, hike to the patient and carry her to the ambulance.

The patient maintained a positive attitude, however, throughout the two-mile hike. She even cracked jokes throughout, making everyone laugh. The patient knew relief would be on its way once she made it to the car, and that is what kept her going.

Ashton Callahan asks the patient if she has ever had Hydrocodone before and if it made her nauseous. Philmont EMTs keep a pouch of narcotic pain medications with them during their shifts to use on patients in severe pain after working with a medical doctor at the Infirmary. Callahan radioed down to the Infirmary to ask permission to administer both Hydrocodone and Toradol. The Infirmary also keeps a yellow bag full of medicines for cardiac life support and other medical emergencies in the infirmary vehicles.

The patient lies in a litter in the back of the backcountry Suburban ambulance. The litter has straps to secure the patient and allow for a safer transport in the Suburban. Unit 151 transported the patient down to the Infirmary at basecamp, a two-hour-long drive.

Callahan advocated for the patient to get a shot of Toradol in addition to Hydrocodone because the patient endured a grueling hike and still had a long ride ahead of her. The Toradol would kick in faster than if they just used the oral pain reliever.

Will Maniscalco, Ashton Callahan and Christian Sanders help the patient out of the backcountry ambulance and into the Infirmary emergency room at Philmont Scout Ranch in Cimarron, N.M., on July 7, 2022. The patient has since been treated and is doing better. After filling out some paperwork and resupplying Unit 151’s medical kit, Callahan and Sanders return to Beaubien to finish their 48-hour shift before the next Infirmary staff members become Unit 151.

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