Remote Medical International Blog

Travel Smart, Travel Safe: Radio Interview with Andrew Cull

Tom Milne — Tue, 09 Jun 2009 14:47:47 PDT

RMI CEO Andrew Cull recently gave an interesting online radio interview, hosted and moderated by Larry Kaminer, President of the Personal Safety Group, which offers public and private training for a variety of groups including corporations and schools. The Personal Safety Group's online radio show brings experts in various elements of safety to his audience.

During this interview, Andrew outlines considerations for pre-trip planning and safe practices for international travel, and gives some interesting tips from his diverse experience.

Click here to listen to the interview on Travel Medicine online.

Wound Management in the Land of the Yeti

Kate Earle — Mon, 18 May 2009 18:45:21 PDT

Flying in a twin jet otter airplane (named after the abominable snowman "yeti") high above the Himalayas in the 12th poorest country in the world makes you question your mortality. "WOW! Look at that mountain!" is interrupted by sudden statements of sheer terror, "I think we are going to crash into it!!!" As the plane tumbled and pitched through the choppy Himalayan air, I furiously fumbled through my iPod to find appropriate music should the plane come any closer to scraping the peaks and mountain passes below. In just 40 minutes, we had flown from the hot, malarial, dusty, and flat Tarrai planes of Southern Nepal to one of the poorest and remote districts of Northwest Nepal perched high in the Himalayas along the Tibetan border.

It was no sooner than we hit the dirt runaway (that was incomprehensibly short) that we began to see signs of the recent Maoist insurgency. Dugout fox holes, sand bags, and rolls of barbed wire surrounded the airport and otherwise picturesque town of mud-walled and tin-roofed houses. Brian Smith (Founder and President of HAND- Helping Assist Nepal's Disabled and former RMI WEMT student) and I had come to conduct a Disability Needs Assessment in the Humla region. We quickly found that many of the disabilities would be war related and the others would be the result of lack of basic infrastructure such as roads, electricity, and a minimum 10 day trek to the closest staffed medical post.

In this small Himalayan town, there are no cars, no trucks, and no motorcycles, only the ringing of Tibetan bells around the necks and muzzles of yaks, burros, and horses making their way up the hillside. This was drowned out by by the piercing thud of the UN helicopter's rotors- slicing the mountain air and drowning the town in a cloud of dust. Several times a week, the United Nation brings in bags of rice since the Humla region suffers from food shortages year round. It is a critical lifeline for the 45,000 people of the Humla region where only 1 percent of the land is arable.

As an RMI Instructor, I am constantly defining "remote" medicine and "remote" environments. As the plane and chopper disappeared over the mountain range in a cloud of dust, I knew that definitive medical care was out of the question. The weather in Simikot (like most of the Himalaya) is known to spontaneously turn so the flight schedule was entirely contingent on conditions. Limited resources? Check. Lack of communication? Absolutely. Environmental challenges? Between the altitude, temperature, and UV exposure, this was also certainly the case. We set out with our medical kits, gear, a porter, and a translator into the definition of remote.

I am carrying a customized version of the Adventure Medical Kits Mountain Medic II and I am glad I have it as we immediately stumbled across an eight year-old who had sliced his finger open with a rock. Gangrene infection had set in. Not long after, another 12 year-old boy had hit the top of his foot with an ax while chopping wood. To control the bleeding, his family poured ground flower tikka powder (usually Hindus reserve this for covering the third eye to protect the wearer) to assist in clotting. Both patients needed considerable wound cleaning and management in a setting where soap and clean water is virtually nonexistent. We were not just treating them until they could get to definitive medical care, we were the medical care- a responsibility that runs through your head incessantly as you make decisions.

Irrigating a gangrenous axe injury with drinkable water while we figured out our next steps.

In the remote regions of Nepal, soft tissue wounds secondary to simple accidents such as these can lead to life long disability and even life threatening infections. The power of rudimentary skills and supplies,such as soaking, high pressure irrigation, tincture of benzoin, triple antibiotic cream, and sterile dressings cannot be underestimated.

We are now gearing up for phase three of our work here in Nepal which will involve identifying and guiding patients with treatable blindness through the Solokhumbu region to a remote eye surgery clinic in Phaplu. This is sure to be an unforgettable experience. The path is steep and narrow and the patients will be partially or completely blind. With that said, HAND (with Remote Medical International's donated medical gear and medications), will attempt to restore their eyesight if at all possible at a remote Cataract eye surgery clinic.

Despite the sometimes harrowing plane flights, food shortages, probable monsoon leeches, and political unrest that seems to shut down the roads everywhere we go, we are thrilled to put our knowledge and skills to the test. Our work in Nepal has and will continue to prove the critical nature of WEMT skills in places where medical care can be as elusive and virtually nonexistent as the infamous yeti.

Dispatch From Everest Basecamp - Part 3

Melissa Arnot — Wed, 13 May 2009 14:07:34 PDT

The weather at Everest Basecamp can be very unpredictable. Mostly, when it snows or the clouds move in it is just a little less comfortable, but at other times it can be the difference between life and death. The past few days at BC have seen really bad weather, cold with lots of snow and wind. In that same time there have been a few people who needed to be evacuated by helicopter, but have had to wait due to the poor conditions.

Remote Medical instructor Melissa Arnot assists HRA doctors in treating a poisoned climber.Unfortunately, in the midst of this bad weather a major medical emergency occurred. Some small bottles of whiskey came into basecamp that contained Methanol in them, which is a toxic poison if ingested. Two people drank this whiskey. Right away I heard the Himalayan Rescue Association needed help and went over to see if I could do anything. Watching the doctors move around and working was seeing remote medicine at it's finest. The patient that they were helping was very sick, and my Wilderness EMT skills were greatly appreciated. One of the first things to do as care providers was to think of all the things that could go wrong and how we would deal with them. The most important priority for this patient was airway, and with no suction device present, we immediately went to work on fashioning an improvised suction that could remove the fluid in the airway that we couldn't get to any other way. It was amazing to see everyone take inventory of what we had and start thinking outside of the box just like we teach in all of our wilderness medicine courses.

Once we were able to manage the airway, evacuation become our next priority. It was snowing outside and it didn't look good for a daytime evacuation, which meant preparing shifts to take care of the patient through the night. So much of taking care of this really sick patient was basic ABC care and watching for any changes that might tell us what was going on inside of this patient. In addition, we had to maintain IV fluid, foley catheter and simple cardiac monitoring. It truly made me realize the value of teaching these skills in the Remote Medical Wilderness EMT course to future WEMT graduates that could be in this situation.

A team of helpers carry the poisoned climber over difficult terrain to the helicopter landing zone.At first light we received word that a helicopter would be coming. We quickly secured the patient and prepared him for transport as a whole team of people prepared a litter for carrying. I was elected to stay at the patients head and manage the airway as we carried him to the helicopter pad, about 1/4 of a mile away from the clinic over rocky (and snow covered) terrain. We prepared a group of 7 to carry the litter and headed out. As we were walking, the helicopter landed and then took off again. I couldn't worry too much about what was happening, as I had to worry about the steps in front of me, but I did wonder where that helicopter went. Once we got close to the landing pad, we got word that the helicopter hadn't been able to idle and instead took another two patients out who were already at the pad when the helicopter landed. I, and all the other rescuers, felt disappointed but we were assured another helicopter was on the way, just as we watched more clouds move up. We waited for almost an hour, then decided we needed to get the patient back to the clinic and hope for a helicopter the next day.

The doctors at the HRA, and 3 other doctors from around base camp, did such an amazing job of stabilizing this patient. Everyone really came together, and much to everyones surprise his condition began to improve over the next day. It was such a great sign, especially knowing that we would have another full night ahead of us. Fortunately, a helicopter was able to land at first light the next day, and the patient was transported to a hospital in Kathmandu in stable condition, which was a big improvement from the critical condtion that we started with. No doubt the outcome would have been different if everyone hadn't been so dedicated to helping and also willing to really practice remote medicine and think outside of the box.

Dispatch From Everest Basecamp - Part 2

Melissa Arnot — Mon, 04 May 2009 10:54:25 PDT

May 2, 2009

As I made my way down from Camp three at 24,700 feet the feeling of an increased oxygen supply was energizing. As I moved past camps lower and lower, the angst and the danger lifted. Unfortunately, though, one of the most objectively dangereous parts of the mountain is the closest to base camp, the Khumbu Icefall, and this time would be no exception.

Just one hour from basecamp, a loud rumble from above let me know that we were in the danger zone. An enourmous ice avalanche came rushing down the side of the mountain, into the path in front of us, dusting the climbing route for more than a minute. I quickly took stock of the climbers that were with me, everyone accounted for and uninjured. Immediately the radio started going off with climbers checking to ensure that everyone was safe and after a few moments the determination was made that we were the closest climbing party above a group of climbers that were unmoving and out of contact.

I took over as accident site commander, and headed to the spot where the climbers were reported to have been last seen. My mind was racing with all the possibilities of injuries... what supplies did I have with me, what training the people around me have, and again the possibilities of injuries. As I approached I quickly communicated with the climbers. Luckily, everyone was accounted for and uninjured, but the climbing route had taken a beating, making it hard to pass. Our Sherpa's immediately took control of the situation and helped to move the shaken climbers through the area of hazard. As we continued on, my mind raced thinking about the potential disaster that was avoided.

Upon return to basecamp, I went to the clinic to check in with the staff and see if anything interesting was happening. It is an incredibly interesting and challenging place to be learning new medical skills, and the amazing doctors have promised to alert me if anything unique is happening. Dr. Eric Johnson greeted me with the tally from the past week. Among others, there had been a heart attack that was evacuated by helicopter, a possible thrombus in a climbers knee stopping circulation to the foot, and as I was there a Sherpa came in with a crush injury to his hand.

As I looked at the nailbed that was cut open, Lhakpa Sherpa, a WFR, gathered cleaning supplies. The doctor quickly looked at me as she searched for the right suture material. "You know how to suture?" she asked as I looked at the damage. "Not on a nailbed" I said as she prepared the anesthetic. "Skin is skin" she said, and it is true. Sometimes the big picture blocks the way of what is really in front of me. As she draped the hand, it was true, I could no longer tell where the skin was, and it truly was skin, no different from the practice I had done in the WEMT courses.

Like I said, basecamp is a tough place to learn, but also a great place to challenge myself and my remote medical skills. I have a few more days now at Base Camp, and I hope to spend much of that time in the clinic, seeing how a clinic functions on the terminal morain of a glacier, and seeing how I function in that clinic.

Techniques for Fishook Removal

Andrew Cull — Fri, 17 Apr 2009 11:45:00 PDT

I was forwarded a link today from a discussion board at Northwest Kayak Anglers discussing techniques for Fishhook removal, a great self-study with interesting images. Click the following link to check it out: Techniques for Fishhook Removal

Dispatch From Everest Basecamp

Melissa Arnot — Thu, 16 Apr 2009 13:38:08 PDT

17,500 feet Everest Base Camp

(April 10, 2009)

I have taken the responsibility of Expedition Medical officer for First Ascent's "Return to Everest" Expedition, and each day I have been checking in with the team. As we have trekked, my work has been little, but prior to the trip the task was large. We have 15 members and prior to the expedition there was a lot of work to be done. As I completed health histories and checked on members own personal first aid supplies, I felt thankful for the guidelines that Remote Medical has given me for pre-expedition medical care. Now, at Base Camp, talking with the doctors, I can rest a little easier knowing that our team started off on the right foot.

Yesterday our team completed ten days of trekking in the amazing Khumu valley, on our way to Everest Base Camp to begin our 60+ day climbing expedition. The trek starts at about 9000 feet, which is a big elevation jump for all of our team members coming from the states. As we trekked along through the amazing river valleys and endless hills of the Himalaya, I was struck by the remoteness of the area. One unique attribute of the Khumbu valley is the lack of motorized traffic. After landing in a small village of Lukla, all the villages are linked by a series of trails. All the goods travel to and from the villages on the backs of residents and yaks. The weather has been nice most mornings, which allows the occasional helicopter to land, but as you can imagine, that is a lesser used option for transporting goods.

Remote Medical International Lead Instructor Melissa Arnot outside her tent at Everest Basecamp.As we walk for a few miles each day I find my mind thinking about the 'what if' of medical emergencies. I have seen a porter carrying another sick porter on his back, by no means a rapid evacuation. The Khumbu valley is one of the most highly traveled regions of Nepal and there are a few well placed resources in the event of illness or injury. At 14,200 feet in a small village of Pheriche there is an aid clinic for both trekkers and porters. It is staffed by volunteer physicians and each day they give a talk about the risks of altitude and the environment. It has proven to be a great preventative measure in education that has certainly stopped many people with altitude illness from ascending. After Pheriche, the villages get more sparse and the next major community is Everest Base Camp.

The arrival at Base Camp marks the site of a clinic that is run by a non-profit organization called the Himalayan Rescue Association (HRA). This clinic ends my feeling of being in a remote setting. It is currently staffed by three amazing volunteer doctors and one Sherpa, who is trained as a WFR. The clinic has advanced imaging equipment, gammow bags, and a pharmacy of medications to treat everything from GI illness to severe pulmonary edema. Perhaps the most amazing part of the clinic is the communication and evacuation. They are linked by radio to the clinic in Pheriche, and if needed, there is a helicopter landing pad which a contracted helicopter can use to complete rescues (weather permitting).

As I spent my first night in Base Camp, I sipped tea and chatted with the physicians that will staff the clinic this year. We were all in agreement that a successful season would include lots of high-altitude horse shoes, golf and the occasional softball tournament. To accomplish this, the HRA clinic sits right in the middle of Base Camp where almost all climbers will need to pass by to start the climb. As people pass the doctors offer a friendly wave and everyone hopes for a quiet season, free from illness.

Stay tuned for more entries concerning the medical side of an Everest expedition at Remote Medical's Blog.

Follow the daily dispatches from our expedition at First Ascent's Blog.

Tempus IC®: The Next Step in Telemedicine

Tom Milne — Wed, 15 Apr 2009 10:04:47 PDT

Imagine that you are presented with a patient with a potentially serious medical emergency, far from definitive care. You have to use your medical training and experience, if you have any, with the assistance of whatever diagnostics you have on hand and make what could be a life-or-death call. Is it a cardiac incident, a gastric ulcer, or simply indigestion? Do you have enough information and the confidence to either decide to mobilize a complicated and costly medical evacuation, or to try to manage the situation yourself hoping that you have made the correct diagnosis? It's a huge responsibility, a worst-case scenario even for trained responders.

Breakthrough

Enter the Tempus IC® Remote Diagnostic Device. The Tempus IC ®has simply revolutionized the field of remote medicine. The Tempus® is a remote diagnostic device that transmits clinical grade vitals signs, video and voice, wirelessly and in real time. The user is guided through activation and diagnosis via video prompts, and touchscreens allow for complete ease of use. Signals are sent via satellite to a server, and those signals are sent directly to our Remote Medical ACCESS™ Telemedicine team where our doctors can read and analyze data and even direct the device to take readings with a push of a button. Remote Medical International is proud to offer our clients this valuable device, with the additional capability to send readings directly to our telemedicine team for unprecedented remote support. I recently ran the Tempus through the paces in France and was simply blown away.

Compact and portable: 8" high x 10" wide x 3" deep, less than 6.25 pounds (stand alone dimensions, without case)Capabilities

The Tempus IC® generates a full range of clinical-grade readings including:

Blood Pressure
Pulse Oximetry
Tympanic Temperature
Blood Glucometry
Full Diagnostic 12-lead EKG
Breath Gas Analysis and Respiration

Any materials needed for diagnosis (glucose strips, alcohol swabs etc.) are packaged in color-coded compartments in the device's carrying case. The Tempus will automatically notify the user when items need to be restocked based on it's own audit of the readings history. Most of the diagnostics are Bluetooth enabled and run using common battery types in order to preserve the life of the rechargeable lithium-ion battery. That battery has a 6 hour battery life per recharge, and the Tempus can also be run on external power.

The Tempus IC® allows the user to integrate directly with telemedicine backup via:

Real-time video: there is a video camera built in to the device that transmits directly to our telemedicine facility in real time
Photos: the user can snap pictures using the built in camera which are sent directly to the remotely located telemedicine staff, who can then mark the photo (for example, circling an area they would like the user to show them video or a closer view of) and send it back to the Tempus screen
Wireless Bluetooth headset: the device includes a headset for hands-free communication with the attending physician during the entire event
Additional viewers: additional MD's or practitioners can monitor the event and readings by logging in to a secure site with the appropriate password. Those users cannot directly control the device, but can see all of the diagnostics in real time

Connectivity

The Tempus IC can send a signal wirelessly via a variety of communications devices including:

Integral GSM phone
Integral WiFi
Satellite phone systems including Iridium, GAN, Thuraya, etc. (the Tempus needs only 2.4 kb/minute to transmit the full range of diagnostics. With lower bandwidth systems, real-time video and photo may not be available)
Ethernet
Commissioning (that is included in the purchase price of the device) will ensure that your Tempus will integrate seamlessly with your site, plane or ship's communication systems

Tom's self portrait using Tempus' integrated camera function. The user can take a photo, immediately send it to our telemedicine center, where a doctor can review it, mark it, and send it back to the Tempus screen to facilitate treatmentWho the Tempus IC® is For?

As you can imagine, the Tempus® is not inexpensive. But compared to the cost of a single remote site evacuation, or the ability to intervene at the soonest point of a potentially life-threatening medical emergency and have the chance to save a life, the cost is more than justified. The Tempus also gives you the ability to rule out life-threats in order to keep people in the field or on a trip abroad. It's also very durable and has gone through comprehensive testing to ensure that units in the field are solid and have a long life. And the ease of use allows even non-medically trained responders to manage the most stressful medical incidents. It must be understood that Tempus is not a "silver bullet". Successfully resolution of medical issues will likely also involve medical equipment and medications, having backup (such as compatible telemedicine support) directly available for complex situations, and training is important. But as part of a medical support system for users at sea, airborne, or at remote sites or destinations around the world where local medical support is unreliable (or non-existent), it's an invaluable resource.

Ideal user groups:

Superyachts
Destination resorts and islands
Aviation
Research
Commercial maritime and fishing
Remote mining camps and seismic
Expeditions and safaris
Special Operations teams and military units
Protection firms
Expatriate worker populations

Inquiries

Contact the staff at Remote Medical:

Tom Milne, Yachting and Luxury Travel Account Manager 1 (206) 734-3427

Matt Griffin, Government and Law Enforcement Account Manager 1 (206) 734-3428

Sean Meade, Energy Account Manager 1 (206) 734-3434

Remote Medical International main line: 1 (800) 597-4911

Three Days with a True Remote Area Medic

Matthew Griffin — Sat, 04 Apr 2009 15:12:48 PDT

Ed "Doc" Pepping, EZ Company Medic"They were supposed to drop us at 700 feet and 95 knots. Instead, they dropped us at 300 feet and 160 knots. When I hit the ground, everything was ripped off me. I had three cracked vertebrae and a concussion. I don't remember half of the invasion."

I was fortunate enough to spend the last three days with a true American hero, Ed "Doc" Pepping. If you remember the hit HBO Series Band of Brothers, then you probably remember EZ company's medic--Doc Pepping. By today's standards, a remote area is defined by evacuation times exceeding one hour to a Western level medical facility. When I mentioned this to Ed, he replied, "When you got hurt, there was no evacuation." From the very moment Ed impacted with European soil, he used his medical training to scrounge equipment, improvise tools, and deliver emergency medical care to injured soldiers in the face of a trained enemy. Ed represents a true remote area medic.

Ed attended Trexpo convention and tradeshow in Long Beach, California as a member of the Honor the Fallen Foundation (HTF). Honor the Fallen is a 501(c)(3) non-profit organization dedicated to honoring American men and women that lost their lives in the fight against terrorism. Ed signed autographs, took photos, and sold personalized copies of the Band of Brothers book. The book is filled with pictures of Ed's journey from basic training to the war to his "first landing in a plane" on American soil after the war. In addition to the signed copy, the book has a variety of legacy items to include nylon fabric from parachutes used on D-Day and sand from Normandy's beaches. If you're interested in a copy, please visit honorthefallen.org.

As a former service member dedicated to saving lives downrange, it was amazing to sit, listen, and learn from the sharpest 86 year old I've ever met. His ethics, integrity, and honesty set the example for service members and leaders of our generation.

(Left to Right) Matthew Griffin, "Doc" Pepping, and Dr. Brock Blankenship

Ibuprofen: Hydrate Before You Medicate

Janet Peterson — Wed, 25 Mar 2009 19:14:01 PDT

The author during a recent climb in the Goat Rock Wilderness. Dry, winter and/or high altitude environments increase the risk for dehydration.Many people who venture into the backcountry turn to their old friend ibuprofen when their muscles get sore or in the case of injury. Wilderness medicine training courses such as Wilderness First Aid, Wilderness First Responder and Wilderness EMT along with other wilderness medicine practitioners often recommend using ibuprofen as an adjunct to rest, ice, compression and elevation for the treatment of minor musculoskeletal injuries. In the backcountry, ibuprofen is commonly taken for pain relief (analgesic), fever reduction (antipyretic) and as an anti-inflammatory. Ibuprofen, along with other common over the counter (OTC) analgesics such as aspirin and naproxen sodium, belongs to a class of drugs called non-steroidal anti-inflammatory drugs or NSAIDs. The mechanism of action for Ibuprofen is to inhibit the cyclooxygenase enzyme (COX) which is an integral component of the arachicdonic acid metabolic pathway that results in the production of chemical mediators called prostaglandins. Prostaglandins are a group of ubiquitous biochemicals that have a diversity of homeostatic regulatory affects in the body including pain perception, inflammation and fever production. Prostaglandins are also involved in many other aspects of the body’s attempts at maintaining homeostasis including healing of injured tissue, blood pressure regulation, renal function and fluid balance. In general, in a healthy population, OTC analgesics are considered to be safe when taking the recommended dose for the treatment of minor aches, pains and fever. For those who spend time in activities and/or environments that increase the possibility of musculoskeletal injury and/or dehydration , two particularly concerning side effects of taking NSAIDs are delayed tissue healing and damage to the kidneys.

Pain relief and decreasing inflammation is an important part of the healing process and may allow for earlier rehabilitation and increased usability in the case of musculoskeletal injury. Several studies suggest that long term use of NSAIDs may interfere with healing associated with musculoskeletal injury leading to delayed tissue regeneration. There may be some benefit from acute use of NSAIDs in musculoskeletal injury, but long term use shows no benefit or greater negative affects with regard to recovery time, muscle and connective tissue regeneration and regaining strength.

The data on the renal affects of ibuprofen are concerning in a wilderness setting due to the increased possibility (probability) of hypovolemia due to dehydration. A majority of the studies suggesting renal complications with OTC ibuprofen examined susceptible populations such as those with renal or liver dysfunction, congestive heart failure or dehydration. It is the last of these that is of the most concern in the backcountry. The level of dehydration that puts one at risk for renal complications with even a one time, OTC dose of Ibuprofen is not well defined. There are several studies indicating that COX inhibitors (such as Ibuprofen) also inhibit renal prostaglandins which results in a decrease blood flow to the kidneys and associated decreased renal function. In an already compromised kidney, such as in dehydration and volume depletion, this could lead to fluid and electrolyte disturbances, nephritis and in severe cases renal failure. The good news is that for a majority of cases, cessation of the offending NSAID results in reversal of the renal adverse affects.

Recommended doses for OTC Ibuprofen:

Analgesia/antipyretic: 200 -400 mg every 4-6 hours – not to exceed 1200 mg/ day as needed

Anti-inflammatory: 400 – 800 mg, every 6-8 hours- not to exceed 3200 mg/day , for no longer than two weeks.

To minimize the possibility of renal damage, it would be advisable to avoid taking ibuprofen while in a dehydrated state. It would be highly advisable to rehydrate properly prior to taking NSAIDs and to drink plenty of fluids along with the medication. Also avoid chronic use of OTC pain medications unless prescribed by a physician. Seek medical attention for pain, inflammation or fever that does not improve or becomes worse.

Adverse effects: the most common adverse reactions to ibuprofen are gastro-intestinal upset. Other symptoms include edema and fluid retention. Individuals who experience these (or other) side effects should discontinue the ibuprofen and seek medical advice.

References

Almekinders, LC . Anti-Inflammatory Treatment of Muscular Injuries in Sport – an update of recent studies. Sports Med (1999); 28(6): 383-388

Rainsford, KD., Roberts, SC., & Brown, S. Ibuprofen and Paracetamol: Relative Safety in Non Prescription Doses. J. Pharm. Phamacology (1997); 49:345-376.

Ulinski T, Guigonis V, Dunan O, Bensman A. Acute renal failure after treatment with non-steroidal anti-inflammatory drugs. Eur J Pediatr. (2004) Mar;163(3):148-50.

Whelton, A. Renal Effects of Over-the-Counter Analgesics. J. Clin Pharmacol. (1995); 35:454-463

"What does Remote Medical International do?"

Andrew Cull — Tue, 24 Mar 2009 17:23:10 PDT

For some reason, that question sometimes becomes complicated to explain. I have seen several staff struggle with trying to plug our entire suite of products and services into a single sentence or two. In the course of a day in our office, you might see military personal, guide service owners, people getting ready to sail around the world or the captain of a super-yacht provisioning medical supplies, setting up projects or evaluating evacuation plans. It is understandable then that putting Remote Medical International into a box on the telephone is difficult.

Today, I set out to make a short pitch explaining what we do by a series of activities involving all the office staff. I stayed out of it and facilitated a couple of group activities, took a vote and we arrived at the following statement:

"We are a medical and rescue services company specializing in remote areas. We provide equipment, training, telemedicine and onsite medical care for anyone who works or plays where the hospital is not an option."

That's our short sales pitch, and our mission remains the same:

"To enable humans to explore the most remote places in world by providing an unrivaled level of medical and rescue services."

Since no blog entry is complete without a good photo, I attached an image of a rafting trip we took on a break while working on a project in Alaska this past summer, thanks to our friends at the Denali Salmon Bake.

RMI staff rafting at midnight on the Nenana River near Denali National Park during a break between high angle rescue courses.