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A report last week about an individual suffering a medical issue in the BWCA gave the highlights of the rescue, but a closer look explains more about the process and complexity a backcountry rescues involves. Below are some questions and answers provided by Karla Pankow, NRP, CCP-C, EMS Director of North Shore Health Ambulance.
Q- Can you say what kind of medical emergency the patient was suffering?
This patient experienced a new onset of seizure activity with the first episode taking place early that morning in their sleep and the second in a canoe in the middle of the lake as we made the return trip back to Sawbill Outfitters.
Q- Do you know if the person is okay today?
While we don’t know how the patient is doing today, we do know that they made it safely to Duluth for a higher level of care. Thankfully, we were an ALS (advanced life support) unit that day. After making the rescue and stabilizing the patient, we intercepted with Life Link III at the Lutsen Fire Hall landing zone for a more timely and efficient transport over to Duluth.
Q- Did Sawbill outfitters loan you canoes?
The two members who responded to the call on behalf of Cook County’s Search and Rescue came equipped with a 4-person canoe and Sawbill Outfitters loaned us one of their 3-person canoes. Our only critique – no lights and sirens!
Q- Or do you have quick access to canoes?
North Shore Health EMS does not have any canoes on our fleet, but maybe that should be in the budget for 2024?
Q- Could the patient walk on the mile long portage?
There were two portages, one measuring 139 rods and a shorter one at 27 rods, one way. All in all, the two portages totaled 332 rods, or a little over 1 mile. The patient was able to slowly walk on their own between lakes, but an EMT and I were at the patient’s side every step of the way, while the other crew members ensured that our canoes and equipment made it across the portages.
Q- Or did you have to carry him/her on a backboard?
Because the patient experienced a seizure on the final stretch of our journey, they were still postictal (confused, weak, fatigued) as we approached the dock at Sawbill. At that point, they were physically lifted out of the canoe and onto the dock where we supported them until the stretcher was retrieved from the ambulance. As part of our preparation, however, we did bring a MegaMover, which is akin to a large, heavy-duty tarp with handles around its perimeter for rescuers to transport patients. Had the patient needed to be carried across the two portages, we would’ve been ready.
Q- Have you ever taken part of such a long rescue?
Cook County is no stranger to unique situations and potentially challenging rescues. Not every 911 call takes seven hours, but when it involves the Boundary Waters, state parks, hiking trails, and the like, the crew is well aware that we may be in for an adventure.
Do you and the crew workout so you can perform these kinds of rescues?
As a person of a certain advanced age, I may have been extra grateful for such a vibrant and youthful crew that day! Given our location, we tend to attract the outdoorsy and adventurous type. When not on the ambulance, our team members are active in many ways; from being on ski patrol, the fire department, or search and rescue, to lifting weights, cycling, or running. Self-care isn’t always easy or a top priority for those in EMS. One of my goals for our department is to work on establishing a partnership with the YMCA and secure memberships for our crew of first responders.
Q- What kind of medical gear did you have to take in?
Our duty crew that day initially consisted of two EMTs (making up a BLS or basic life support unit). Our ALS crew (advanced life support) had just left for a patient transport down to Duluth when the 911 call came out for Beth Lake. In addition to my role as EMS Director, I am also a paramedic. I jumped into my Jeep, ALS “go bag” and medications in tow, and met my ambulance crew up at Sawbill Outfitters. From there, we prioritized our equipment needs to include a MegaMover, ALS bag, airway/respiratory/oxygen bag, bottled waters, and a can of bug spray. (Side note: if anyone is looking to make a donation to our EMS department, we’ll take ALL the bug spray, head nets, and bug jackets!)
Q- And did you have fluids, nourishment along with you in case you got stuck out in the woods?
Given that we were a rescue crew of five in two canoes that ultimately needed to reserve room for the patient, we focused on the potential needs of that patient and prioritized equipment. We did have a few bottles of water in our go bag though and I stashed a few peppermints into my tactical pants when I headed out the door at 0600. Does that count?!
As an extension to our patient care, however, we did ensure that the patient had protein bars, water, and electrolytes with them before venturing out on a canoe across three lakes. My ALS bag was equipped with fluids, an IV kit, and glucose had there been any needs among our crew or the patient for fluid resuscitation or some quick-absorbing carbohydrates.
Once we knew the patient arrived safely in Duluth, we gathered together in the back of our ambulance garage for some much-needed nourishment ourselves. Hearty food from My Sister’s Place, the best iced-cold Coke that ever touched our lips, and a moment of reflection as a team.
Compared to most, we’re not a busy ambulance service. We don’t have fancy uniforms. And some may wonder why we would choose to work this far north, so far removed from a plethora of resources at our fingertips. I’ve had the pleasure of working alongside this EMS crew at North Shore Health since April 2022. Over the past six months in my role as director, I’ve come to value each and every one of them in a deeper way. They don’t need to be part of a busy ambulance service or sport fancy uniforms to provide great care to our patients. What they need is what they exhibit each and every day, a true passion for helping others and serving their community.
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