Episode Transcript
[00:00:07] Speaker A: Hello. Welcome back to another episode of the Code 321 podcast. I am joined with a very special guest today. Chance Sullivan is here. Chance is the medical director for Precision Training and a great friend of mine. Chance, thanks for jumping on with me.
[00:00:20] Speaker B: Thank you. Nick, excited to be here, Excited to do this whole podcast thing.
[00:00:24] Speaker A: Yeah, I'm excited. And as always, starting for this season, we have Prescott Naidu joining us as the co host. Prescott, how are you?
[00:00:32] Speaker C: Really well, good to be here.
[00:00:34] Speaker A: I appreciate that. Thank you. And what I'd love to talk about today is a little bit into mountain medicine and expedition medicine. It's a shared passion for Chance and I, I think it's fascinating. I've watched almost every documentary on Netflix and Amazon and Max and any other streaming service you can imagine because I just can't get enough of it. I love climbing, love mountaineering, and I know you're interested in as well. So if you don't mind, can you give the listeners just a little bit of a background on how you got to where you are today and what you're currently doing?
[00:01:07] Speaker B: Sure, yeah. So after undergrad, I knew I wanted to go into medicine. Didn't know exactly what field, but I just wanted some time off before I just dove into the hours and hours of, you know, med school classwork and libraries and all of that fun stuff that goes forth for the next eight years or so. So it started to take a gap year. Didn't know exactly what I wanted to do, but didn't have any money. So I needed to find a job somewhere. So started searching around on Google, literally. I think I Google searched badass summer jobs and found a job out in Jackson Hole, Wyoming, guiding trips out in the back country around and in Yellowstone and Grand Teton National Park. And I grew up on a farm in Iowa, had no, like really formal credentials. I had no business being a guide in the backcountry. But for some reason they chose me and it was an amazing experience. I did awesome things. We whitewater raft the Snake river, we did a bunch of backpacking in the Wind River Range, in Yellowstone, in Grand Teton National Parks. And one of the things that we did, one of the keystone things with these groups, they were about 20 day trips out in the backcountry, was climbing the Grand Teton, which is, you know, almost 14,000ft. It's like 13:4, something like that out in Jackson Hole. Beautiful peak, great climb. It's like a classic mountaineering route. That was like my first time being climbing on a big mountain. And I was blown away. Wow, this is so cool. I would love to do this. Maybe I should, like, cancel my plans to go to med school and just be a, you know, know, climbing ski bum for the rest of my life.
Fortunately or unfortunately, I decided to continue on with the plans to go to med school, eventually went on and decided to do residency and emergency medicine, but always, like, kind of continue to foster that love and joy for being out in the wilderness doing outdoor activities, backpacking, climbing, hiking, that kind of stuff.
But wanted to find a way to like, kind of combine those two passions, which kind of seem like two ends, two different ends of the spectrum. Like, you know, emergency medicine training in an urban area with all of the resources possible at hand versus, like, being in these really remote areas away from civilization, resetting yourself.
And I eventually found the field, the kind of idea of wilderness medicine through different courses that I did. One during med school. We went out to Colorado for a couple weeks and did like a wilderness medicine elective out there and had some great mentors through that and then ultimately did residency at University of Vermont, where we're just exposed to so much wilderness and outdoor activities out there.
So, long story short, was able to, like, find a way to combine my two passions. One, like these outdoor activities, the idea of wilderness medicine with like my career, which currently is emergency medicine.
So, yeah, it was a way to like, you know, find the things that you love to do, but bring them into the job that actually, you know, pays the bills and is much more sustainable.
[00:04:21] Speaker A: Yeah. Almost reminds me of when I went to an athletic training camp because I thought I wanted to be an athletic trainer. And almost every single person in that camp had the same story. It was like I was a top tier athlete. And then in the fourth period I got hurt and I didn't know what to do. Like, it's like they're these top tier athletes, they get hurt, they see the other side, and now they're like being 80s because it's the passion for the game, passion for the sports team, the camaraderie. And they also now have a job that's meaningful. And so like that blend of those, those passions you have and the job, that's going to scratch that itch as well too. And then I discovered EMS was just all the sexy parts of AT and none of the rehab. And I was like, dude, I'm going to go work on the, like to resuscitate people. Like, stop the bleeding, man. That's. That's what I want to do. So, yeah, fascinating. And you're out in Colorado now, which is awesome. That's like the Mecca for outdoor sports, like right in the center of the Rocky Mountains. That sounds amazing. And you're working as an em Physician, right?
[00:05:20] Speaker B: Yeah, it's been great. So I just moved out here a few months ago. Had to leave my family, a professional work family in Vermont that I fostered over the last five years.
So Ms. You all, but have moved on to some bigger mountains out here in Colorado. It's been great. I went back country skiing today.
Access is great. Really loving the hospital that I'm working at and, yeah, a little bit closer to family. I grew up in the Midwest, so Colorado is a little bit easier of a. Of a drive than Vermont. That was kind of a big haul for us. So. Yeah, like, excited for the next chapter?
[00:05:56] Speaker A: Yeah, for sure, man. And, you know, you never break up the family. We just have more free airbnbs around the country. That's all it is. For sure.
[00:06:03] Speaker B: Yeah. We were just talking, you know, before the podcast. I, um, just got back from a ski trip to Japan with a couple of my buddies from Vermont that I went through residency with. So we still find ways to, like, continue to connect. We're just not bumping elbows in the hallways of UVM anymore, which is sad.
[00:06:21] Speaker A: But you guys are all growing up now. You know, you're out of school, you're all running ers all over the place. That's great. So that's gotta be exciting.
[00:06:26] Speaker B: Yeah, no, it's good to have a network around the world.
And, yeah, always someone to call when you're stuck in a layover somewhere, you know, in the middle of nowhere. You know, it's nice to have friends kind of all over the place.
[00:06:39] Speaker A: No, for sure. And if. If any of you listeners are interested, way back in season one, episode 25 actually had chance on as a baby resident, and we went over to his downtown apartment and I chatted with Noah, Nick and Chance. And those guys are all great and they're all on to bigger and better things, but pretty cool to watch the progression, you know, from, know, four years ago to where you guys are, are now. That's. It's so exciting for us.
[00:07:02] Speaker B: That's a deep cut right there.
[00:07:04] Speaker A: The deep cut. Yeah, the og, the original mix. So, yeah, anyway, and. And so what. What I'd love to talk about today is this idea of expedition medicine. And what I'd love to do is, is get Prescott in on this. And Prescott, when you think of expedition medicine, you know, what. What are you. What are you thinking? What's the first thing that comes to mind? Because I think a lot of people are going to share, you know, the same outlook as you.
[00:07:26] Speaker C: Sure, yeah. I mean, my thought with expedition medicine is the. It's twofold. One is improvisation. Right. And the fact that when you're out there, you know, you. You have to. It's so much improvisation that for someone like me who hasn't done a ton, ton of that, it's quite scary to consider that I have my protocol book, I've got the back of my ambulance or, you know, the ER, which is all of, you know, 25 minutes away at the most kind of situation.
So thinking about expedition medicine, mountain austere medicine in general, terrifies someone like me, which is why a conversation with someone like Chance is so awesome. To hear how his brain. Right, Chance, how your brain says, okay, I like the outdoors so much, and I like em so much where those worlds blend. Because for me, the improvisation and then the decision making in complete uncertainty.
Yeah, that's all you, my friend. But that's where my brain instantly goes.
[00:08:28] Speaker A: Yeah. I think one of the things that gets people into trouble, and I'm sure Chance and Prescott can both commiserate with this, is this idea of like, oh, it's not going to happen to me. Or like, you know, it probably won't. Probably won't happen. I'm not going to worry about it too much. And, you know, I think Chance and I were talking before the show about this idea that, you know, austere isn't just the wilderness of the Arctic Circle or the ice shelf of Antarctica or the desert in. In northern Africa. You know, this, this can be. This could be Hinesburg right in the middle of a blizzard, in a flood, when all your roads are cut off, you know, And Chance, you want to talk a little bit about this idea of like, how do you change that, that approach, that mental, you know, predisposition people have, that's. It's not going to happen to me.
[00:09:12] Speaker C: Yeah.
[00:09:13] Speaker B: I think, you know, so often people get caught up on the idea that, you know, expedition medicine, mountain medicine, wilderness medicine, general is people climbing Mount Everest or being on this exotic faraway land where you are hours and hours away from any sort of medical care.
And I think people forget that you can be hours and hours away from medical care, stranded on a road in rural Vermont, or, you know, on a trailhead in Colorado where cars and buildings are around you, but you are just like stuck in this position and you don't have the resources that you normally want to have, you know, what you would do in an ideal situation in a fully staffed hospital with your full team, your rt, your nurse, your tech right there with you. And you have those skills and knowledge, but you can't utilize them in the same way that you normally would. And that, like, is really austere medicine in a nutshell of, like, not being able to practice what you normally would with the cards in front of you.
And, like, I guess to get back to what Prescott was saying, that's kind of the fascinating thing for me. I think so many people, you know, in our field in emergency medicine ems, like, we're a bit of, like, adrenaline junkies in the sense of, like, we're crazy enough to. To sign up for this job of, like, you know, playing defense, not knowing what the next play is going to be and just getting a call, having a patient come in through the front door and responding and, like, still doing that, but with, like, a. Not a full deck. And it's kind of like, for me, the next level. And that's what, like, makes wilderness medicine so exciting for me is, you know, it's. It's not. It's never a repeat. It's never boring. You're, like, just always doing something different in a really, like, beautiful but terrifying environment. And that's what keeps me coming back, is there's just, like, you know, you don't know what's next. You don't know what the next play is going to be, but you just, like, are stoked to see what happens.
[00:11:12] Speaker A: You're here for it. You're ready.
[00:11:13] Speaker B: Yeah. Like, bring it on.
[00:11:15] Speaker A: Yeah. And I like to call those what you're talking about. I like to call them go fish scenarios, which is basically like, you have a problem, and every time you reach for a solution, that solution doesn't exist, and you just have to keep moving. And so when I was running the recruit academy and teaching new providers and when I was running the training company, one of the things that we tried to do regularly is as they started to gain confidence in the standard scenarios, start adding new factors where they weren't able to go through the same pathway to see if they were flexible enough to come up with a solution. You know, hey, you know, I want a, you know, an EKG here. And you say, well, that. That monitor is not working right now. How are you going to get around it? Because, you know, Prescott, I can kick this question. You. I think back in the day, I remember a situation where, you know, the monitor wasn't working well and the AED was Kept on the outside of the truck. And all of a sudden it was like this big question of, like, man, like, we need something and we never run into this before. And now we're, you know, using these new neurological pathways to solve a problem. And, you know, Prescott, can you share an example of, like, you know, a situation where you had a plan in your head, it didn't work, and you're like, what are we gonna do now?
[00:12:23] Speaker C: Yeah. So I. It'll take me a hot second to think of an exact scenario, but what I can tell you from a plethora of, you know, just thinking back to a career worth of situations where I was totally unprepared for those neurological pathways to be working at the time. I was like, all right, I have plan A, and plan A is going to work. Right? Right. And then when plan A totally collapses underneath you, my first go to is always the people around me. Right. More brains and more brain powers is better than one by all stretches of the imagination. But when even that doesn't occur, the thing that has totally come back into play, and this is kind of want to. Want to lean back to chance on a bit, is it's the fact that when the people around you are sometimes getting very excited about the situation, Plan A isn't working. Plan isn't working. What are we going to do? It's the person who is able to keep calm. It's the person who's able to keep their brain space locked in and say, all right, this is okay, you know, we may not have seen this, but let's revert back to some training or maybe potential experience and keep things calm, cool, and collected. So that's been my experience with, you know, if you're able to keep a cool head, then something usually is able to come up. Okay, is it as simple as stopping the ambulance and getting the compartment on the outside? Sure, that's probably a really good plan B. But when all of that fails because you're going mock Jesus to get to the hospital with your cardiac arrest or whatever, then you make it do. And saying, chance, we were talking about this earlier. What's the basic component? Right, okay, let's just do cpr. And something in our little adventures of CPR is going to crop itself up at work.
[00:14:04] Speaker A: Yeah, definitely. So, Chance, maybe you can talk just a little bit about, like, what is your approach to an expedition? When you find out that, you know, they're looking for a physician, you're interested, you match up, you know, whatever it is, the eharmony of physician and Expedition medicine, you know, expeditioners, how do you start that? What's your first step? How do you start thinking about that process and what goes into the preparation phase of actually going out on the mountain?
[00:14:33] Speaker B: Yeah, I think couple important considerations are where are you going and who are you going with? You know, a trip to Alaska with like a group of professional skiers or National Geographic, like elite photographers is going to look a lot different than a cruise ship medicine trip to the Caribbean with like a group of 70 year old retirees.
So like there is no just like bag of expedition gear that I take with me. I have like, you know, I dial it to the exact trip that I'm going on. What's my patient population? What types of activities are we going to be doing? What's the climate that we're going to be exposed to? What are the local resources?
So there's a lot of like pre trip considerations that you need to do. What are the most likely injuries or illnesses that I'm going to see?
What like contingency options do I have to have planned? Like what's an evac? Like is it just calling a, calling an ambulance or am I calling the Coast Guard on like hopefully a clear day to call to bring a helicopter? Um, so there's so much pre trip planning that goes in beforehand and a lot of it is like what resources can I carry with me to. You know, I've worked on trips in Alaska where the gear that I have is what I can ski with on my back. So that's obviously going to be pretty dialed kit versus if I'm doing say you know, a base camp in like a climbing base camp where I can have a mule bring and carry my gear, like a giant duffel, like yeah, I'm going to like maximize my 20 kilos that I'm allotted on this poor mule that has to carry my gear.
So you're, you're a lot. It's just there's so much variability in what you have. But I think, you know, to, to truly be a good provider, you have to do a lot of research beforehand and not just feel like you can show up and be like, yeah, I've like done this before and I'll figure it out as I go. And there is a lot of that, like as we were talking about before, you have to be flexible, you have to be able to just deal with what's in front of you. But I think if you want to truly be like good and provide adequate, appropriate care, you got to do your due diligence. Beforehand with like kind of that pre trip assessment. And ideally, if possible, you're getting information about like the people who you're going to be working with. If you're with a group, you can get like their medical conditions beforehand. You're like, all right, I have an asthmatic, I have someone with like a history of coronary artery disease. I'm going to be like packing these things. But you know, unfortunately oftentimes you don't have that information. So there's a little bit of guesswork that goes into.
[00:17:20] Speaker A: Yeah, I gotta imagine that it kind of complicates the situation when you discover their diabetes at 23,000ft instead of sea level.
[00:17:28] Speaker B: Oh yeah. And you're hoping that like, you know, say you come across that diabetic who's, you say hypoglycemic and you're like, all right, I hope they have something in their bag that they've prepped for because you don't always have everything possible, but you're hoping that that person has at least planned for those contingencies so you can raid their stuff. That's totally fair game. There's no rules in the wilderness.
So sometimes it's like going through their bag and like, all right, like, great. They have, have glucagon or like they have a bunch of Jolly Ranchers. Perfect.
So you know, obviously you try to bring as much stuff as you can, but sometimes you're just relying on MacGyvering with whatever someone else has.
[00:18:06] Speaker A: Yeah, no, that makes a ton of sense. I was thinking about it as you said that this idea of like in sales or in public relations, we would call this market research. You know, the idea of like understanding what you're walking into. You know, if you're going on the cruise ship, maybe you pack a few extra nitro tabs. If you're going with the National Geographic crew, maybe it's a cefapime, you know, and like this idea of, you know, titrating and customizing your package for the person and the group of people that you're going with. You know, if you watch any of these like Alex Honnold films that are super popular right now, you can see that, you know, 45 minutes of the hour long video is about the preparation, the planning, like if this goes wrong, where are we going to go? If this goes wrong, who are we going to call? What channel are they going to use? You know, and I, I know you've been on these expeditions all around the world and have you found situations where you, you notice that the Regional areas have different level of support for you that you run into different levels of rescue capability based on where you are.
[00:19:10] Speaker B: Yeah, I mean, you'll notice like different support levels from both like local institutions and like the bigger government at large.
For example, when I was working up in Alaska, I was on this big ice field with a bunch of glacier scientists who'd go up and study climate science, glacier melting. And I was just stationed with them on these remote ice fields in case something went wrong. And we had a pretty good working relationship with the Coast Guard up there, which are some of the most badass pilots in the world. And they can fly in just about any conditions, which is good because in this area, Juneau, about 90% of the time it's just completely socked in. You're in a, just a snow globe of whiteness a lot of the time. So if you were relying on just calling a local pilot or the local 911 institution, like no sane pilot is going to fly in those conditions. But if you already have like this contingency beforehand with someone, say like the Coast Guard, that's a little bit more reliable to rely on.
However, sometimes in like, especially foreign countries, it's hard to have that pre established relationship. So you're much more kind of at the will of who's available. And you, you should plan on like plan B, plan C for evacs on those types of trips where you're like, all right, like this is ideally who we can call. But like I don't have enough money for a, you know, for this particular request that they're asking for a bribe or like they're just, no one's working today.
So I need to have these contingencies in place. So yeah, it's, it can be challenging in some of those lower resource places about kind of pre trip planning because even if something's written in stone, you still can't rely on it oftentimes.
[00:21:08] Speaker A: Yeah, and I know we've had, we had Dave Cohen on the podcast. He was talking about all this enduro races. He works as a medic doing enduro races all over the world, in New Zealand and the Alps and down in, you know, Latin America and stuff. And he was talking about how sometimes it's not the places you would expect that have low resources. You know, he said when he was in Mexico doing enduro, they were phenomenal. I mean they had great resources, you know, and then there were other places that he worked where you couldn't get a helicopter if you had a briefcase full of money, you know, and it's like, it's just understanding your environment. And I think this dovetails well into a question for Prescott, which is this idea of, I think what we're dancing around here is like an incident action plan or some sort of predetermined process of how we're going to resolve an emergency. And Prescott, can you just, just talk just for a second about if you were. Let's say there's a big event that's going to happen in Hinesburg, right? They're going to summit a big mountain in Hinesburg. What are some things you would be thinking about as the fire chief? And what are some very basic questions that you would want to have answered before that event happens?
[00:22:13] Speaker C: Yeah, sure. I mean, so an incident action plan. It's so funny, in the place that I used to work, it was the first opportunity for me to see that from time to time. But it doesn't often happen where we put official IAPs in place. And we, as a, you know, the culture of the fire service, ems, we need to change that. We need to make, make the formal introduction of an IAP a real thing. Because the questions that I would ask are similar to what Chance was asking, right? You know, who am I going to be working with? How many people are going to be at this race? From a planning perspective, the more knowledge I have about, you know, do we have a predicted weather?
How is that going to play into things? What is our plan A and B from a standpoint of resources that we can provide? Do we have one ambulance or 10ambulances? Do we, you know, how many personnel that sign up? Are we working strictly on volunteers or paid people? You know, that kind of situation? Because all of that is going to go into. And this is actually, I don't want to hijack this, but I want to toss this back to both of you because if, you know, all of this is the predicted stuff. If we can put these questions into a written down plan and then really, at the end of the day, even if a part of that plan fails, we have the plan B, the plan C. That's the best part of it, is we can introduce that, you know, okay, this part didn't work out so well. Let's, let's go here. What about. And this is kicking it back to both of what about something. I'm a big MCI guy. Okay, so what about something like that? Where it is totally, you know, we might have a plan, right? There is a generalized MCI plan or something. But when you get there, it feels if an MCI hearkens a lot to the tenets of austere medicine, but in an area that might be urban or, you know, you might have a lot of those resources, but you're working on prioritization, resource conservation, something like that. So how do you then take this great planning process that, like, chance, you do all the time for this mountain medicine? And, and. And then when you don't have the time for the plan, how does that then unfold?
[00:24:21] Speaker B: Yeah, for me, a lot of the time when, you know, shit's really hitting the fan and, you know, you can't follow the plan that's in place, you just have to take a step back and focus on the training that you've had. And I mean, for us, the. The people in emergency medical services, It's. It's your ABCs, and you're just, like, trying to focus on what you have in front of you. And like, MCI in the wilderness, it could be fairly small. Like, if it's just you three people. If you had three victims, like, that's an MCI in the wilderness, and you're just quickly triaging, which is something we do every day in the er. But you're saying, like, all right, who's my red tag? Who am I focusing my resources on? Who's the walking wounded? Who can I ignore?
And just really relying on those fundamentals. And if you have other people with you, great. You know, you're hoping that they have a similar basis of training, but if not, yeah, it's tough. But you're just trying to figure out what can you do with the resources you have, with the time you have, with the people in front of you.
And it's. It's. It's not something you could necessarily like. Things like that. You can't necessarily plan for every single move that you're going to do. This is not an orchestrated event. This is just you performing, like, back to your instincts, back to the training that you did at whatever point in your. In your career, and just hoping that that's, like, going to work in that situation.
[00:25:48] Speaker A: Yeah, and I think you're 100% right. Like, if you have three patients, you have two hands, that's technically MCI. You're overwhelming your resources, you know, and. And I think what I was thinking of when Prescott was mentioning that is, you know, I'm also a big MCI fan. Just. Just talking through the planning process and being prepared. And I think there are MCI plans that fail because they're too specific. I think if we're too specific, and we say, we're gonna call, you know, Chance Sullivan, helicopter evacuation. Every time we have an accident, and all of a sudden that helicopter's down for maintenance. We don't have a backup, we don't have an idea. You know, I think being specific enough that we accomplish the objective, but not so specific that we rule ourselves out when one thing doesn't work. So saying, you know, the language being, you know, call a helicopter for medevac is different than call Chance Sullivan for medevac, you know, having the objective in mind, not necessarily, you know, the specific task. Because I think, you know, we pigeonhole ourselves. You know, we think about, you know, Prescott, you know, working in Hinesburg. He's like, well, I'm always going to call Charlotte. You know, mutual aid is always going to be first due from Charlotte. But what if Charlotte's busy? What if they're not available? What if their truck is broken down? What if they don't have any staffing? You know, this idea of call the nearest appropriate resource is a better language, and making sure that we develop our plans with that intentionality in mind, I think is really critical for sure. So. Well, Chance, I want to thank you for jumping on the show today. One of the things I want to end with is this idea of. Of if someone's interested in this type of medicine, whether they're paramedic, nurse, you know, critical care, if they're a physician, what are some steps that they can take to start getting involved? What are some organizations or opportunities that maybe you had or you could recommend for people who are interested in this type of work?
[00:27:39] Speaker B: Yeah, I think it's just recognizing it's a really big field and there's a lot of options out there. And it might seem overwhelming at first, but just finding what. What your passion is. I mean, you know, for me, it's being in the mountains and, you know, finding a way to combine climbing and medicine together. So I look at organizations that are doing medicine, and the mountains are in these austere environments. For me, that was like getting my fellowship of wilderness Medicine through the WMS or Wilderness Medical Society.
And then I do some work with Wild Med Adventures, which is a group that does, like, a bunch of these CME trips mountaineering around the world. But for a lot of people, that's not necessarily their interest. It might be dive medicine, it might be working events medicine. So I think just finding what really draws you into these kind of more austere realms and just finding a way to get your foot in the door, signing up for the event, being a participant, and then kind of seeing the lay of the land, who's. Who's providing medical care, trying to introduce yourself, seeing how you could get involved.
And I think if you do that in an area that you're. You're really passionate about, you're interested in, it's going to be a lot easier for you to kind of kick that door open. When it's. When you get that kind of foot in the door, then being like, oh, I need to go through these, like, very generic societies and, like, go through steps A, B and C. And if it's something you're not passionate about, you're just not going to go forward with it.
[00:29:03] Speaker A: Yeah. And I think one thing that, you know, I had heard from Dave Cohen before, too, is also being a realist about this and recognizing that, like, if you want to be a climbing, you know, physician, you probably should know how to climb as well, you know. So, like, don't forget the fact that if you want to be with these teams and doing these things, make sure that you're comfortable doing these things too. If you want to be a dive medicine doctor, like, you're probably going to want to have an understanding of diving, and the best way to do that is to dive 100.
[00:29:33] Speaker B: And I think one thing I always think about before going on some of these trips is at the end of the day, I don't want to be a liability. And if, like, I become an additional victim, like, putting myself in a situation where I have no business being in, like, that's going to make a subsequent rescue way more challenging. So I think if you're looking to go on a, like, mountaineering expedition or this big dive trip. Yeah, exactly what you were saying. You should be pretty competent in those particular techniques or skills required, which is fun. I mean, I think a lot of us have gone through a lot of training that involves a lot of, like, gaining medical knowledge and skills. But training for these things might be like, all right, like, dang, I got to go out and practice rock climbing today, or I'm going to go scuba diving today to practice for this dive trip I'm going on. Like, it's pretty easy to motivate yourself to go train for these kind of things, but you should still be putting in the time, putting in the hours. So, again, you're not a liability for the group that you're with.
[00:30:29] Speaker A: Yeah. You're just going to be like, listen, honey, it's work. I got to get out there and ski. It's just really tough for Me, you know, I got to do some backcountry. It's my boss that I got to get out there. He's really riding me hard.
[00:30:38] Speaker B: You know, I'm just dedicated. This is my passion, I guess.
[00:30:41] Speaker A: Sorry, babe, I got to do it. It's really. I'd love to be here and watch this Netflix movie, but I got to get out there. Prescott. So for those firefighters are listening in the group or members, emergency services that are interested in this systematic approach to incident planning and solving problems on the fly and being flexible, what is your advice to how they can approach that and be successful?
[00:31:07] Speaker C: All right, the first step, and this is absolutely back to the basics like Chance was talking about for that previous question. And that is you need to understand the incident command system, the National Incident Management System. It's there for a reason. You have to dive so deeply into that understanding that if I ask you tomorrow, what's the difference between a division and a group, you could tell me that. And then you could go so far as to say how that applies to your respective agency, department, what have you. Because if you have that fundamental understanding that back to the basics approach of what the National Incident Management System is there for and why we should be experts at it, then we can tier that, we can unfold that for a very small incident like a two car crash or a massive incident like you know, the bus full of nuns that lands on a 747 somehow getting into the air, whatever.
[00:31:53] Speaker B: Right.
[00:31:54] Speaker C: We can tier that approach. And so if you gain that understanding, then bring that to your respective agencies. You, you know, Vermont is, is a little bit scarce on resources outside like National Fire Academy has some great classes you can take. That's a jump on that for sure. And then, you know, take a look at your local resources. I know the state of Vermont is bringing in a command and control of Incident operations for target hazards class, things like that. Jump on those opportunities.
[00:32:26] Speaker A: Absolutely. And I would add too, just from, from my time on the national circuit as well, most conferences will have an MCI track, if not MCI courses. So just, just be aware that if you are looking for education and you want to get involved in expedition medicine or MCI work or command structure and you're not getting it where you are. Don't be afraid to just, just type in EMS conference in Google and just pick one. There are probably courses in there taught by vetted credentialed professionals that can help you gain some knowledge in how to, you know, exercise your best authority. I know, I've taken classes with People who are at the Pulse nightclub shooting in Orlando, classes with people who are from Clark county where the Mandalay Bay shooting was. And these folks have real life on the ground experience about how to manage these complex MCIs. You know, I was telling Chance in the pre show I had an opportunity to meet a guy who is an Air Force pararescue jumper. We did a podcast with him. He was up in Alaska and he was dealing with these situations. And so if you're not getting this education in your, your bubble that you're in currently, don't be afraid to reach out. You know, you can reach out to Chance. We're gonna, we're gonna put some information on the website. You can connect with people outside of your local bubble. So feel free to reach out. There are people out there and, and they love to, they love to talk, they love to teach you, they love to connect you with other people. People who are passionate about this really want to get it done. So, Chance, I want to thank you so much for joining us from the great Rocky Mountain region. Thanks for being here today.
[00:33:53] Speaker B: Yeah, buddy, thanks for having me. Always happy to chat with you more. And Prescott, great, great catching up with you too. We were saying beforehand that I think the last time we interacted was like six or seven years ago when you were teaching me how to do CPR as a first year resident. So great to circle back and catch up with you as well.
[00:34:12] Speaker C: You as well, Chance. Always a pleasure.
[00:34:14] Speaker A: Prescott, thanks for coming on the show again. I look forward to a great episode next month and the listeners stay tuned. The 15th of every month, we'll be releasing a new episode. Keep an eye on our website, precisiontrainingusa.com for any recent updates and reach out if you have any questions. Stay safe out there.
