Preforming Wild Rescues In The National Parks- Kevin Grange

Hi, everyone, and welcome to this week's episode of Enduring the Badge Podcast. I'm host Jerry Dean Lund, and I don't want you to miss an upcoming episode. So please hit that subscribe button. And while your phones out, please do me a favor and give us a review on iTunes or Apple podcasts. It says, Hey, this podcast has a great message and we should send it out to more people. So please take that 30 seconds to a minute to do that review. And just maybe by doing that, it will push this up into someone's podcast feed that really needs this message. 

My very special guest today is paramedic Kevin Grange, who is also an award winning freelance writer that talks about the medical field adventure and travel. And we're going to talk about some of those adventures and travel and what it takes to work in the national parks. As a paramedic. He's got some very cool stories. And we're also getting up some tips with Spring Break ahead and outdoor adventure season coming about how to be safe in the outdoors. Let's jump right into this episode with Kevin. 

How are you doing, Kevin?

I'm doing great, Jerry. Yeah, super excited about this podcast and honored to be here.

Yeah, I'm super excited to have you on, you've written a couple books. And then you've got some pretty cool experience in some that you do for work that we're gonna dive down into and share with the audience. Why don't you tell the audience a little bit about yourself?

Sure. Well, again, my name is Kevin. I'm currently a firefighter paramedic with Jackson Hole fire. And I also sometimes work part time for Grand Teton National Park, which is just up the road a few miles. And I guess my EMS career kind of began as a lifeguard in high school, and then none of my family members were in the fire department or working in EMS. So I sort of left that occupation didn't really think about it. And then as I, you know, I grew up age, and I kind of thought what was most important to me, which is helping people serving my community and working as a team. I started you know, to meet some EMTs and firefighters, and it seems to be a collection of everything that I held like most dear and most important, so I got my EMT and then went to paramedic school, and then just kind of jumped out into the job market, which, as you probably know, is, you know, 1000s of people vying for a few spots. So that took me a few years, and I was down in Southern California at the time. And then I heard about paramedics working in the national parks. And that seemed to be, you know, just merging my two main loves, which are the outdoors and medicine. And so I worked for the park service for a few years and Yellowstone and Yosemite in California and Grand Teton and then got hired on full time with Jackson Hole.

 
Yeah, that's pretty cool. I've always thought about how unique would that be to be a medic inside the park. Can you kind of explain maybe just a little bit about like, what that's like?

Sure. Well, you know, I trained in Los Angeles and was working there. And the funny thing with working in National Park is most agencies are told what to expect. Whereas when I worked for the National Park, I was kind of told what not to expect, which was, don't expect a lot of fellow first responders on scene with the, you know, don't expect the weather to cooperate for ordering a helicopter. So you're really working in that like austere and rural environment, which initially was very daunting, but it's kind of a sink or swim environment. And I just, you know, kind of wrap my arms around the experience and I just said, Hey, for that first summer Old Faithful, I'm going to take every night page out call and you know, I was both attracted and terrified of working in that environment. But I came to love the challenges of it. And also like the autonomy of being able to kind of work down the whole protocol page because your transport times are a lot longer.

Yeah, you're you're out there on your own could be you covered the entire park when you're there?

I was mainly Yellowstone's about 2.2 million acres. And so I was mainly in like the old faithful area and then would go up towards like, you know, Madison campground, sort of the middle of the park and then down south towards like Grant Village. So I can be basically responding maybe an hour or two from Old Faithful, but then the closest hospital is about two and a half hours away in Rexburg, Idaho. So really, the longest transport times along with getting to the scene was getting to the hospital.

Yeah, that's pretty incredible. That's probably could be a little bit mentally taxing on you that all that pressure and then operating alone for such a long period of time at like, how did you handle that? I know you said you just kind of embraced it, because you really were forced to sounds lighter. But what were some of the key points that like you maybe could share with the audience about about that.

Sure. Well, one thing I appreciate about your podcast is just sort of that exploration of the inner experience of first responders, which I think until the last few years hadn't really been discussed. We were just sort of like, you know, the stoic first responders, but there is that whole inner life going on. And so I guess, you know, I tried to control what I could control. Like, when I mentor people and work as a paramedic preceptor, I'm like, the environment we're going into is chaotic and unpredictable. So if you can control what you can control, which is knowing your protocols, knowing where everything is on the ambulance equipment wise. And then, you know, there's different ways to kind of, for me to psych myself up for a call. And there's a really good podcast by a former pair rescue guy named Mike Laria. And he has this kind of mnemonic BEAT the stressful. So for B is like, BREATHE. You know, maybe it's a three second kind of like mini meditation. T is for like, positive self talk. So it's like, Hey, I got this, you know, I've practiced it many times. Maybe it's that innovation or that, you know, if you're trying to nail s, I can't. I'm on the spot right now. Yeah. Well, it's also, I may not do right, exactly the mnemonic, but another key element was like, visualizing success of that skill. So, you know, as you go into the call, I really like to assign roles. And I could, you know, if I was working with you, like, hey, Jerry, you're on airway. So then as you're going to the call, you're visualizing, and they've done studies where visualization is as good as actual practice, right? Yeah, and then another one is like a trigger word. So maybe right before you walk in that scene, it's like, hey, it's go time. So just kind of different things to get you ready. And so that worked a lot for me. And then, of course, I was working with, you know, sometimes I'd arrive on scene by myself, you know, driving the ambulance, and I'd meet Park Rangers, but they were great in sort of mentoring me and, you know, kind of teaching me about how the process works. And one thing I always like to do is, there's that idea, like two is one, and one is none, he could have always had a backup plan. So maybe you call that helicopter, but you're already thinking when the weather changes, we're going to do this, or maybe you're starting that IV, but you're thinking, hey, if I miss this, we're going to go right to the IO. So you're always thinking kind of two steps ahead.

Yeah, I really liked the breathing, you know, we coach patients on it so much about, you know, trying to get their breathing in line. And yet, as a first responder, we kind of skip that part of ourselves. Like, we can amp ourselves up on the way there or basically be doing this that you know, and the opposite of that of just like kind of just not breathing as fast as we need to breathe and just kind of maybe a lacking some of that confidence. It's I think, as a first responder, it's hard going into some of these calls. They have no idea what's going on, and to be confident that you're going to come to a resolution.

Sure, yeah. And another thing I really learned was, you know, when you show up on scene, you have a lot of things to do, and just how to triage treatment, like what I need to do right now versus, hey, we've got this hour transport, or hour and a half to the hospital. So like, what can I do in route? What do I have to do right now? And just that whole learning curve.

Yeah, yeah, for sure. If you have this super long transport, the amount of time that you're on scene is, I'm sure you want to be as short as possible. I mean, that's right. The ideal in every EMS world is there on same time to be short, give them to the definitive care.

Yeah, definitely. So I, I think urban and urban versus rural remote EMS, we all have our challenges. And so like the city guys, like yourself, you say you're up all night. And, you know, I just have so much respect for you guys running calls all night. You know, some of my friends are run 27 calls in a 24 hour period. We're in the park, we might only run three calls, but it's an hour to get there. You know, an hour and a half to the hospital an hour and a half back. So one call could take like three to four hours.

Yeah, yeah. And then how does that different from being where you're at in Jackson Hole working for the fire department there?

  
Well, we do have a small hospital here, which is staffed with amazing doctors who kind of want to live in the Teton area. It's not it's not like a stroke center level one or two trauma center or a cardiac facility. So luckily we have A hospital that's closer here and can maybe stabilize the patients. But then the closest level two Trauma Center is in Idaho Falls, which is about a two hour drive. So, you know, ideally, we can land the helicopter at the hospital or get that fixed wing flight at the airport. But I've been on a few transfers that night, you know, middle of a snowstorm where air isn't an option, and we're taking that patient having a heart attack over Teton Pass, which you mentioned. So yeah, it's kind of his white knuckle ride for sure.

But a long transport time on it with a critical patient.

Yeah. And then there, again, sort of that like mental visual rehearsal slash visualization, throughout the transport and thinking, hey, if this patient crashes here, I would call this agency or maybe we'd reroute. So I'm always thinking, what's, you know, if they crash, what would I do? You know,

Right, right. Right. I love always having those, those backup plans. You know, just the other night, we went on a call, where your, the patient seemed fine, and basically released them, they wanted to be released. And then two minutes later, they're in full cardiac arrest, you know, that plays out. Yeah, that plays out different, you know, the later in the night, you know, we're not, you know, 30 seconds away from the door, we're, you know, 10 minutes, or in the middle of a transport down the road, or with just one medic in the back, and you have a full rest. Yeah, always prepared and thinking of something's going to happen that I may not, you know, anticipate, but I have somewhat of a plan for all these, you know, things that may be kind of like funneling down this aisle of the chest pain or, or different types of calls like that, you have an extended amount of transport time where your mind is always got to be thinking, you find that a little bit draining?

It is, yeah. Because as you probably know, you know, with that stress response, you get that adrenaline surge, and then there's that exhaustion phase afterwards. So it can be draining, but I guess one thing I do is I have a little, little cash or backpack that has, you know, food and, you know, hopefully some healthy food like power bars or whatnot. Yeah, maybe some caffeine. There's this gum that I like that has caffeine in it, you know, keep you going when you need to sort of like boost up performance. Right,

Right. Yeah. Yeah, cuz I would imagine doing such a long transport with a critical patient is a little bit draining. And then that return drive home, we dumped all that adrenaline is probably a little bit hard to get home and stay mentally alert, especially in you know, some of the worst conditions of weather. 

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Yeah, definitely. And I guess I was talking to a friend the other day and we get into EMS when we're younger. And probably healthier. We can compensate more with that lack of sleep or we can use but as we get older, our you know, ability to compensate might get get less and then you start to see it and you know, like my blood pressure has kind of been rising. So I think it's good for people to know, hey, as you get older, you got to possibly like take care of yourself a little bit more. But on those transports, I guess one really cool thing about the National Park was whenever you come back in, you're driving back into a national park and I'd always see something that would like renew me maybe it was like the sunrise over the mountains or like some of the hot springs in Yellowstone are the bison and Dr. Will Smith. He's my medical director here and he lectures throughout the country and you know, internationally. He says he loves wilderness medicine because you're running these stressful calls, but you're also kind of getting renewed by the environment the same time. Yeah, so we're pretty lucky in that we kind of keep that connection to nature even as we're running these difficult calls.

Right and then you're live in some of the most beautiful and rugged area. I feel like in the in the country that I've been able to experience. You know, we travel up there once a year. And it's such a beautiful place both during like all the seasons up there. It has a different beauty to it.

Sure, yeah. And I know my friend nice Escape patroller here, they do like an exchange program. And, you know, I, I'd love to do some sort of exchange where like, the city folks could come out here for a week or two, and then we could maybe go into some of the urban areas and just get that repetitive call volume. And, you know, it'd be fun if we could kind of set up an exchange like that.

Yeah, yeah. I think each side would gain a more of appreciation for each other and what they do, definitely, 

Yeah, cuz, you know, a lot of this job is just seen something once. And then, like, once you've seen your first pulmonary embolism, or your first, you know, AAA, you can really spot it a lot faster. So here, you know, since we don't have the call volume, I think we're doing probably around 2000 calls a year. It might take us a while to see a lot of this stuff. Whereas in the city, you guys might even see it a few times. Every month or you know, yeah, every shift, you're getting something pretty crazy.

Yeah. And you're Yeah. And then the things that you're seeing are probably a little bit different sometimes then we're seeing in the wilderness type medicine, you know, or the ski ski resorts that surround you. You know, that is bringing a lot different kinds of traumas, you know, then we'll see here.

Definitely, we have sort of like the human wildlife. I've gone to like a motorcyclist who's hit a bison. There's been in my book, a car hit a pronghorn antelope, and then it flipped over the car hit a motorcyclist on the back. Who was driving behind the car. Wow. Yeah, we got called the other night to like, someone hit an elk. And the elk was still alive on top of the car. So just, you know, there's been various bear attacks. I haven't actually personally responded to one. But yeah, so yeah, that whole human wildlife element. And even in Yellowstone a few times you tried to land the helicopter, and there's a bison on the landing pad who just doesn't want to move? Or your one, my friend was doing a cardiac arrest and bison started walking towards them. So play the scene is not really safe at that time, like, what do you do? So those are all some of the fun challenges out here.

Right? Right. Bison, I feel like they have their a mind of their own and a drive of their own, they just in their own special world, no matter what's going on, they're living in their own special world. And if you want to, by the way, that those get out of the way when they want to.

Sure, yeah. And then as you mentioned, the ski resorts. And with COVID, we're seeing a lot of people venturing into the outdoors, which is awesome. But a lot more people going into the backcountry. And you know, it's pretty dangerous out there with, you know, the avalanche potential. And so you just want to make sure you take your avalanche safety classes and have the proper gear beacon shovel probe. And so there's a whole sort of ski snowmobile accident demographic that we get up here as well.

 
Right, with everybody seen as far as national parks growth, are you seeing more people venture out into the wilderness or, or into the park areas and exploring with probably being less prepared than they should?

Yeah, definitely, like visitations been exploding and all the national parks and the breaking all the records. So it's awesome that people are wanting to get out there. And I think during COVID, it just kind of brought the outdoors brought that sanity to people and they could maybe quarantine with their family while they camped or something like that. So. But, yeah, I think there is sort of a new demographic of people that aren't used to hiking and things can happen really fast. As far as weather changing, or so you really want to have the 10 Essentials of hiking, which people can find online or maybe put them up in the show notes. And yeah, again, kind of like an EMS call, just be prepared for anything. And right, maybe it's sunny, but have that, that rain gear with you. Because you know, the weather changes super fast in the mountains.

Yeah, I think that's what a lot of people experiences, they're going out in these places that they're not familiar with the weather. And how fast it change. You know, I I've traveled lots of different places in the country, and they're all say, Oh, the weather is so crazy here. And I'm like, yeah, that's how the weather is in Utah. You know, it's it's super crazy here too. But it's a different kind of like crazy weather that you just don't see the signs of, you know, and recognize that this is potentially going to be dangerous, or I'm way too far hiked out into the mountains to actually get back to someplace, you know, to where I'm camped or something like so what am I going to do?

Yeah, exactly. And the park service there really big on like preventative search and rescue now, and so like it the Grand Canyon to hike down towards the river. It's I think it's like a five mile hike downstairs, down these wooden steps or these rock steps. So people go there in the morning and it's all downhill and it's kind of cooler. But then at the base near the river by then it's probably midday and then five miles of straight uphill. So they've been posting Rangers at the trailhead, letting them know, Hey, it's 110 degrees down at the bottom and, you know, making sure they have enough water and electrolytes and everything. So prevention is the best medicine in this case. So we're trying to kind of I think they're doing at Yosemite just educating people at the trailhead. You know, if you're in a hot environment, yeah, heat exhaustion type of concerns. Whereas in other areas, maybe it's more hypothermic or maybe lightning here in the Tetons kind of comes in most afternoons. So that type education definitely helps out.

Yeah, you need to educate yourself before before you just go out and explore. Because I would imagine it's super hard for the park service to put on a full blown, you know, search or rescue operation and maintain any other services that they're doing within the park.

Yeah, exactly. Most park rangers have like multiple multitude of hats. So maybe they're an Interpretation Ranger, but they also do search and rescue or maybe they're a law enforcement, and they do EMS and search and rescue. So when a search and rescue drops, it's pulling from a lot of different areas. And then, you know, Old Faithful, they get probably 12 to 15,000 visitors every day. So every 90 minutes when the geyser goes off, there's like 3,000 people, you know, so there's that slowly accidents happening at once. But yeah, like you say it can definitely drain the resources.

Right. Let's talk a little bit about your your books and and how you came about writing those pick, you can you can pick which one you want to talk about first.

Sure, I guess well probably talk about my it's actually my second book, but it's my first book on EMS, which is called Lights and Sirens. And that's about going through paramedic school. And I think, you know, there's been a lot of physician writers that have talked about their experience and EMS hadn't been as well profiled in writing, although there's some definitely great books out there like Peter Cannon wrote one and about the time Lights and Sirens came out Kevin hazard wrote one called A Thousand Naked Strangers. So I think for me, the inspiration came from, like, the amazing experience of paramedic school that I wanted to share with people, just like that bonding of your classmates. And it was the most stressful year, but it's also like the funnest, you know, and just studying together and, you know, having beers after we pass the test or something like that. So I wanted to sort of share that inspiration, but also like educate the general public about how much we learn and how stressful it is. So that was lights and sirens. And then it kind of ended. It ended right as I got hired at Yellowstone. And then with that, I hadn't really thought of writing about the national parks. But then I realized, you know, the Rural and Remote EMS hadn't really been written about, and it was kind of increasing in popularity. And an interesting thing is, we have wilderness medicine, but we're also seeing like, elements of wilderness medicine in the cities. So like, when Katrina comes in, or some of these hurricanes, it's like, the city's a wilderness, you know, there's no power and there's no electricity, or he. So it's even, you know, applies to cities at certain times. Right. But again, I want to sort of share that amazing experience. And then each book, I'm sort of, I'm not really the hero, I'm more of a student. So I'm learning about maybe paramedic school in the first book and then Wilderness EMS on the second book and so as I learn from the other characters in the book, the reader kind of learns in turn. Yeah.

I wanted to go back to the you know, the, the Lights and Sirens, you know about paramedic school and stuff like that. It is one of the most difficult times in and stressful times for a person in EMS to go through and it's there's so many variations of paramedic school now. There's, you know, different such a huge demand for paramedics. You know, there's the year class and nine month class So night time class that daytime class, like, so many different classes, and it's comes with a ton of stress, some of these guys are off, pulled off shift and just go into class, which is great. And I highly, highly recommend, that's the best way to go. But a lot of these other versions of these classes, these people are going to class on top of working their shifts, ran trying to maintain for most, most of them a family life. How in that book, do you talk about that type of those dynamics?

I do mention them. I didn't have a family at the time. So I guess I was sort of, you know, lucky in that regard due to the less demands on my time. But yeah, one of my classmates, he had like six kids, and he was driving, I think, an hour and a half to class every day to and from and some of the fire guys from Santa Monica, they that was their only job. But like you mentioned, here, Jacksonville fire fire paramedics go to Weber State and Utah. And they've had to work full time, you know, their normal shifts and go to paramedic school and drive down to Utah, and I think just recently learned that that's, and they have families that it's probably too much, you know, maybe give them a few ships off. So yeah, that, like you say, the demands are definitely tough. And then there's the stress of the internship and the stress of all the calls. And yeah, it's it's definitely a busy time.

Yeah, it's hard to be at your best, when you're tired. We kind of talked about this before we started the podcast, you know, it's just, when you get tired, you're just your cognitive recall. It's just not as fast. Totally. And, you know, I really feel for somebody that's driving an hour and a half both ways, and trying to figure out a way to study I'm sure as they're, you know, driving down the road, like, how can I study and make use of this time, as I'm driving down the road? And how do I show up and be prepared for my family when I get home, because I'm only going to be able to talk to them for just a short period of time, because I gotta go right back into studying.

Yeah, those are all definitely like, good points to bring up. And I think podcasts obviously helps with the studying, you know, a lot of great EMS podcasts now. And but then you mentioned that transition to which we all make from like, work to home life, you know, and so you don't necessarily want to bring your work self into the house. And then you may not want to bring yourself at home into the workplace, you know, yeah. But, you know, you being aware of that transition, you can sort of plan for it. And what me and some of my co workers do is we we do for 48 hour shifts here. And then we'll do like a short hike after shift or we'll, you know, skin up a mountain and ski down. And that helps that transition just to kind of work where it is. But I know sometimes I've gone to work where I'm probably in my like fight or flight response, or that adrenaline. And I'll come into the house and still be in that mode. And it's not really the best my best self it just No, no more reactive than responding, I guess.

Yeah, yeah. I think just as first responders, you know, making that transition, and learning how to be aware of it can make or break our relationships with our spouses and children and other other family members. It just as some people probably make that transition a little bit easier. And others, it's always a difficult transition for me to make sure you know of coming home, I live just 10 minutes away from from work. So, you know, I don't have a lot of time to like, maybe decompress as much as I should. So that's, that's, that's a super huge key I think in in this first responder world is learning how to make the different types of transitions of you know, coming home or going to work.

Sure. Do you have any tricks of the trade that you do? I mean, one, one thing, I used to wear my uniform home and then wear it from home to work, but based on sort of when COVID head I started just leaving the uniform at work, and I find that helps, you know, just taken off the uniform at work and I'm already on my street clothes. But do you have any suggestions that kind of work for you or?

Yeah, that is one of them. I actually so I wear my street clothes to and to and from work now. A big one for us is we have an app on our phone called ISpy and it alerts us every every quarter

In the city, but you have to manually turn that off on your days off. And so where I do fire investigations and stuff for the SWAT team and different hats for the fire department, I would always leave it on. And just, you know, all day long notification after notification after notification. And I think that just raises your stress on a level that you really don't realize, by getting all those notification. It's probably just like, somebody's getting constantly getting bombarded with work emails, you know, there's that too. But it's just trying to separate yourself from work as much as possible. Sometimes I'll just sit in my truck, and just Yeah, and listen to the radio for a little bit and just try to consciously be aware of making that transition. My wife knows she, I walk in the door, and if she's up, like she looks at my face, and she can tell like, how I slept? If I've been up on call. Sure. And how much engagement does she want to make in the morning, knowing that I'm, I'm tired. And I think that helps on their part, you know, the, I think as you know, a spouse of a first responder, you got to realize, you know, things happen throughout the shift that they are trying to still process when they're coming home. So for them to be right. Totally turned on into family mode, when you get home. Might be a little bit too much to expect.

Sure, yeah. And then, I guess if I when I do a 48 hour shift, don't want I've been gone for two days. So I want to get home, but maybe just taking that extra hour after shift to Yeah, trail run or like, if you're in California, go for surf, because then when you're home, you're more present versus like, like you say to still dealing with some stuff.

Yeah, yeah. I mean, ideally, I would just love to go to work and go to the gym. But like, traffic in our town is insane. And so is a gym at that morning. So I think that would just be a worse option for me. Yeah, totally be amped up for the gym. But then you get to the gym. And there's like zero equipment to be had. Because it's like everybody does that time a morning. Yeah. So we do the four. Yeah, but 96 shifts as well.

Yeah. And then I think you get better at making the shift. So you know, you're probably awesome and doing it in 10 minutes. And you develop that skill. Yeah,

yeah. It's something you just have to consciously practice. Let's dive down into your book, the Wild Rescues.

Sure, yeah. And that that book is about working for the National Park Service at Yellowstone, Yosemite and Grand Teton. And that came out last year. So it's almost been out a year. And just kind of all the crazy calls that I ran, and everything I learned kind of making that switch from working in urban EMS to wilderness medicine.

And those are some of the most huge boat some of those most amazing parts of the country has.

Right, definitely. And then we do where we kind of have the all hazards model out here. And so you know, we do structure fire, and we do tactical EMS, and wildland fire. So those are those are also in the book. It's not specifically just paramedic, but it's kind of me learning all these different, you know, different hats of a first responder, and they're all super exciting. And it takes a lot of training to stay competent in them. Right, right. So, but yeah, and then again, I just wanted to share that great experience. And I love the National Park Service and share my love of the outdoors and medicine. And you know, hopefully people will have a new appreciation for the outdoors and wilderness medicine, but I'll also I hope they learn things that they can take into their own patient care whether they work in a city or somewhere else.

Yeah, who would your ideal reader be for that book?

Ideal is probably, I guess there's two different ideals. One is someone within the first responder community who loves the outdoors. They could be law enforcement, EMS fire, you know, because they seem to enjoy it because it is just all these crazy calls, like bison attacks, you know, bear attacks, and just everything outdoors, you know, search and rescues. But then also a lot of readers are just from the general public who aren't in the profession and just had no, no idea that this these kinds of rescues went on and they had no idea that there's EMS, you know, it makes sense once you realize it, but it just kind of opening their eyes up to this whole new world.

Right? I think sometimes when people call 911 They're expecting a certain type of response and a certain timely response? And that's not what you're getting in, you know, in these national parks for sure.

Yeah, and I guess you just come to expect the craziness. You know, like, Dr. Will Smith, he's my medical director. I mean, they had a lightning strike with 11 patients up on the Grand Teton. So just stuff you couldn't really make up happens.

 
Yeah. Yeah, that's pretty interesting, you know, that you're describing like, you know, a motorcycle, or a car hit, what was it? The car had something on

 Yeah, the car had the elk. And then the elk was on on the hood. Just still alive, which, you know, and then the people in the car like, didn't, because it wasn't really safe to get out, because it's kind of thrashing around and, you know, cars into the river. So there's that whole kind of rope rescue element that we have out here. They do a lot of like scenic floats on the Snake River here. So, you know, there's kind of swift water rescues, and pretty much everything you can think of out here.

How how do you stay proficient in so many disciplines?

Yeah, that's a great question. Basically, training. What I learned on my EMT class, which I took down there in Utah was when we finished class, he said, the moment you leave classes when you start forgetting the information. So I've always remember that, that I'm constantly in a state of forgetting stuff, so that I have to constantly remind myself to study and stay proficient. So I know, training can be hard on shift, just because you're busy running calls, but my, my current shift, we have this, instead of doing like one four hour training, we just do these quick little half an hour, you know, maybe it's just like a quick MCI triage training. Or maybe we do a quick, you know, drafting from a static water source, just one out elution, and then kind of move on to the next thing. And we like to do a day one around nine. So I guess, finding out what works for yourself and the department. But yeah, you just got to always keep training, because we don't use the skills a lot. But when we need them, it's like we need them now.

Right? Right. Yeah. So I think probably a lot of people listening or find themselves in the same situation as you is you and I do, we do a lot of the exact same things. You're just trying to wear so many hats, and be batting 1,000% You know, when you go up to when it's your turn call to you know, to lead the team or whatever. And it's, it's hard to be that all the time within every single discipline. I think for me, sometimes it's just like, we have people that special lies in these different areas. And sometimes it's as a leader, it's great to look to them and like, Hey, you are the specialist in this just because I may be your captain or chief or whatever. Like you're the specialist, I'm going to look to you to help you know, affect this rescue in the most safest manner type of thing.

Yeah, I love that. It's like great leadership doesn't mean great leadership can delegate. And, you know, sort of maybe take that like tactical timeout and yeah, like you say, have that humility to know like, hey, this person's the expert, and Yeah, cuz the collectively, that's kind of how it is that our department like, one guy loves wildland fires, someone else loves hazmat. I love EMS, you know, so we all have our specialties. And yeah, on a certain call, just delegate, maybe that person, you know, make make the calls. So

yeah, I think our departments and I would imagine probably most departments probably like try to sprinkle those type of people in each of their, each of their crews. Like we have guys who love wildland too, and you know, the travel country doing, you know, wildland fires and stuff. And so they're great to have when I incident breaks out that's, you know, shoot, I don't have to be in command, you can be in command, you do this, you travel around the country doing it like and you're amazing at it. So why would I take that from you?

 
Yeah, and I guess, knowing ourselves to know when to maybe give up that leadership. And what I say is like, some calls on fine being a leader, but for instance, like a hazardous material call. I'm fine being like a follower on that call. Yeah, yeah. be told, where's my captain? He loves hazmat. It's just, it's his passion. He loves chemistry and all that. So I know for my call together, you know, he's the leader and I'm kind of following his direction. Whereas I teach pediatric advanced life support and we had, you know, a nine month old allergic reaction. And so they're like, Hey, this is your call. And that's kind of my wheelhouse that I'm comfortable with. And so yeah, it's, it's a great way to work for sure.

Yeah. And it's great for you to take that pediatric call and help run the call doesn't mean you have to do everything right, you can delegate to your other crew members to you know, to do different things for you. It's just kind of being the lead of that call. You don't have to actually physically, I think sometimes we get caught up with like, we've had to physically put our hands on everything. Like now that's, that's not really going to work, right.

Yeah, definitely. One thing I have, like, when I'm teaching, you know, new people in our department, I feel like every call has momentum. And if I'm running the call and say hold C spine, it just like the momentum of a call just stopped, because now I'm engaged in this one skill. Yeah. Or maybe you started assessing, but it's leading towards transport, you know, get the gurney going. Just, you probably like, you know, it's like, there's that momentum, we feel it when it dies on a certain scene. Right, right. You know, I'm always trying to keep that flow going.

Yeah, the there is a silence I think that comes over everybody. And then like, oh, okay, good. Someone's forgot to pick this up and, and run with it.

Yeah. Okay, the senior providers who, like they're like, just great. They're almost like conductors of the call. Yeah, John Politesse. He's worked here in Grand Teton. And he does a lot of great leadership conferences, seeing him run a call is just like, this grand conductor of just orchestrating everything, like the providers connected with the patient, but also like the public, you know, because how to handle them if they're going crazy on scene. Right. Right. So yeah, it's picking, picking mentors, I think is very important. Yeah, you know, picking the right ones. So

Yeah, I'm gonna have to steal that from you about the conductor, because we have some great conductors in the first responder world, and they sometimes probably don't recognize for all the, you know, elements of their, their production that they're, they're doing. So like you said, you know, they're not only handling the call of the patient, but the public also gets involved in trying to handle them. And there's just so many different aspects. When someone's just calm, cool, and collected, conducting it, it just seems to go so much smoother. Right? Definitely. This is going to air really soon. And before a lot of people get out into the wilderness for spring break. But spend the like the next five minutes just kind of maybe preparing a family for what you know, going out into the wilderness on spring break what they should be prepared for. Sure, we talked about some of that, but we can get maybe more a little bit more into the details.

Yeah, I think having the 10 Essentials, you know, which is like some kind of illumination like a flashlight, and you know, sunscreen, sunglasses, extra food, people are always kind of like chronically dehydrated, as you probably know, an EMS and you know, there's not like water fountains as you hike. So like, definitely bring more water than you think. And then bring like proper clothing, footwear and that type of thing. So you can look up on like REI's website or you know, some of the outdoor stores like what the 10 Essentials are and then study up on where you're going. The weather, and you know, if it's hot, just be thinking of some of those heat related emergencies, if it's cold or unpredictable, maybe some that lightning and that type of thing. A really huge one is, you know, even a day hike, you can put your itinerary in just on your dashboard, and just write itinerary on it. And then if you ever go out missing, you know, search and rescue law enforcement, they'll start with your car. Yeah, that seems like a lot of lives over the years. And you know, people wondering, Oh, someone gonna like break into my car. Because it says itinerary. Yeah, I've worked for the park service, like many years, and we've never really had that break in. So that's a huge thing, you know, have a plan and let people know, you know, like, I'll tell family and then I'll leave that itinerary in the dashboard. Yeah. And then I guess, you know, it's if you can stay healthy and hydrated. Because then if you're at altitude, your body is able to compensate better for the altitude, but if you're dehydrated, and you know, you're out of shape, and you're hiking more than you normally do, then the effects of the altitude and that thing's going to kind of hit you harder.

Right? I think people forget of kind of a couple things that you touched on is one you may start out your hike in the morning, really cold, and then it being really hot and then back to Being really cold again. So, you know, wearing different layers of clothing is very essential.

Yeah, and then I guess those spot devices, those have saved a lot of lives, you know, like the Garmin in Reach. And now we have one, it's only like $12 a month. You know, you only want to activate it on a true emergency. But those are definitely helpful because people rely on their cell phones a lot. And you know, your battery's gonna probably die if it's cold, and you most likely won't have service out there.

Right? And then you talked about altitude Do you see a lot of altitude sickness because I feel like a lot of people come to the national parks that may be coming from a lot lower elevation. 

 
Ahm we're probably like, you know, here and all faithful between like 6 and 7000. So we're not seeing like the high altitude pulmonary edema or the high altitude cerebral edema that you'd see, you know, probably like above 10, or 12,000. But the altitude affects them. So they're like pre existing conditions get exacerbated. So that's the main way we see it, there's that increased like workload on the heart or the respiratory system from being 7000 feet. So it's more those their existing medical problems tend to get inflamed if you will.

Yeah. Yeah. I mean, it's great also to have like a basic first aid kit when you're out in in the wilderness. And maybe right yeah, and maybe just you know, your maybe like Well, one day extra supply of your you know, as possible right, the meds that you're that you're on, because you just never know if you're gonna get stuck out there. People sprained their ankle broke their leg or, you know, been out there an extended period of time without their medication. And that just exacerbates that problem.

Right? Yeah, I guess in the 10 Essential, I forgot to mention the most important the first aid kit. So thanks for reminding me. But yeah, with that, I don't get too crazy. I just bring stuff to like, stop the bleed, or a bleed, and then aspirins really great. You know, cuz, either if your party gets chest pain, or if you see someone else out there, so, you know, blister kit type stuff, it doesn't have to be like a huge Basic Life Support bag and right and you're hearing all this way, but just definitely like a carry a tourniquet and, you know, some gauze and whatnot.

Yeah, they're getting those kits really, like come compressed now that you can get them in, you know, something that just, what is it probably eight by four and four inches thick, you know, and you can pack a lot into one of those little packs and just wear it on your belt or, you know, loop it to your backpack.

Sure, yeah, definitely. Um, so that's what I would tell, you know, families who are venturing in the outdoors. And I think that's yeah, pretty good advice, just kind of the 10 Essentials and definitely that first aid kit and leave that itinerary and know the weather of where you're going.

Yeah, yeah, like that. Kevin, before we in the podcast today, where can people find you?

Sure. I'm here in Jackson Hole. And quite a lot of readers come through here and Miles say hey, swing by the fire station. And if I'm working I can give them a tour and I try to get them like a Jacksonville fire EMS t shirt, you know, maybe trade T shirts. So I can be found in this area and then also in the bookstore. So Lights and Sirens about is about paramedic school and wild rescues is about working as National Park paramedic. So yeah,

You know, what about on social media, you're on social media you're on so right there somewhere. Yeah,

Yeah, I'm on Instagram, @kevin.m.grange and then Facebook. And then I have a website as well. So the website has my email. And I do get a lot of emails about people who are interested in working for the park service. So I have a document that I send them, because you know, many people have the same question. So yeah, get them started reading. It's like yeah, the first responder family. So I love meeting fellow first responders. And so yeah, definitely reach out to me if you're in the area if you have questions.

Yeah. Yeah, I will definitely reach out next time. I'm up there. Last time. I was up there in Jackson Hole in October because the fall is just incredibly beautiful up there to watch the leaves change. I'm sure there's a huge influx of tourism at that same time, I met another first responder there that were had retired and he was going through traveling, you know, through that area as well. So it was really cool just to meet up with another first responder and chat.

Yeah, definitely. So yeah, look forward to seeing you hopefully this summer if you can get out here. 

Yeah, yeah, fight the crowds right. 

For sure, well you get on. If you can, like get up early, then you know the crowds are kind of mainly there between like 11 and two or three. So, yeah, get up early and you know, can beat the crowds for sure.

  
There you go. There's a pro tip from Kevin, on how to be. Definitely. Alright. Thank you so much for being on today.

Yeah, thank you. I had a great time and stay safe out there.

Yeah, I appreciate that you as well. Thank you so much for listening today. If you found value in this podcast today, please tag me in your Instagram Stories. That is the only way this podcast grows organically is through things like that, the ratings and the reviews and tagged me in different things and I will also do my best to reshare anything that you post and tag me in. Also, if you're looking for a little extra help, trying to find some right answers and some difficult times in your life, please reach out to me enduring the batch podcast, there's a place you can leave a message for me and I will get back to you as soon as possible for some one on one coaching.

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