Beth Phillips, M.D., Takes Emergency Medicine Into The Wilds

When Beth Phillips isn't showing new residents the ropes as an attending physician in the UAB Emergency Department, you might find her zip lining through the trees of Costa Rica. If she isn't busy helping an accident victim hands-on during shifts at Baptist Hospital in Montgomery, she could be rapelling down cliffs, diving in costal waters, or hiking through the deep woods of a national forest.

Or, you might find her teaching other health professionals how to cope when the nearest ER is miles away and the only medical equipment at hand is duct tape. For the past several years, Phillips has been teaching Advanced Wilderness Life Support and Dive Rescue classes to health professionals, military medics and others who might be called on for help in remote emergencies.

"Whether you're out hiking with friends, or, working with scouts, people may be depending on you as a health professional to step in if there's an injury or illness. It can be so frustrating to have the skills to help, but be in a situation where you don't have the tools you need. In these classes, I show people how to improvise using what is at hand," Phillips said.

Originally from Opelika, Phillips became interested in emergency medicine when she was an EMS volunteer for the local fire department during college at Suwanee.

"It was something of a 'Hello' moment," she said. "I'd always wanted to be a doctor. Emergency medicine was still a relatively new specialty then, and I decided I wanted an opportunity to train in it."

Her volunteer EMS work also led her to take a mountain rescue and repel course in the Cumberland Mountains of Tennessee, which inspired a continuing interest in wilderness medicine.

Following medical school, two tours with the Navy took her to sea as a ship's doctor. She was one of three women on the USS Essex out of San Diego, then she served in the Mediterranean on the 6th Fleet flag ship, the USS La Salle.

Returning to civilian life in Alabama, she joined the Emergency Medicine Department at UAB. "We see things you don't often see in most ERs —transplant patients who may be having issues, or unusual conditions," she said. "It's a complete change of pace when I do community medicine in the ER at Baptist Montomgery. I like the variety--pediatric patients, traffic accidents, sniffles, shooting—you never know what's next."

Over the past few years, Phillips has taught several Advanced Wilderness Life Support Classes, some sponsored by UAB and some for private groups.

"In a hospital, when an emergency comes in, your first instinct is to respond. You're focused on the patient—assessing his condition and beginning treatment. In the wilderness, you have to learn to hold that instinct in check," she said. "Out there, the most important rule is to first assess the situation. Never let yourself or someone else become a second victim. People are depending on you."

The next challenge is figuring out how to help with what you have.

"You may have to stabilize a fracture or a C-spine, or irrigate or close a wound without a suture kit," Phillips said. "That's where being able to improvise other uses for what you have comes in. Duct tape can splint an ankle or even close a wound. Branches can brace an injured leg. Clean socks can help you hold pressure on a bleeding wound."

What's in Phillips's own pack? A small basic first aid kit includes antibiotic ointment and moleskin for blisters. A compass with a reflective back, a whistle, and a mobile phone make it easier to get help. A light, folding "space blanket" can help prevent hypothermia.

"And always, always take duct tape, safety pins, an extra pair of clean socks, and a knife sharp enough to shape what you have into what you need," Phillips said. "You never know when you're going to have to cut a backpack into a litter to get someone to where help can reach you."

Her wilderness medicine students have lately included both civilian health professionals and military medics.

"They learn a lot from each other. The civilians like to hear about their approach to combat medicine, and the military medics are sometimes surprised when they find themselves in a wilderness environment where their tactical skills may not apply. They have to think outside of the box and learn to respond to different types of situations without their usual equipment."

After her latest round of classes and most recent adventure vacation, Phillips is back in the ER. She never knows what will be coming through the doors next—but that's what makes it interesting.