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Wilderness Drum > Wilderness Schools > Medicine | |||||||||
— Renee Soule It goes without saying that everyone in the wilderness should know wilderness first aid. There is still a lack of standardization among the various providers of training in prehospital wilderness emergency medicine, but, as a general rule, there are four levels of training and certification.
Many wilderness organizations and employers routinely require that their wilderness leaders have a WFR certification. Wilderness emergency medicine, as a subspecialty of prehospital emergency medicine, has been evolving in this country since the 1970s. It had become clear that standard first aid and safety programs, such as those administered by the American Red Cross and National Safety Council, filled a specific need in urban environments, but could not be easily imported into the wilderness, for several reasons. The urban programs were premised on the availability of rapid transport to primary care centers – the "scoop and go" approach; and they were based on the sorts of illness and trauma, primarily heart attacks and auto accidents, found in the urban environment. The problem was one of defining the field of wilderness emergency medicine and of setting certification standards that would be acceptable to outdoor organizations. Over the years, three schools emerged as setting the de facto industry standards – SOLO, Wilderness Medical Associates (WMA), and Wilderness Medicine Institute (WMI). Although their programs differed, their certifications were universally recognized. Additional schools also offered certifications of all sorts, without standardization or quality control. At the 1994 Wilderness Risk Managers Conference in Conway, Washington, it was agreed that the Big Three would join with a neutral representative, later decided to be a delegate from the Wilderness Medical Society, to work out standardized curricula for wilderness emergency medicine, beginning with the Wilderness First Responder certification. Eventually, after a lot of politics, attempting to balance the interests of the Big Three, the smaller and younger providers, and WMS itself, the WFR standardization project was turned over to a subcommittee of WMS, the Prehospital Emergency Training Standards and Accreditation Committee (PETSAC). Early on, WMS had developed a needs assessment questionnaire to identify areas of importance in prehospital wilderness emergency care. These included hazards of environmental exposure, cold and head injury, altitude illness, dive medicine, trauma, white-water injury, search and rescue, resuscitation, survival techniques, hazardous marine life, mammalian bites, venomous bites and stings, infectious diseases associated with travel, medical fitness for wilderness sports, nutrition for wilderness activities, and expedition medical planning. These features have served as the basis for the WMS’s recommended minimum course topics for Wilderness First Responder certification. In addition to this now more-or-less standardized WFR curriculum, the National Association of EMS Physicians (NAEMSP) has placed online a number of position papers offering clinical guidelines for delayed or prolonged transport, dealing with cases of cardiorespiratory arrest and wounds; an additional position paper on dislocations has not been made available online. Similarly, the Wilderness Emergency Services Institute (WEMSI) has made available online portions of its WEMT lesson plans. Featured School
Stonehearth Open Learning Opportunities – known almost universally as SOLO – was founded in 1976 to teach wilderness and emergency medicine. SOLO offers an educational, research, and conference center to both the international outdoor rescue and emergency medical communities as well as the local rural communities of New England. Its headquarters in Conway, New Hampshire, is just minutes from 770,000 acres of the White Mountain National Forest. SOLO has instructed more than 75,000 individuals, guides, mountain rescue teams, and staffs from organizations such as NOLS, Outward Bound, the Appalachian Mountain Club, Nantahala Outdoor Center, The Sierra Club, and the National Park Service, as well as fire, rescue and ambulance services. Many students return regularly to refresh first aid skills, research new field developments, and exchange ideas and experiences with fellow outdoor and emergency care professionals. SOLO is staffed by a small group of dedicated outdoors people who are currently involved in wilderness activities and expeditions and whose qualifications range from WEMT to physician. All of SOLO's staff are active healthcare providers involved on mountain rescue teams, fire departments, and ski patrols. SOLO instructors teach from a hands-on, long-term, prehospital level of experience with currently accepted techniques and procedures constantly under review by physicians and emergency care professionals serving SOLO in advisory capacities. Combining the theoretical with the experiential, SOLO wilderness and emergency medicine courses are designed to teach the skills and knowledge for a safe, successful rescue operation or outdoor venture. Regardless of the course, the emphasis is always on awareness, prevention, and the environment with lots of hands-on practice. Courses offered range from a two-day Wilderness First Aid Course through a month-long WEMT program. SOLO also offers courses in marine medicine, travel medicine care, and rescue skills; courses in wilderness arts such as kayak building and and in outdoor leadership are also available. All courses offer nationally recognized certifications, and many are approved for continuing education credits. Wilderness Medicine Schools
PROGRAM: Wilderness EMT, Wilderness First Responder, Wilderness First Aid, Wilderness Medicine Workshop, Wilderness Rescue
PROGRAM: WEMT and WEMT transition for EMT and FR, Wilderness First Responder, Wilderness EMT refresher courses Professional Training
WEMSI provides training in wilderness medicine for two categories of persons – those who already have EMT training or better as well as basic wilderness search and rescue (SAR) certification or the equivalent; and licensed physicians who are both qualified and experienced in providing medical direction to prehospital personnel. It offers its Wilderness EMT and Wilderness Command Physician classes in western Pennsylvania and nearby areas. Organizations offering Wilderness EMT or Wilderness Command Physician classes that follow the WEMSI curriculum, and meet quality-control requirements, may register their classes with WEMSI. WEMSI also is involved in a curriculum project, with the goal of producing teaching materials and a textbook to be used to instruct persons who are currently certified prehospital personnel in providing an appropriate level of medical care in the wilderness. Additional Schools In response to requests from members and their colleagues, the Wilderness Medical Society assembled a listing of providers of wilderness prehospital training. The listing below is of those schools, apart from the Big Three, that informed the WMS of their operation. The listing does not represent an endorsement by the Wilderness Medical Society, or by me, for that matter. The list does not pretend to be exhaustive. American Alpine Institute Center For Emergency Medicine of Western Pennsylvania First Lead Wilderness Emergency Training William N. Moss Mountain Medicine Education National Safety Council Wilderness Trauma Life Support Wilderness First Aid Custom Training Services Wilderness Medicine Training Center | |||||||||
      
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Perhaps if we had the wings of an eagle, or the body of a juicy peristaltic worm, or the swift sure-footedness of a jungle panther, then meaning would merge with experience. These papery symbols would be unnecessary. But we do not. We have language and our imaginations. We live in a self-created world of symbols and interpretations. If accurate, they blend gracefully with the rhythms and fluctuations of the larger ecosystems from which they emerge. If inaccurate, this inaccuracy cascades down into the sea of troubles we are currently experiencing as ecological crises and cultural autism in our relationship to nature.
Wilderness First Aid (WFA) is generally a weekend course with about 20 hours of instruction, demonstration, and practice in basic life support and basic wilderness emergencies. 
The following are the remaining two of the Big Three. The only reason they are not featured is because of my own lack of extensive personal experience with them. All of the Big Three have excellent reputations, teach similar curricula, and tend to serve different geographic areas. All three focus primarily on teaching wilderness emergency care to non-medical personnel, although they all offer, on an occasional basis, EMT-to-WEMT upgrades. They also frequently teach courses away from their own campus, so a check of their schedules may show a course being offered near you.
