Backpacker Magazine – October 1998

Wilderness First-Aid Courses

Take an advanced wilderness first-aid course and you'll never have to say "I didn't know what to do" to the next-of-kin.

by: Dennis Lewon

Tags:
• Health & first aid
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• Skills
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When you start looking for a good school you soon discover that the field of wilderness medicine is fairly broad. In fact, it's grown tremendously over the last 20 years. Advances in knowledge, treatment, and instruction have been steady, but so have the number of ill-equipped schools. The problem, says Vanderwege, is a lack of standards and accreditation. "No government agency has stepped in and created a standard for wilderness medicine programs or instructors. There are large schools and small schools offering high-quality instruction, but it's still a 'buyer beware' market."

That's why you should consider SOLO, the Wilderness Medicine Institute, or Wilderness Medical Associates. These are the three largest, most widely respected schools, and when you consider their well-deserved reputations, it's safe to assume you won't go wrong if you choose any one of them.

But what if you can't journey to where these three schools are based? What if you need a course closer to home? As Vanderwege says, buyer beware. A little investigating will go a long way toward ensuring you enroll in the right class.

For instance, ask about the school's history. Who founded it and why? What's the school's philosophy about dealing with the injured? If they offer hands-on practice for a variety of injuries, that's good; if they merely provide "Band-Aid" advice designed to make the wounded comfortable as you wait for medical personnel to arrive, then pass.

How long has the school been in business? Avoid fly-by-nights. If the institution has been around a while, it means the school turns out happy, well-trained graduates and hasn't been shut down by lawsuits. Is the curriculum reviewed by a board of advisors that includes licensed physicians? Can you get recertified there, or must you go to another school in a distant state? How many recertification courses does it offer each year? If only one or two, that means to stay certified you have to work around the school's schedule. What's the wilderness and medical experience of the instructors? If they are certified paramedics, that's a good starting point. Those teaching the classes should also have plenty of on-the-trail backcountry experience and know about the conditions and complications that can arise when hikers are deep in the boonies.

After picking a school, the next step is determining the level of training that's right for you. There are generally four types of courses available, though the number of hours and course curriculum may differ slightly from school to school. Costs can vary dramatically, depending on where the course is offered. Price has no relation to quality of instruction, by the way.

• Wilderness First-Aid: 16 hours (two days); $100 to $200. This is the standard introduction to backcountry medicine: patient assessment, trauma, environmental concerns, some wilderness rescue, and equipment improvisation. "You get the concepts, but not much practice time," says Forgey. This one's a must for anyone who goes into the woods-even dayhikers. Backpackers who go on extended trips or are responsible for groups-church, Scout, or hiking clubs, for example-should add one of the longer courses, Forgey says. You'll learn, among other things, how to clean and close wounds (something "frontcountry" EMTs aren't taught), straighten fractures, reduce dislocations, tape ankles, improvise splints, monitor vital signs, head-off environmental illnesses like hypothermia and heat stroke, and deal with such backcountry threats as snakes, insects, and allergic reactions. You'll also learn how and when to evacuate an injured person. Generally, advanced skills fall under the following three headings:
• Advanced Wilderness First-Aid: 36 hours (four days); $200 to $400. This course builds on the WFA class, with more time spent practicing. You'll be involved in plenty of hands-on scenarios (lots of fake blood and makeup) that help you put the instruction to practical use.
• Wilderness First Responder: 80 hours (10 days); $400 to $750. This one addresses patient assessment and treatment skills in much greater detail. More time is devoted to simulations and organizing/leading rescues. The WFR course is the standard certification required for wilderness guides and outdoor leaders who work for organizations such as the National Outdoor Leadership School and Outward Bound.
• Wilderness EMT: 180 hours (about three to four weeks); $1,500 to $1,800. Instruction is aimed at rescue-team members, backcountry rangers, and medical professionals who work in remote settings. Approved programs have met U.S. Department of Transportation requirements for an EMT license. The next step would be medical school.

Regardless of which type of training you take, there's one highly important thing everyone learns, according to Melissa Gray, director of operations for the Wilderness Medicine Institute in Pitkin, Colorado: how to avoid becoming a victim of what she calls the most unfortunate of backcountry situations. "I've been at hundreds of rescues, and the most tragic ones are always those where loved ones are standing there saying, 'I didn't know what to do...I wish I'd known what to do.'"

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