In September 2020, I travelled to Ogden, Utah to take a Wilderness First Responder (WFR) course through NOLS. NOLS says the course "is the industry standard for professional guides, trip leaders, search and rescue team members, outdoor recreationists, and international travelers." Following the completion of the course, I earned the certifications: Wilderness First Responder, Adult, and Child CPR & Airway Management, and Epinephrine Auto-injector.

​

This course was incredibly informative and thorough in teaching my classmates and me the vast type of care we may need to provide to ourselves and others in the backcountry. This included the common injuries we will most likely come across, like sprained ankles, blisters, minor burns and wounds, and some more minor abdominal issues. We also covered medical conditions and emergencies like MI, diabetes, asthma, epilepsy, and other preexisting conditions that can be exasperated by or occur in the backcountry. We spent a lot of time learning about environmental factors- both the problems that can be caused by the environment (hypothermia, frostbite, nonfreezing cold injury, heatstroke, heat exhaustion, acute mountain sickness, HAPE, HACE, and more), and how the environment can complicate unrelated problems (such as how an unplanned stay overnight, like after a broken leg occurs or after someone gets lost, can turn dangerous if you are caught in the rain and/or cold without shelter, or how terrain and condition can affect your evacuation options). We also learned BLS and about more severe trauma, like severe bone breaks, hemorrhage, spinal cord injuries, TBIs, airway and breathing problems, shock, and more. 

​

Since the focus of the class was being in the wilderness, we learned many valuable techniques and principles. Though 95% of the class is applicable to urban environments as well, we did learn some things that we can only do in the wilderness, mainly reducing dislocations and focused spinal assessments. The "wilderness" is an environment where you are far from or unable to access definitive care (1 hour or more form definitive care is a rough guideline). It is unique because it involves limited communication, limited resources, more exposure to the elements, and greater patient care/contact time. This leads to a whole other set of decision-making skills needed.

​

Due to the focus on wilderness medicine, one of the most valuable skills I took from the class was how to improvise and make do with what you have. We were taught to "treat what you find" since we wouldn't have access to true diagnostic tools or treatments. We learned to provide care with the tools we actually carry with us in the backcountry, and, during our big mock rescues, we were told to pack our bags with what we actually bring on a long day hike, and were only allowed to use those tools to perform the rescue. I learned to improvise a c-collar, make good splints out of trekking poles, sticks, sleeping pads, sleeping bags, and clothing. We learned to make an ace bandage out of a t-shirt.

Here is an extensive list of what we learned (photos below):

​

• Infection Control and Personal Protective Equipment (with recent additions due to COVID-19)

• Patient Assessment System

• Documentation Methods (SOAP Notes)

• Chest Injuries

• Shock (taught to always be concerned of shock)

• Spine and Spinal Cord Injury

• Lifting and Moving Patients

• Spinal Protection & Litter Packaging- fun going over picnic tables and trees, interest in SAR

• Focused Spine Assessment (can only be done in a wilderness setting)

• Head Injuries and TBI

• Athletic Injuries

• Fracture Management

• Pain Management in the Wilderness

• Dislocations (reductions are also exclusive to the wilderness)

• Wilderness Wound Management

• Heat and Hydration

• Hypothermia, Frostbite, and Non-Freezing Cold Injury

• Altitude Illness – including HAPE and HACE

• Bites and Stings

• Lightning

• Submersion Injuries

• Leadership, Teamwork, Communication – very important, learned in mock rescues and especially the large casualty incidents

• Stress First Aid- (with mental health/psychological first aid)

• Cardiac Problems

• CPR/BLS

• Respiratory Problems

• Altered Mental Status

• Acute Abdomen

• Allergies and Anaphylaxis- (certified as epinephrine administrators)

• Diabetes

• SAR, Evac and Emergency Plans

• Wilderness Drug and First Aid Kits- stressed improvisation and importance of knowledge

• Decision-making – loved this part, very useful skill that also ties into other areas of my life, being able to stay calm and make good decisions in stressful situations is applicable to many real life scenarios and will play into my future career

• Mental Health

• Poisoning

• Dental

• Communicable Disease

• Urinary and Reproductive

• Medical-Legal Considerations