Why take a wilderness first aid class? It’s your responsibility

by Kelsey Dayton
— February 4, 2014

“I am going to lift up your shirt and take a look at your abdomen,” I tell the woman I had just barely met that morning in a classroom. This is more than I bargained for, I thought as I began to press on her stomach.

I tried to palpate her abdomen with confidence and resisted saying “Sorry, I have no idea what I’m doing.” We’d learned early on that isn’t something you should say to a patient.

When I signed up for Wilderness First Aid I imagined we’d talk about blisters and washing cuts. And that was briefly covered. But so was how to move a patient with a suspected spinal injury.

For the past couple of years I’ve said I should take a wilderness first aid class. When Aerie Backcountry Medicine offered a class on a convenient weekend in January, I finally signed up. I’ve written about people who were struck by lightning, who broke legs and who have become hypothermic. I’ve met people on the trail with ankle injuries, and people suffering from dizziness. I’ve heard first-hand accounts of snake bites and even a punctured lung. I myself have suffered from crippling blisters, scary dehydration and a broken arm (not all on the same trip). It seems if you spend enough time outside you are eventually going to come across someone who is hurt or sick.

Shana Tarter, the assistant director for the National Outdoor Leadership School’s Wilderness Medicine Institute agrees. “Anyone who takes themselves out of the environment where the ambulance is just a quick phone call away has a responsibility to take care of themselves,” Tarter said.

That includes people who merely go out for a hike, or like to car camp. A wilderness first aid class, which includes 16 hours of training, teaches skills needed for challenging environments — in extreme cold or heat and with the assumption there is a long wait period before a patient can get medical care. It includes basic first aid and decision-making; What is serious enough to warrant an evacuation versus forging on?

All wilderness medicine classes include a hands-on component where you practice splinting arms, applying pressure dressings and closing gashes, and how to do it out in the elements. It was a cold day when we examined patients in different scenarios, learning not just how to guess what was wrong, but also how to examine people through layers of winter clothing and keep them warm while we did it.

Wilderness first aid is the lowest level of wilderness training by the institute, but it’s the most popular, Tarter said. Most people engage with the outdoor as casual recreationists.

When the Wilderness Medicine Institute started in 1990 in Colorado, it consisted of three courses with 83 students. Last year it consisted of more than 700 courses and trained more than 16,000 people in various levels of wilderness medicine. That is a result in a growing interest in outdoor recreation and adventure travel, Tarter said. It’s also a reflection of a trend of heightened risk management standards, with outdoor jobs requiring or encouraging increased medical training specific to the outdoors.

Students who take the class often report back on when they use their skills and not just in the backcountry. One student helped a friend who fell off a balcony. Another was driving on the interstate on a snowy day when they saw a car go off the road. The student assessed the patient and held c-spine — holding the head to avoid movement and damage to the spine — until EMS arrived. Another came across a man on a trail with a hurt shoulder. The student improvised a splint and stayed with him until search and rescue arrived. It turned out he’d broken his shoulder blade in three places.

I hope I never have to use the training I received. But if I do, I at least won’t say “Sorry, I have no idea what I’m doing.”

What should be in your first aid kit?

Your first aid kit should be tailored to your trip and seasonally appropriate. The Wilderness Medicine Institute discourages carrying items you can easily improvise in the backcountry. But there are a few things you should probably always have on hand:

• Wound care supplies like band aids and gauze pads
• Tape
• An irrigation syringe
• Your choice of blister treatment
• Note pad and a writing instrument for recording vital signs
• Over the counter medication for itching and pain
• Tweezers
• Elastic bandages

Take a class

There is no accrediting body for wilderness medicine programs. Choose a program based on reputation and ask questions about the curriculum and what you’ll learn. The Wilderness Medicine Institute has several Wyoming courses. View the schedule here.

The three main levels of wilderness medical training

Wilderness First Aid (WFA): 16 hours teaches prevention and treatment of mild and moderate injuries and illnesses. It is meant for people who recreate outside, from hiking to car camping to short backpacking trips.

Wilderness First Responder (WFR): 80 hours aimed at people who lead trips or work in remote areas. It focuses on various injuries and illnesses that can occur in the wilderness.

Wilderness EMT (WEMT): 200 hours that combines EMT training with specific wilderness training allowing work in urban and backcountry settings. It is for people such as park rangers who need EMT and backcountry skills.

— “Peaks to Plains” is a blog focusing on Wyoming’s outdoors and communities. Kelsey Dayton is a freelance writer based in Lander. She has been a journalist in Wyoming for seven years, reporting for the Jackson Hole News & Guide, Casper Star-Tribune and the Gillette News-Record. Contact Kelsey at kelsey.dayton@gmail.com. Follow her on twitter: @Kelsey_Dayton

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