Prevention is key in the backcountry, whether you're hiking, skiing, camping; anticipating a trouble spot is always better than getting tangled up in one. But even the most cautious, observant and proficient folk incur accidents-it's a matter of chance. This is something that didn't completely sink in until I took a Wilderness First Aid course with Wilderness Medical Associates.

It's the second day of Wilderness Medical Associates 2-day Wilderness First Aid course, instructed by Faculty Instructor, Fay Johnson, a highly regarded, rad woman who also directs the Ski Patrol at Bridger Bowl, Montana. It's obvious to our class of 18 that Fay knows her stuff-- in the matter of a 12 hours so far, we covered general physiological concepts, the Patient Assessment System (PAS), the circulatory system, respiratory system, nervous system, musculoskeletal injuries, thermo-regulation, drowning, frostbite, burns, lightening, allergy/anaphylaxis, and backcountry medicine. The true wonder of it all was Fay's presentation was so logical and practical, that I absorbed every bit.

Right now we are outside participating in field simulations, where we implement class discussions in mock accidents. We split off in groups of three and Fay selects one member of each group, pulls them aside and secretly describes the injuries they're to mock. Tessie, our group's vicitm, returns and contorts herself on the ground. Fay lays out the scene for us all: we've all been bouldering when there's a thud. This is how we find the victim. Now what. I look down and see Tessie twisted like a pretzel. There are two of us, and we're a good 3 miles from any help.

This is where procedure comes into play. If you've ever experienced trauma or a good scare in the backcountry, you'll know your wits start scattering quickly, so having a system that's second hand, will help you put your body in motion while your senses return. I immediately grab my SOAP (Subjective Objective Assessment Plan) and start procedure.

First thing is filling out the scene: where we are and a patient description. Then I start the Patient Assessment System (PAS) while my partner, Amy, transcribes these findings in the SOAP Notes, which we'll give to a medical professional when we get to one. When that does happen, we'll have a complete injury report to give in a particular order that helps the professional treat the patient efficiently:

Subjective Info-- the story and SAMPLE findings
Objective Info-- exam findings and vital signs
Assessment-- problems and anticipated problems
Plan-- treatment and evacuation

Step one of PAS is assessing the safety of the scene, considering personal, partner, patient and public safety. Step 2 of scene assessment is finding the Mechanism of Injury (M.O.I.) which is either trauma, medical (diabetes) or environmental. Step 3 is evaluating the number of patients, rescuers, and resources we have.

Next is making an initial physical assessment by checking the patients circulatory system, which means simply evaluating the victim's skin color and temperature since we don't have any medical instruments. Then I check the respiratory system-are they breathing?! And then check their nervous system using the AVPU rating scale: the victim is Awake, responds to Verbal stimuli, responds to Pain stimuli, or is Unresponsive.

Next comes the SAMPLE section: Symptoms, Allergies, Medications, History, Last Meal, and Events. Of course if the victim is unresponsive you won't get too far on this list, but that's even more of a reason to know your partner before you head in the backcountry.

Finally comes the physical exam where we look, listen and feel for deformities, contusions, swelling, tenderness and wounds on the victim. Tessie, we find, is breathing but is only pain responsive. Since we don't have a radio, we'll have to carefully realign her body, stabilize her and make a litter (or stretcher) to carry her out-this is nearly a worst case scenario. Only being unresponsive or not breathing would make the situation worse.

Had I not taken this 2-day course, I wouldn't have known how to even start assessing a scene like this, or one with less serious consequences. Yeah, I could put some common sense together and flub my way through an evac, but my reality is that I travel backcountry with good friends, who are like family to me and deserve the best treatment possible. This course made me realize that my best needed much more training!

For now, at least I have a system, a procedure to follow and have learned a language understood by most medical professionals. Next year, I'm taking the Wilderness First Responder.

ADDITIONAL INFO

For more information contact: www.wildmed.com. (888) WILD-MED

Wilderness Medical offers a variety of courses that address the additional complications of extended patient management, extreme environments and limited equipment that traditional EMT and Emergency Response courses don't cover. Here's a brief outline of WMA courses offered:

Wilderness First Aid (WFA, 2 days) and Wilderness Advanced First Aid (WAFA, 4 days): Designed for outdoor enthusiasts looking for personal knowledge and anyone likely to assist a WFR.


Wilderness First Responder (WFR, 72 hours): Often referred to as a 'wolfer' these fully certified courses provide a high degree of backcountry medical competence for Outward Bound and NOLS instructors, river guides, trip leaders, mountaineers, climbers and others who travel deep in the backcountry.


EMT + Wilderness EMT (EMT+WEMT, 181 hours): Another fully certified course for medical professionals needing even more extensive backcountry medical competence.


Wilderness Advanced life Support (WALS): Designed for paramedics, RN's, PA's, MD's, and DO's who may need t use ALS techniques in the backcountry.

Last Updated: Feb 24th, 2006 - 14:18:11
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