Who Needs Wilderness Medicine Training?

Wilderness Medicine is just first aid training for backpackers that need to help each other out on long hiking trips, right?  Wrong.  So who needs wilderness medical training? Wilderness Medicine is a growing field of practice that is relevant to those involved in remote fieldwork, the military, natural and man-made disaster relief, medical rescue, and expedition medicine.

“Three elements – austere environment, sparse resource availability and an extended time to definitive care – serve to identify the field of wilderness medicine,” writes Dr. Gwynn Curran-Sills in the 2011 article Rural Medicine Goes Wild.  When understood through the interaction of these three elements – environment, resources and time – Wilderness Medicine training clearly benefits a broad cross-section of industries and workers.

A closer look at the interaction of environment, resources and time begins to illustrate the variety of individuals who will benefit from Wilderness Medicine training:

• Environment – Don’t be fooled into thinking that “environmental” issues are limited to things like hot temperatures, heavy rains, and high altitudes.  While these extremes certainly heighten risks in pre-hospital care, they do not encapsulate the entire issue of environment.  Consider how access to advanced life support is affected in urban settings plagued by natural disasters, or armed conflict.  Suddenly, the high-risk environment has come to you, instead of the other way around.
• Resources – Having access to limited resources is an obvious challenge to Wilderness Medicine practitioners.  Practitioners must display resilience and creativity in allocating whatever resources they have when formulating a treatment plan. Improvisation and the ability to make decisions with limited information are essential. Consider the creativity required when responding to, “disasters in resource-poor settings (including humanitarian emergencies and urban disasters with loss of infrastructure),” as described by Dr. Christopher Tedeschi.  In these settings, resource allocation challenges similar to those found in stereotypical wilderness settings will be encountered (Wilderness Medicine in Disasters and Humanitarian Crisis, 2011).
• Time – It doesn’t matter why access to definitive care is delayed… what matters is that something (logistics, distance, or hazard) has interfered with getting a patient to the care they need.  Ron Morrison, Raven Medical Program Director, points out that, “when considering access to care, spending two hours rescuing a worker from the side of a cell tower is no different than spending two hours rescuing a climber in the backcountry.”

Wilderness Medicine is a discipline that requires the integration of a variety of competencies. Separate any of these competencies from one another, and chances increase immediately that a practitioner may carry out ineffective or even dangerous efforts when the time comes to provide care.

For example, most personnel in natural resource management, exploration, mining and industry are required to have a minimum of 16-hour Red Cross Standard First Aid (SFA). While basic life support such as CPR is covered in SFA, field workers are likely to be faced with more advanced challenges in an emergency, such as triaging, formulating a treatment plan in the field, and implementing an evacuation. Due to the nature of their environment, field personnel will further benefit from having a background in survival, incident command systems, and search and rescue.

Research in this field continues to increase (for example: one of our favorite Canadians, Dr. Gordon Giesbrecht, researches thermoregulatory issues and produced excellent work on methods to cool hyperthermic firefighters wearing turn-out gear) and support among the medical community is positive.

If our goal is to prevent further injury and give our patients the chance for the best possible outcome, we need to evaluate our current first aid training to ensure that it equips us in the right ways. Wilderness Medicine prepares practitioners to integrate varied resources, positioning everyone involved for the best possible result.

Now that you have a better understanding of who needs wilderness medical training, learn more about Raven Medical training and how it can be part of your organization’s safety program.