I think sometimes, people forget where the national EMT and paramedic standards come from. The DOT, the department of transportation so things that occur in the wilderness aren't under their control. Local medical direction can though, but from the best of my knowledge this is pretty rare. I worked for four years in Yosemite as a professional rescue technician, part of that time I was an EMT-1, our medical director allowed us to push subcantanous EPI for anaphylaxis. By doing so he basically accepts responsiblity for my actions. In a world of litigation, I think it will be harder and harder to find MDs willing to put their professional careers on the line for EMTs to "practice" in this type of setting. We were obviously hours away from help so only two of us were actually signed off.
The wilderness courses basically add to your mental and psychomotor tool box, of how to use your scope of practice to the most benefit to the patient. I have been a paramedic in california for 6 years, have over 3000 patient contacts, I have worked as a medevac paramedic for federal fire agenices during the wildland fire season. I actually want to attend a wilderness als course, just to challenge myself, and see what I can learn. It really won't change what skills I can perform if those skills aren't in my scope of practice or I have permision from a physician to perform them, either on line or off line medical direction.
Many people become cert hogs and the WFR became a cert for many to pursue. It is an excellent cirrculum and course but remember, know your local protocols, and if possible carry a set with you, just for reference and if verbally challenged you can back up your actions with the written word of your medical director.
kary
