Wilderness Awareness

[diesel]

Hi all I ask recently asked by our training officer to give a roughly 2-3 hour wilderness medicine "awareness" class during our next Inservice day. Honestly I have no idea what to talk about, I've tried to google ideas but all I can find are just basic "mom and pop first aid" and links to wilderness EMT classes. Was hoping someone could provide some assistance in developing a lesson plan, no one at my service has been able to. This will be taught at first responder/EMT intermediate level (ALS will come later). Thanks in advance

 

[NomadicMedic]

An overview of ortho injuries and environmental emergencies.

Perhaps a "rescue an injured hiker" scenario?

Discuss the limited resources on such a rescue and the logistics of packaging and moving an injured person from the wilderness to a waiting ambulance.

 

[Summit]

Medicine for Mountaineering
http://www.amazon.com/Medicine-Moun...4&sr=1-1&keywords=medicine+for+mountaineering

ETA: Of course one can focus on the flashy issues like lighting, envenomation, altitude, or avalanches. If you only have 2-3 hours, focus on the issues salient to your area. The most common wilderness specific subissues are usually the little things that become big with time, remoteness, and exposure to the elements: hydration/electrolyte imbalance, GI/GU/wound infection, heat/cold injury, minor ortho/burn injuries, etc. The biggest issue for wilderness care coming from an urban EMS mindset is that you have to think beyond the next 5 minutes and think about the next hour, the next day, the next pitch, and the next ridge.

 

[Summit]

On second thought, it would help to know what wilderness role your agency fulfills that they need an awareness training.

 

[TheLocalMedic]

I work in a rural area... A good point can also be made about knowing how to obtain alternate modes of transport and who has them. Some agencies have access to ATVs or similar vehicles. There is at least one fire department in northern California that has a rail "speeder car" that can zip down the tracks where there aren't intersecting roads. Also, I know of one guy who "commandeered" a horse to get to an injured hiker (experienced rider though). Boats and helos are also viable options if available.

 

[diesel]

Mostly we are performing rope rescue from the technical aspect of it and using other services for the medical aspect but are needing to prepare for the "ifs" of if they aren't on-scene yet and how to prepare to remove them. As someone else said all of our emts and paramedics are from urban environments and this is a different role for us.

 

[wildrivermedic]

As said above, it would be good to know what situations this information will be used in... how do your patients end up in need of rescue? What activities are popular in your area, and what specific risks are present?

Talk about what is relevant - snakebites? Heat? Recreational MOIs like climbing or rafting and their injury patterns?

For a few hour lecture, stay away from the expanded scope stuff, and focus on the extended care scenario as Summit said. What tools do you carry, and how can you do a really thorough patient assessment with it? What do trends in vital signs over time tell you?

Wilderness rescues take a lot of resources. You could spend your time well talking about how rescues are coordinated locally, and what resources are available.

And improvised splinting is a pretty fun way to end. Bring some extra clothes / ace wraps and practice immobilizing through padding and compression, no rigid pointy sticks needed!

 

[Sandog]

For technical rope rescue, you need to cover lowering systems, raising systems, and attaching the victim and rescuers to the raising system. 2-3 hours is not enough time to cover all that is needed even at awareness level.

 

[Summit]

Mostly we are performing rope rescue from the technical aspect of it and using other services for the medical aspect but are needing to prepare for the "ifs" of if they aren't on-scene yet and how to prepare to remove them. As someone else said all of our emts and paramedics are from urban environments and this is a different role for us.

I am confused. Are you part of a newly formed SAR team training in high angle rescue? Are you urban EMS providing medical personell to the local SAR team? How "wilderness" are you getting with your rope rescue? Embankments off the side of the road or multipitch mixed routes with long approaches? Something inbetween?

Needless to say, 2-3 hours is barely enough time to discuss a brief overview of the medical issues related to high angle rescue... nevermind practical application or technical competence.