Wilderness EMT

Fezman92

NJ and PA EMT
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I’m considering getting my wilderness EMT cert this or next year and possibly SAR training down the road. Does anyone here have any experience in this area?
Thanks
 

DrParasite

The fire extinguisher is not just for show
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waste of time. unless you are on a SAR team, and they are paying you to get it, I would skip it.

it's similar to EMT-T training: while the training is good, it won't get you onto a tac team, but if you do get onto a tac team, they will send you
 

NomadicMedic

Pot or Kettle? Unsure.
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Yes.

Unless you’re a member of a SAR team and you have actual need for it, it’s basically just a useless, but fun course to take.

I was a training coordinator for a SAR team in King County Washington. In 5 years, tromping through the cascades, we did not run a SAR mission that required a WEMT. You’d be much better served taking SAR tech I and II and getting involved with a team.

SAR is a lot like HazMat. It had its own language, culture and unique mission operations that are almost a complete 180 from what it looks like from the outside. Most SAR missions are either a quick hike out readcur or an occasional long, involved, multijurisdictional camp out. (Those usually end up as body recoveries)

Now, if you want to drop a grand or so and go camping and learn how to make splints out of sticks and litters from sleeping bags, take a WEMT course. It’s fun, but mostly useless unless a wildness experience is your full time job.
 

Summit

Critical Crazy
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I have 18 years of SAR in CO, 6 years as medical officer. My original instructors are now the director for DMM and the director for CMC's WEMS program.

WEMT FAQ:
Will it get you on a SAR team, nah.
Will it provide a good mindset and techniques as well as enough CE to refresh your EMT? Yea.
Is the WEMT upgrade a similar curriculum to WFR? Yes.
Does the "industry" regard an EMT with a WFR as a WEMT? Yep!
Do we preferentially train our rescuers as WFRs over EMT? Yes (unless they want to practice as an EMT outside of the team).
Is there a difference between austere, wilderness, and rescue medicine? Yes... kinda... sometimes...
Will a SAR team sponsored class taught by SAR providers have more focus on organized rescue medicine? Yes.
Is WEMT worth your time any money? Up to you!

8 years ago a physician on this forum, Veneficus, asked me about WEMT courses and this was my response::

WEMT as an initial certification is a combo of EMT course with another 48-80 hours of wilderness focus added on. That is what I did. I found it a little confusing to simultaneously learn wilderness and urban protocols. On that note, virtually no EMS agency outside of those who teach WEMT utilize the expanded Wilderness protocols.

I do think WEMT is a great CE course for EMTs and is great for SAR, ski patrol, guides/usps/usfs/blm and other EMTs who recreate in the wilderness. Its good practice for packaging and improvisation. I do like it when my back country partners have a WFR. Incidently, when a WFR takes an EMT, their WFR issuer will often grant them a WEMT card.

You ask: are they actually worthwhile? The answer is: for whom? I'm sure for many students, they are merely "playing in the woods." There are plenty of players in the market: SOLO, NOLS/WMI, WMA, DMM, CMC, ASHI, etc following curriculum based off of WMS's practice guidelines. Recently, most of these players did get together to streamline their curriculum.

What can you get out of it? Primarily mindset and improvisation practice/techniques.

For most providers: the courses are really good at teaching improvised care, making some care decisions with limited resources and extended extrication, and some best practices that are different in the wilderness setting. For a physician who has familiarity with austere care, they'll see little benefit in that regard.

For EMS providers specifically, I think courses like WEMT Upgrade etc also help enforce the idea of preventing problems and thinking beyond 5, 10, 15, 30 minutes, thinking about limited resources and wilderness extrication, etc when making care decisions and plans.

I will agree with you that the courses are rife with gee-whiz improvisations that nobody (besides the instructor) would remember how to do, much less implement, in the real world. My favorite example is the rope litter. It looks neat, requires practice, and sucks when done correctly. But I can surely go grab a book, Dr. Aurebach's giant wilderness cornucopia or ASHI's Wilderness manual and see an example of how to make your very own rope litter. Sure, I learned how to improvise a traction splint from ski poles or paddles and webbing... they were even timed drills. I could still make one relatively easily, but I doubt I ever would, and the evidence on traction splints in the wilderness is questionable!

I think that almost everyone charges too much (at least CMC you can do your WEMT upgrade for $300 or a WFR for $500 while NOLS wants $500-950 for the same).
 
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Summit

Critical Crazy
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You’d be much better served taking SAR tech I and II and getting involved with a team.
Really depends on your local team. Many teams including my own don't use NASAR and instead teach all that curriculum and more as part of in-house new member training. Meanwhile, one neighboring teams puts you through NASAR SAR Tech whether you have it or not... and sends you to WFR if you don't have it.

Most of SAR is
1. Looking for people who might need help, or not
2. Carrying heaving things up.
3. Getting heavy people down
4. The above, but at night
 

GMCmedic

Forum Deputy Chief
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I don't know much about wilderness curriculum, but reading the post from @Summit makes me think the the focus is on improvisation, recognizing your limitations, and prioritizing decision making.


All of which you'll learn for free as you gain experience.
 

Summit

Critical Crazy
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I don't know much about wilderness curriculum, but reading the post from @Summit makes me think the the focus is on improvisation, recognizing your limitations, and prioritizing decision making.


All of which you'll learn for free as you gain experience.
Indeed, although depending on one's practice, it may take a long time to build that experience, so the course could fast-forward (and reinforce) one's proficiency.

There is certainly an emphasis on environmental injuries and illnesses and the extended management thereof in the backcountry... content not found in most EMS curricula (and certainly not in nursing curricula) such as altitude illness, dive injuries, hyper/hypothermia management, exertion/over/dehydration recognition, bites/envenomation, and other injuries that you would roll you eyes at in an ambulance but could be critical in the backcountry.

When I look at a candidate for SAR, seeing WEMT or WFR shows me interest, enthusiasm, and some small level of base knowledge above an EMT relevant to SAR. That being said, being an EMT with patient care experience makes you stand out nicely all by itself and in my candidate pool is certainly a Very-Good-Thing without the additional W. My team has the funds to send people to WFR or WEMT Upgrade if they want it and have demonstrated dedication.
 
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