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During an emergency we may not remember the number to call for help. Especially in a country as big as India, where emergency response teams even in metropolitans are scarce. The knowledge of basic first aid  can really help save lives.

If you are an outdoor instructor, a search and rescue professional, a trek leader or an adventure enthusiast, you might  be familiar with the term, Wilderness Medicine. In wilderness medicine the term “Wilderness” refers to a  location which is an hour or more away from definitive medical care. Wilderness medicine courses are focused on imparting practical skills to their students so that they may provide care to anyone in need. Whether it is on high mountain passes, while off road biking, climbing trips, taking care of a patient at home, kids or seniors; these skills can be useful to decide an appropriate response to emergency situations.

Factors that play roles in wilderness and urban medicine are- 

Time – Time is a very important factor in medicine. Depending on your location it might take you from a few minutes to an hour or more to get to a place of definitive medical care. This can be a matter of life and death for critical patients. In a wilderness context, care providers spend a significant amount of time stabilizing and monitoring their patients.

Resource – In an urban environment where definitive medical care is easily accessible you have access to a lot more resources compared to what is available in the wilderness. In a wilderness setting you only have what you are carrying for your trip, which is usually very limited. Having the most basic resources available like shelter, sugar, clean water, food, firewood, and a lighter can really be useful resources out in the wild. Absence of resources requires improvisation from the care providers.

Environment – Hot, cold, rain, altitude, thunderstorm and lightning are some of the different environments you are exposed to in the outdoors. These can really have an impact on the well being of patients, rescue team members and quality of care they are able to provide. Any of these can contribute to worsening of an existing problem or raise a secondary issue. 

Who is it for?

These courses are designed for anyone who lives away from definitive medical care, works in search and rescue teams, ventures in the remote areas for personal trips or leading clients, fire fighters, disaster management teams or anyone who would just like to learn about the human body so that they may be able to respond to an emergency situation.

Wilderness medicine courses are helpful for nurses and doctors practising in metropolitan cities. These courses  provide them with the opportunity to manage a patient in an environment that is very different from the one in hospitals. It can prove extremely challenging to perform the simplest of tasks while working in an uncontrolled environment, as it increases the chances of infections and causes risk to the patient’s life. In a controlled environment there are many medical instruments and equipment available to perform tasks such as sutures, wound dressing, cast on a broken bone.

Whereas in an uncontrolled environment it is your training and judgement of the situation that can help in saving the life of your patient. These uncontrolled environments that are of course away from definitive medical care, can be but not limited to – a mountain, an accident site on a highway, battlefield, nearest rock climbing site, disaster site.

Apart from doctors and nurses, those who venture in the great outdoors to seek adventure or to lead groups can also benefit from such training as they are in remote areas and have higher likelihood of an injury occurring. In India, only a few outdoor learning and adventure companies have made it a compulsory for their staff to go through such training. 

Course types 

Currently the following wilderness medicine courses are available in India, 

WFA (Wilderness First Aid) is typically 16-20 Hrs long spread over 2-2 1/2 days.

WAFA (Wilderness Advanced First Aid) is typically 32-40 Hrs long and spread over 4-5 days.

WFR (Wilderness First Responder) is typically 70-80 Hrs long spread over 9-10 days, it is a must if you are a trek leader, search and rescue volunteer – professional, army personnel, firefighter or an emergency responder.

What does it cover?

Topics include, but are not limited to- 

 

• Patient assessment system

• Shock

• Patient documentation and reporting

• Respiration, Circulation and Nervous system 

• Musculoskeletal injuries

• Heat illness

• Altitude illness

• Wound management

• Cold injuries

• Water purification

• Snake bite and poisoning 

• Submersion

• Burns

• Hypothermia

• Allergies & anaphylaxis 

• Dehydration and hyponatremia 

• Patient lifts and moves

   

Some organisations have emphasised on adding leadership and risk management curriculum on longer duration wilderness medicine courses. Some of the relevant skills covered are;

• Communication & Feedback

• Situational awareness

• Self management

• Extended evening scenarios

• Designated leadership

These are few of the topics that are covered in these courses. Longer duration courses focus much in depth classes on physiology and more time spent on scenarios.

 

Why is it unique?

Wilderness Medicine is a unique area of practising medicine, because it offers understanding of human physiology during lectures and practical training during hands on scenarios in a short span of time. Organisations strive to maintain a 60-40 ratio of time spent on the course between lecture and practical simulations. The course curriculum and scope of practise is decided in conjunction with the Wilderness Medicine Society, however the practical implications of such guidelines are dependent on your current valid certification, course provider, employing organisation and country law.

 

WMS is a physician based society registered in the USA, that is committed to education, research and the practical aspects of medicine in wilderness contexts. Registered in 1983 WMS works with organisations like WMAI (Wilderness Medicine Associates International, Wilderness Medicine of NOLS, Aerie backcountry medicine, SOLO schools, WMTC (Wilderness Medicine Training Centre) and others. 

Depending on your level of training and situation these courses can equip you to respond to situations like managing a wound, providing traction and creating a splint, treatment for relocating a joint, patient packaging, creating improvised stretcher. 

 

Author– 

Amit Arora, Outdoor Leadership & Wilderness Medicine Educator. 

Reach out at amitarora004@gmail.com to inquire about Wilderness Medicine & Outdoor Leadership training at your organisation. 

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