Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments

“Backcountry” Injuries and Wilderness First Aid

In a recent issue of Wilderness and Environmental Medicine (Volume 20, Number 2, 2009), Thomas Welch and colleagues have written an article entitled “Wilderness First Aid: Is There an Industry Standard?” The purpose of their inquiry was to determine if an “industry standard” exists for wilderness first aid training and certification of outdoor adventure and education leaders. To attempt to answer the question, they queried regulatory authorities, national organizations, and school/college groups with regard to their requirements for first aid training of their wilderness trek leaders.

They discovered that 10 or the 22 states with guide licensure programs required any first aid training as a condition of licensure, and none specified a specific course. Of the programs requiring such training, the requirements ranged from a 6-hour standard first aid course to more structured “wilderness first responder” (WFR or “woofer”) certification.

The authors concluded that there exists no uniform industry standard for first aid training and certification of wilderness leaders. They further commented that the epidemiology of backcountry injuries as well as what is currently known about clinical skills retention indicate that there may be little evidence basis for much of current practice with regard to wilderness first aid training.

What can we take away from this? First, there are not great data collections to determine the true incidence of specific injuries and illnesses that occur in the outdoors. We are familiar with the serious afflictions, such as drowning, falls, and frostbite, that can occur, but everyone’s general impression is that most medical events are minor. The implication of this is not clear for training, because we train for all eventualities, including the worst ones., even though they may not be common.

We also know that it is difficult to retain skills, particularly those that are complicated, without repetition and frequent reminders. Such is the case in medicine as much as it is in music, math, and athletics. There are good studies to show how quickly medical skills, such as cardiopulmonary resuscitation (CPR) deteriorate if they are not refreshed and practiced regularly. So, what should be taught to guides, instructions, and trip leaders who are responsible for the care of their participants in the outdoors? The best we can advise right now is that basic first aid with augmentation about wilderness-specific concerns seems reasonable, and that knowledge and manuals skills should be tested at sensible intervals. There is definitely a role of guidebooks, in written or electronic format, so that one can obtain guidance in a prompt fashion. There is no substitute for skill, but that is only acquired through years of experience, enhanced by repetition, resourcefulness, and sometimes bravery.

Tags: , , , , ,

This post, “Backcountry” Injuries and Wilderness First Aid, was originally published on Healthine.com by Paul Auerbach, M.D..


You may also like these posts

Read comments »


Comments are closed.

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »