Medical know-how is part of adventure-travel training Emergencies: Wilderness adventurers and guides are taking courses in how to make the right response when things go wrong


August 02, 1998|By Patrick Joseph | Patrick Joseph,SPECIAL TO THE SUN

Would you know what to do if someone in your climbing party accidentally impaled himself with an ice ax? What if your tent mate were suffering from hypothermia? Let's say you've just pulled a friend, unconscious and bleeding, from a crevasse: What do you do next?

Such incidents are not altogether uncommon. If you've ever flipped through the cautionary pages of the American Alpine Club's annual report, "Accidents in North American Mountaineering," you know that things can go horribly wrong in the mountains. When they do, it's best to know how to respond quickly and competently.

To gain that knowledge, many people are enrolling in wilderness-medicine courses taught by licensed instructors in what is a young but growing industry. First taught in the late '70s by SOLO Wilderness Medicine and Wilderness Medical Associates, such classes have become increasingly popular. For some, the training and certification they provide have become a prerequisite for employment.

According to Melissa Gray, co-director of the Colorado-based Wilderness Medicine Institute, "Wilderness First Responder (WFR) training has become the de facto standard for outdoor instructors and guides." Certification in the training is now required of instructors by such groups as the National Outdoor Leadership School and Outward Bound, she says.

Similarly, as of the summer of 1999, the American Camping Association will require that its trip leaders be certified in the less intensive Wilderness First Aid (WFA) program. The reason for the new requirements is that insurance companies want to see credentials before issuing liability coverage. As yet, however, no national standard exists for certification. Aspiring guides and the like should ask prospective employers what programs they sanction, and check with the instruction company to make sure that recertification will be available in the future.

Instruction is by no means limited to outdoor professionals. Tom Clausing, a Wilderness Medical Associates instructor in Leavenworth, Wash., sees a wide range of students in his courses, from employees of federal agencies, including the FBI and the Bureau of Land Management, to "folks who just want to be as safe as possible in the backcountry."

WFA training is different from standard Red Cross instruction.

"First and foremost," Gray says, "Wilderness First Aid is designed specifically for remote locations where 'remote' is defined as 'anyplace more than an hour away from a hospital.'

Clausing agrees. "In the backcountry," he says, "you may be with the patient for hours or even days, so the emphasis is going to be more on prolonged patient care."

In the case of an ice ax through the leg, conventional first aid dictates leaving the impaling object as is, stabilizing the victim and getting him as quickly as possible to a hospital. But, in the backcountry, with miles of rough terrain to contend with and no ** hospital nearby, the ax might have to be removed in the field.

"In wilderness medicine," Gray says, "care needs to be improvised to deal with variable conditions and limited equipment. I see it as an extension of urban first aid rather than a different thing entirely."

"Wilderness medical instruction generally covers the standard urban-context curriculum and then some," Clausing says. He says the eight-day WFR course he teaches covers the entire Department of Transportation-mandated First Responder curriculum, while adding a backcountry component. Of the 72-hour course, he estimates that just over half is spent outdoors with three full-scale accident simulations. WFA courses generally take two days.

As to who should consider WFR or WFA courses, Gray says it's up to the individual. Most weekenders, she says, will probably be satisfied with the WFA course, "but anyone planning expeditions or extensive trips in the backcountry would benefit from more intensive First Responder classes." After all, you never know when the worst might happen.


Many universities and outdoor organizations around the country sponsor classes in their areas. Pricing, length of instruction, certification and course availability vary considerably, so it's wise to research alternatives before committing. Many companies offer WFA and WFR instruction, but the three outfits listed below teach both and are generally regarded as the largest and most established:

* The Wilderness Medicine Institute, P.O. Box 9, Pitkin, Colo. 81241; 970-641-3572.

* Wilderness Medical Associates, 189 Dudley Road, Bryant Pond, Maine 04219; 207-665-2707.

* SOLO, P.O. Box 3150, Conway, N.H. 03818; 603-447-6711.

- Patrick Joseph

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