Wilderness First Aid... for Firefighters?
The field of Wilderness Medicine is a constantly evolving place. Initially gaining traction in the early 2000's thanks to groups like NOLS, the concept of giving care differently in a wilderness environment is now a large industry. Currently, Wilderness First Aid (WFA, 16-Hr) and Wilderness First Responder (WFR, 80-Hr course) are well known certifications in the outdoor recreation field, with many industries where employees travel to remote places (think: ecologists) using this training as well.
Some of the biggest concepts in a comprehensive wilderness medical course are 1. the time it takes for help to get to you (or for you to get to help), and 2. what that means about the medical care we can and should be providing for unfortunate people who get sick or injured.
(Photo description: A Wilderness First Aid student practices applying a CAT Tourniquet to a simulated amputation. Capital City CPR LLC includes the Stop The Bleed curriculum in all Wilderness First Aid courses.)
Generally, it's agreed that if you are an hour away from getting treatment in a hospital, you are practicing 'wilderness' medicine. This can happen do to the sheer remoteness of wilderness areas, or due to the lack of communication, extreme terrain, or environmental factors like a major storm. You may be asking, "but why would that change our first aid treatments?"
Well, it doesn't completely. Bleeding, for example, is bad no matter where you are. Not breathing, also bad. But what about an angulated fracture or dislocation? Diarrhea or vomiting? These more complex issues may require a slightly different plan if we can't simply call 911 or drive over to the urgent care. That's where Wilderness Medicine comes in.
(Photo description: Two students practice building a lower leg splint out of common camping or hiking materials such as sleeping pads, trekking poles, and rope. They also used a Sam Splint+Ace Wrap to help with ankle immobilization.)
Although there is no governing body who approves Wilderness Medical Curriculums, there are agreed upon Standards of Practice (SOPs) that all training providers, from NOLS to Boy Scouts of America, should be following. These standards outline what treatments are acceptable (like 'reducing' a dislocation, or taking a different approach toward 'spinal precautions') in wilderness environments. Many of these treatments are things that even highly trained professionals like EMTs don't do in the front country (non-wilderness) setting.
Enter, Cachagua Fire Department.
(Photo Description: Cachagua Fire Department volunteers celebrate finishing a large scenario where they responded to two patients in a cold river. A fire engine reading "Rescue" is parked behind them.)
This volunteer Fire Department is nestled in the remote Santa Lucia Mountain Range, in south Monterey County. They serve an expansive fire district, covering many large properties such as vineyards and ranches, as well as some more small village style communities. One major challenge they face is that their district shares a boundary with a National Forest and a Wilderness Area, and they often respond to calls of people in remote areas that require hiking in for access, since no vehicles can make it.
(Photo description: EMTs from Cachagua Fire Department teach other volunteers how to administer oxygen therapy.)
Capital City CPR had the pleasure of providing them some Wilderness First Aid training, which proved to be a good opportunity to review their medical response procedures in general. Over the two day training, we went from practicing the basics to running a full-on response, where trucks and engines were deployed and they were able to combine their new skillset with their traditional tools and resources.
(Photo description: Firefighters in yellow jackets and helmets provide care for a hypothermic patient who is covered in a sleeping bag.)
Since we are a California EMS Continuing Education provider (CE: 34-4980), we were also able to get their EMTs 16 of the 24 required CE hours via the 2-Day Wilderness First Aid course.
Hopefully, as the Wilderness Medical field evolves, we will see more agencies who work in rural areas incorporate this kind of training and expand their tool kits with the ability to think outside of the box.