Wilderness First Responder
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Wilderness First Responders are individuals who are trained to respond to emergency situations in remote settings. They are part of a wide variety of wilderness medical professionals who deal with medical emergencies that occur in wilderness settings.
Near the end of the 19th century, volunteer organizations such as St. John Ambulance began teaching the principles of first aid at mining sites and near large railway centers. By the dawn of the 20th Century additional organizations such as the Boy Scouts and the American Red Cross began teaching first aid to lay people. Over the years, these organizations trained hundreds of thousands of people in the elements of providing assistance until definitive care could be arranged.
The training in these courses assumed that definitive care was nearby and could be delivered quickly. Eventually there was a realization that this training, while valuable, needed to be supplemented and/or revised to deal with the extended time and limited resources inherent when a medical crisis occurs in a wilderness setting. In the 1950s organizations such as The Mountaineers began developing training programs that addressed these special needs.
In 1966, the US Government, through the National Traffic and Motor Vehicle Safety Act, gave the Department of Transportation (DOT) responsibility for creating a national Emergency management System (EMS). From this program came the standardized curriculum for the position of Emergency Medical Technician (EMT).
Wilderness Medicine Outfitters' director taught his first back-country care course for ski patrolers at Colorado State Univ in 1967. The first Wilderness EMT course was taught in 1976 to help EMTs in Colorado adapt their skills and knowledge when working with Search and Rescue teams. By 1977 organizations such as Stonehearth Open Learning Opportunities (SOLO) and National Outdoor Leadership School (NOLS) were offering specialized Wilderness First Aid training to their instructors.
Meanwhile the DOT EMS program recognized a need to develop standardized training for "first responders" such as truck drivers, policemen and fireman who could lend assistance during the initial part of "golden hour" until an ambulance with an EMT arrived. In 1984 SOLO developed and taught the first Wilderness First Responder course. The purpose of creating the course was to provide Rangers, outdoor leaders, and guides the necessary knowledge to provide care in crisis situations in the wilderness. In 1985, SOLO began providing WFR training to Outward Bound instructors in Florida.
Today WFR certification is frequently a pre-requisite for professional positions that involve work in the outdoors and students may take courses from numerous nationally recognized providers (see below).
A wilderness first responder is trained to deal with many situations that may be encountered in the wilderness. While a standard Department of Transportation defined First Responder course as taught by an organization such as the American Red Cross may require 40 hours of training, the typical Wilderness First Responder Course involves 70-80 hours of training. Wilderness first responder training courses focus on teaching the students to assess a situation, improvise solutions using available resources to stabilize the patient and identify the best way to get the patient to definitive medical treatment. In many courses, students are encouraged to develop the habit of systematically thinking through and documenting their assessment decisions/plans using a SOAP note. Topics covered usually include, but are not limited to, the following principles
- Basic Life Support
- Responding to results of trauma:
- Management of signs and symptoms of circulatory shock
- Management of soft tissue injury such as a burn or wound
- Prevention and/or treatment of blood-borne pathogens
- Treatment of infectious diseases
- Management of bone and joint injuries such as fractures, sprains, strains and dislocations
- Management of suspected head and or spinal injury
- Responding to the onset of sudden illness
- Transport/evacuation planning and implementation
The course usually entails 70–80 hours of work and may or may not include certification.
Leading providers of wilderness medicine are:
- Wilderness Medicine Training Center
- Remote Medical International
- Wilderness Medical Associates International
- Stonehearth Open Learning Opportunities (SOLO)
- Wilderness Medicine Institute of NOLS
- Aerie Backcountry Medicine
Wilderness First Responder is usually abbreviated as WFR. Those with the certification are often called "Woofers."
- Tilton, Buck (1998). The Wilderness First Responder: a text for the recognition, treatment and prevention of wilderness emergencies. Guildford Connecticut: The Globe Pequot Press. p. 314.