NOLS WMI Wilderness First Aid Part 1 (Introduction)
In late October of 2013 I went to a two day wilderness first aid course put on by NOLS and taught at the REI in Bloomington. This is my first stab at some notes: part after action report, part concepts, and part random stuff before I loose track of what my hasty days of scribbles actually say. I'm not planning on rehashing signs and symptoms or treatments for wounds, head trauma, etc. That stuff is listed pretty accessibly in books and on the net.
Hopefully, writing this down will help it stick in my head a bit better.
The course was taught by Erik and Amy. Erik runs a wilderness program at Winona State and Amy is a nurse. Each had their own teaching styles that were great and complimented each other really nicely. Both were obviously comfortable in front of the group, handled questions great, and included everyone all through the course.
Both days stayed as close as possible to the 0900-1800 schedule as 24 random students could allow.
There was a ton of information passed along. Erik mentioned in his introduction that we were not going to simply soak it all up. His goal was to get us doing 100% in class so three months from now, after time takes its toll, we'll still be running at 60% if we need to. I was pretty impressed with the honesty.
How the Course Ran
The two days were split pretty evenly between lecture and actually doing things. We did get to know all the other students going through practice scenarios, checking them over for injuries, splinting, rolling people over, carrying them, etc. Remember to put stuff you don't want others to deal with into your day bag before class starts!
When we did scenarios a group was taken outside and movie make-up dashed on to simulate injuries. I thought it was pretty interesting how much this detail helped get the right mindset setup.
Weather was 40s, overcast, and sprinkling for the weekend and we were outside in it practicing. Just like we would be in a real wilderness scenario. I appreciated this too. I definitely learned some things by really being out there in it.
Wilderness First Aid Goals
The end goal of the class was to get students to the point where we can decide if somebody can "stay and play" or "has gotta go." For the most part, if there's any doubt, going is the right choice. If somebody has a wound that makes you wonder if they're done is anybody going to be having enough fun to stay?
Of course, that's not always cut and dry when you're on the fifth day of a 10 day trip...
Because "going" is an outcome, we talked about that off and on through the course. Again, because the wilderness is a big variable, there wasn't a lot of hard rules. How do you evac somebody that can't walk? With a possible spinal injury? Who is unconscious?
It's not always going to be cut and dry.
I'll get to WMI's "radio report" for calling out for help, but want to mention here that you should be thinking about how to call for help on big trips. Do cell phones work? Radio? What kind? Who do you contact? What's their level of service and their procedures? You don't just get out your sat phone and expect a Chinook medvac in 30...
Do some research on the area you'll be in so you'll know your rescue and medical support options.
Like every specialty there were a bazillion acronyms. Here's my list:
- PAS - Patient Assessment System
- ABCDE - Airway, Breathing, Circulation, Decide c-spine, Exposure (to the elements and expose the injury)
- SAMPLE - Symptoms, Allergies, Medicines, Pertinent past history, Last in last out, Events that contributed to injury
- RICE - Rest, Ice, Compression and Elevation
- LOR - Level Of Responsiveness
- SCTM - Skin Color, Temperature and Moisture
- CMS - Circulation, Sensation and Motion
- MOI - Method Of Injury
- BSI - Body Substance Isolation
- HR - Heart Rate
- RR - Respiratory Rate
- SHARP - Swelling, Heat, Aches, Redness and Puss (signs of infection)
- OPQRST - Onset, Provoke, Quality, Radiate, Severity, Time (pain qualification)
- TO STOP - Toxins, Seizure/Sugar, Temperature, Oxygen, Pressure/Altitude (cause of unresponsiveness)
- SAR - Search And Rescue
The next part will start with the Patient Assessment System.