Often imitated, never duplicated, the WFR (Wilderness First Responder) course taught by the Wilderness Medicine Institute (WMI) has become the nationally recognized standard in wilderness medicine education. Designed to train graduates to make critical medical and evacuation decisions in remote locations, the 80-hour course follows a fast, dynamic pace. Classroom lectures rotate with hands-on scenarios in the wildnerness, placing participants in situations where their capacity to think, analyze and react rapidly are put to the test.
I will be taking the intensive 8 to 12 hours per day program next month at the Lewis & Clack College of Portland. Among the topics covered will be spinal cord injuries, long-term patient care, chest injuries, shock, head injuries, wildnerness wound management, patient assessment, CPR, athletic injuries, fracture management and traction splinting, dislocations, cold injuries, heat illness, altitude illness, cardiac, respiratory and neurological emergencies, blites, stings and poisoning, diabetes, allergies and anaphylaxis, search and rescue, leadership, teamwork and communication, communicable diseases, lightning, submersion, etc.
Follow me as I make my way through this intensive medical boot camp training program in the wilderness and live to tell you about it!
April 13, 2012 – Boot Camp Preps
Josh, coordinator for the College Outdoors department of Lewis & Clark, e-mailed to inform us the course filled up with a total number of 30 participants.
Among the paperwork attached is a list of required personal equipment designed to protect us from the elements, with a note we will be spending considerable amounts of time oudoors in the wilderness, participating in mock rescues in all weather conditions, including evening hours. Multiple layers of non-cotton clothing, waterproof jacket and pants, sturdy boots, head lamps and flashlights are among the list of personal items required, as well as a large day pack to carry our equipment, a sleeping pad, long underwear thermal layers, feece, food and water supplies.
The release forms inform us of the risks linked to the program’s activities. Traveling through rugged, unpredictable, off-trail terrain, including boulder fields, downed timber, rivers, rapids, river crossings, high mountain passes, snow and ice, steep slopes, slippery rocks, ocean tides and currents, waves and surf, participants risk collision, falling, drowning, hypothermia, frostbite, altitude illness, sunburn, heatstroke, dehydration, insect or snake bites, predator encounters and a number of other potential hazards including accidental injury, illness, permanent trauma, disability or death. Can someone remind me why I’m always first in line to experience all of the above?
Stay tuned and follow me as I make my way through this exciting new endeavor!
April 19, 2012 – The Hunt for Equipment
Rugged outdoors flashlights: Check (already part of my deep sea rescue diving equipment). Head lamp: Check (part of my ocean kayaking gear). Long thermal underwear top and bottom: Check (part of my skiing equipment). Two pairs of wool or polypropylene socks: how in the world do you know what your socks are made of? Polypro-what? I’m pretty sure the French lace socks in my drawer won’t do the trick. How about my ski socks? Never mind, found Thor-Lon hiking socks at REI. No idea what Thor-Lon is supposed to be, but they claim “your feet will feel better” … okay. I’m sure I’ll be in need of a serious foot massage when I return to civilization anyway. Seriously waterproof jacket and pants: Question to the friendly REI team members: “Can I use my ski jacket and pants for the WFR course?” Their take: too thick, heavy and cumbersome for the fast-pace hiking and rescue scenarios involved. Price tag on lightweight and reinforced waterproof gear: one word “Ouch!” Sleeping pad: Who can lend me a sleeping pad? Polypro hat, digital readout wrist watch, fleece, day pack, notebook, paper, pencil: check, check, check.
April 29, 2012 – Anatomy
Spent my Sunday studying anatomy by the lake under my windows in preparation for the course. Did you know the human body is made of 206 bones? We are born with more (about 300) which fuse together as we grow up. Each one of our hands counts 26 bones. Though my left hand now has more, considering I pulverized my metacarpals into bone debris in a 1998 motorcycle accident. Only to be brilliantly reconstructed by a superior hand surgeon in Los Angeles, who was able to return it to even more of its capacities: “Gentlemen, we can rebuild her. We have the technology. Better than she was before … Better, stronger, faster…” 😉 The story, entitled Zen in the Art of Survival ©, was published in Chicken Soup to Inspire the Body & Soul ® 2003 . Few things sell better than a French girl’s close calls with “the other side…”
May 1, 2012 – R.E.S.P.E.C.T.
Drove to meet my friend Fred in his Sellwood school this morning. An expert ocean kayaker who tours the planet forward and back, crossing foreign borders under any and all oceanic conditions in nothing more than the carbon/fiberglass shell of his kayak, Fred is the man to see for unmatched lightweight and collapsible gear. I knew I could count on him to outfit me with the lightest, most compact sleeping pad. As expected, he had a panoply of choices awaiting me in the trunk of his car. Of course, I took the fanciest one he had. What do you expect from a girl from Monte-Carlo? Light enough to hold in the palm of your hand, his inflatable speeping pad unfolds into a mattress, a sitting pad or a chaise longue in the blink of an eye. How about that? Will do just fine for me!
The look he gave me, however, when I mentioned I was taking the WFR course, startled me for one reason: it is the same reaction I received from the REI team members I consulted for advice on the equipment I was gathering for the specific purpose of the course. I mention it to make sure I am selecting the right gear for the job and the responses all concur. First there is a silence as they seem to be sizing me up, then a “whoa…” followed by a look of absolute respect. It’s getting to the point where I finally stop and ask: “What?” To which I’m told: “I heard it’s VERY intense…” Okay… Driving back home with my collapsible chaise longue/mattress/sitting pad, I wondered: should I be worried? I have a tendency to assume I can handle anything I set my mind to, but … can I? Oh well, time will tell. Kelly Clarkson’s voice chose that very moment to insist from my FM radio: “What doesn’t kill you makes you stronger, stand a little taller, footsteps even lighter, makes a fighter…” Story of my life after all, nothing new.
May 8, 2012 – Day One
Day one revealed that the release of liability documents warning us we were about to be traveling through rugged, unpredictable, off-trail terrain, boulder fields, downed timber, rivers, rapids, river crossings, high mountain passes, snow and ice, steep slopes, slippery rocks, ocean tides and currents, waves and surf turned out to not apply right away. So far we are on campus grounds, grassy fields, a walk away from buildings. This, in turn, momentarily reduces the long list of risks announced (collision, falling, drowning, hypothermia, frostbite, altitude illness, sunburn, heatstroke, dehydration, insect or snake bites, predator encounters, etc.).
So the intensity everyone was talking about has less to do with physical exertion or athletic abilities than with gargantuan academic overload. Renee, one of our two instructors, warned us when she introduced the course it was going to feel as if you were trying to drink from a fire hose shooting straight at your face. She added you’d occasionally have to turn your head to the side to catch a breath. Only if you do, the freight train continues at full speed and you’re no longer on it. So what does it feel like? Exactly as she said. Imagine taking a straw, thinking you’re about to get a refreshing sip of water, only to find yourself facing an explosion of continuous high-pressure water shooting medical acronyms, technical jargon, deadly injuries and various liability considerations at your wide-eyed, shell-shocked stare.
Imagine having to process that in a foreign language too.
May 9, 2012 – WFR & EMT
During my preparations for the course, I was often asked what differentiates Wilderness First Responders from EMTs. The principal difference lies in the amount of time during which responders have to handle patient care. The goal and mission of EMTs is to get their patients to definitive medical care (i.e. hospitals) within 60 minutes.
The nature of wilderness emergency medicine, however, is that responders will often find themselves hours away from definitive medical care. Having to care for sometimes critically injured patients without any of the resources found with urban medicine and facing environmental concerns such as extreme temperatures, rain, snow, ice, darkness or altitude, which increase stress and risks for patients and rescuers, WFRs have to provide long-term medical care to their patients.
Acting as nurses and psychologists, WFRs have to be able to make and take critical decisions to ensure the best possible outcome for patients and rescue teams alike.
May 10, 2012 – Realistic Emergency Medicine Education
Below Photo by Shawn Newman
WMI courses are intensive. Continuously updated with the emerging trends in wilderness medicine education, the challenging academic program is backed by realistic scenarios and simulated injuries.
The condensed, hands-on training takes place in a wilderness environment. An institute of the National Outdoors Leadership School, the Wilderness Medicine Institute tailors its comprehensive curriculums specifically to address outdoors medicine, leadership skills and risk management.
Graduates of the Wilderness First Responder course come from a wide range of backgrounds and professions, including outdoors educators, ski patrollers, EMS providers, remote researchers, military special ops and physicians. They choose this course because the Wilderness Medicine Institute of NOLS is the leader in wilderness medicine. For the last 15 years, the Wilderness Medicine Insitute has been the most recognized and respected educational provider of wildnerness medicine, setting the standard and teaching over 200,000 students around the world.
May 11, 2012 – High Quality Instruction
Classroom Photo by Kirsten Rudberg
WMI instructors undergo a rigorous selection and training program enabling them to provide the highest quality education available today in the field of wilderness medicine. Wilderness EMTs themselves, they have been there and understand first-hand how difficult it is to make critical decisions in emergency situations.
Backed by the most current treatment and evacuation protocols, the evidence-based curriculum prepares students to handle critical situations and make tough decisions.
Renee and Lisa, our two instructors, gave us a first-class level of instruction. Featured at right during her presentation on mental health, Renee’s constant humor, stand-up comedy style and compelling drawing skills made it possible for us to stay focused through the two-week long intensive academic program. Her presentations were unforgettable and will be forever etched in our memory. “Thirty and two Bro, that’s all you need to know!” Lisa’s supportive and encouraging approach kept me going when I started wondering how I would ever be able to memorize the massive medical curriculum in time for the final exams.
This is no ordinary classroom. Students are taught to act with confidence based on their training, knowledge and skills.
May 17, 2012 – Patient Report / Evac Request
By the end of the grueling two-week training, we were functioning on auto-pilot. The general level of physical and mental exhaustion had obliterated every other emotion, including the suffocating fear of failing. Before being called for our final pratical exam, I glanced at my test partner and smiled: “Between a former paramedic and a future ski patroller, we’re going to ace this!” He smiled back: “You bet!”
“This is Genvièv and Derrick with a patient report / evac request. We are currently located at Lewis & Clark.
We have a 31 year-old female whose chief complaint is sharp pain to the right clavicle. Patient states MOI was falling off a tree while climbing. Patient is currently LOR of A&Ox4. Patient was found lying supine with an LOR of P. Physical exam revealed palm-sized bruising to right clavicle and shortness of breath. Vital signs stable and within normal ranges at 11:00 am. Pertinent SAMPLE history includes asthma. Possible fracture to right clavicle and positive MOI for spine. We released spinal immobilization after patient passed focused spine assessment based on an LOR of A&Ox4, sober, not distracted, CSMs appropriate in all 4 and no spinal pain or tenderness. Treatment included clavicle sling and swathe and assisting patient with her asthma inhaler.
Request evac due to possible clavicle fracture. Hydrate and monitor for signs of shock and shortness of breath. Over.”
Prior Emergency Response Background
Before embarking on the Wilderness First Responder program, Genvièv was a Certified Emergency and Pain Control Hypnosis Instructor trained by US Marine and Police Officer Don Mottin. An Emergency First Responder and a Deep Sea Rescue Diver, she is a trained CPR, AED, First Aid and Oxygen Provider, certified with the Emergency First Response Corporation, PADI, the CMAS, the FMAS and the ANMP, as well as an Animal and Wildlife Emergency Responder. She is now a Wilderness First Responder certified by the Wilderness Medicine Institute of NOLS and served on board the Professional Ski Patrol of Mount Hood Ski Bowl.