Injuries Know No Borders: the Significance of Wilderness Medicine in Europe

By Molly Herber

May 5, 2015


Bike-accident-scenario A rough fall on a bike ride doesn't have to result in calling for a helicopter. With proper training, friends can help take care of each other on trips long and short. Walking out to the trail head and driving to the nearest hospital can save both money for search and rescue services and time for the injured. Photo by Lena Conlan.

By Lera Nichols O’Sullivan, WMI Instructor

As a NOLS Wilderness Medicine instructor, I have come to take it for granted that people who regularly recreate in the wilderness generally want to get trained in wilderness medicine. Most of us wouldn’t go backcountry skiing without being properly trained in avalanche safety, wouldn’t climb without the right gear, and wouldn’t sail without knowing what to do in the event of a capsize. Neither would many of us feel comfortable venturing out into the wilderness without a certain amount of wilderness medicine training under our belts. Or so I thought.

Although I am from the United States originally, I have spent the last decade living, teaching, and recreating in Europe—primarily the UK. We Europeans (yes, I count myself as one of them) are mad for the outdoors. We ramble, we sail, we climb, we kayak, we hill-walk (the British term for mountaineering). Admittedly we do it all in wilderness areas that are markedly smaller than what is available in other parts of the world, but as a people, we really like to get out there. Incongruously, one thing we have been very resistant to is getting trained in wilderness medicine.


shana-tarter-wmi-pair Not every injury needs to be evacuated. Those with medical training can tell the difference between life-threatening or minor injuries and can manage them—without using resources like helicopter teams that would be better reserved for a true emergency. Photo by Shana Tarter.

Why might that be? I have some theories. In the United States, we in the outdoor community are used to very large wilderness areas. We are used to the idea of being out of contact. And, perhaps crucially, we are also used to the idea of paying handsomely for search and rescue and medical services. This isn’t quite the case in most of Europe, where we are often (but not always) relatively closer to a town or at least a reliable telephone.

Here in the UK, I have heard actual outdoor professionals tell me that getting trained in wilderness medicine is a waste of time when Prince William and the Royal Air Force will come with a helicopter to rescue anyone with so much as a sprained ankle. In Iceland, I was told that the (free) Search and Rescue (SAR) helicopter service could be relied upon at any time no matter what the weather and that they actually could be called out without knowing even the most basic information about the patient. In Switzerland, I was told that even minor injuries were regularly evacuated via helicopter.

I think some of the above might be true. There is no doubt that SAR services in Europe can be more affordable and more reliable than what is available in the United States. But communication should not be taken as a given (I can’t make a mobile phone call from my living room just outside London, for goodness sake). Further, I would argue that just because a service is available doesn’t mean that we should necessarily use it. Even free and low-cost services must be paid for somehow. When these services are abused, it puts tremendous cost pressure on them and ultimately puts their very survival on the line. Remember, for every SAR crew that goes out for a search, every helicopter that gets off the ground, every team scrambled for a litter-carry, there is very real risk for the rescuers. Personally, I am not interested in risking the lives of others if there is the possibility that I can deal with the problem myself.


lena-conlan-winter-scenario If you come across an unconscious person on the trail, they may not have time to wait for a trained wilderness emergency medical technician. Knowing CPR could save their life. Photo by Lena Conlan.

It is also important to recognise that when things go really wrong in the wilderness, they often go wrong as the result of poor conditions or even a natural disaster. This week, we have witnessed the devastating results of the earthquake in Nepal. Kathmandu, a major, populous city, is now operating in what is essentially a wilderness medicine situation. Due to the number of people needing help and the damage to the infrastructure, rescue services are working with limited resources and drastically reduced access to hospitals, which are in turn experiencing shortages of supplies, electricity, and sanitation. Mount Everest saw climbers cut off at Camp 1, killed by avalanches at Base Camp, and for a period left without any option for evacuation or definitive medical care, despite having medical professionals present at Base Camp. This is an extreme example, but it serves as a worthwhile reminder that communication, access, and availability of rescue services are never a guarantee. Wilderness medicine skills might well serve us outside of the traditional wilderness context.

It’s time for the global outdoor community to really embrace wilderness medical training. It is definitely not a waste of time, and training can be accomplished in as little as 16 hours. WMI courses are fun, interactive, and definitely not boring. Get trained. It’s just another crucial tool for all of us to have at our disposal, both in the wilderness and in the front-country.

About the Author: Lera has worked for NOLS Wilderness Medicine for nine years and is a Wilderness Emergency Medical Technician (WEMT). She has taught WMI courses around the world, including Germany, Sweden, Iceland, India, Singapore, and Malaysia. Lera served as an ambulance EMT and EMT instructor in New York State before going on to work as an outdoor educator and a ski patroller in Colorado. She holds an MSt in Slavonic Studies from Oxford University. In her spare time, she is an avid snowboarder and backpacker.

Lera will be speaking at the Oxford University Mountaineering Club and Oxford University Exploration Club expedition planning evening on May 6. Learn more and RSVP to attend this free event on the clubs’ Facebook event.

Explore courses with Wilderness Medicine Institute to further develop your outdoor skill set. WMI courses can also be run on-site by groups.

Written By

Molly Herber

Molly is a NOLS instructor and writer. She loves the smell of her backpack and does her best writing before 7:00 am. When she's not scouting the next post for the NOLS Blog, she's running and climbing on rocks in Wyoming. Follow her on Instagram @mgherber

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