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Tod Schimelpfenig

Tod Schimelpfenig
As a NOLS Instructor since 1973 and a WEMT, volunteer EMT on ambulance and search and rescue squads since the 70s, Tod Schimelpfenig has extensive experience with wilderness risk management. He has used this valuable experience to conduct safety reviews as well as serve as the NOLS Risk Management Director for eight years, the NOLS Rocky Mountain Director for six years, and three years on the board of directors of the Wilderness Medical Society, where he received the WMS Warren Bowman Award for lifetime contribution to the field of wilderness medicine. Tod is the founder of the Wilderness Risk Manager’s Committee, has spoken at numerous conferences on pre-hospital and wilderness medicine, including the Australian National Conference on Risk Management in Outdoor Recreation, and has taught wilderness medicine around the world. He has written numerous articles on educational program, risk management and wilderness medicine topics, and currently reviews articles for the Journal of Wilderness and Environmental Medicine. Additionally, he is the author of NOLS Wilderness Medicine and co-author of Risk Management for Outdoor Leaders, as well as multiple articles regarding wilderness medicine. Tod is currently the Curriculum Director of NOLS Wilderness Medicine.

Recent Posts

To Drink or Not to Drink?

By Tod Schimelpfenig on 6/21/16 9:22 AM

"When you find yourself in an emergency situation, is it better to resort to drinking unfiltered and possibly contaminated water or drinking no water at all?"

It’s a question, or as we like to say at NOLS, a judgment call, of which is the greater risk: dehydration or waterborne illness.

If this is an emergency, you need your wits and your health; both deteriorate when you are dehydrated. You need to consider how well hydrated you were at the start of this emergency, how fast you are losing fluids, how hard you are working, and how long you expect to be without a reliable water source. Perhaps you have the experience and self-awareness to anticipate how long you can function without fluid intake.

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Topics: wilderness medicine, education, NOLS Wilderness Medicine, Wilderness Medicine

Treatment Principles, Recipes and Thinking Cooks

By Tod Schimelpfenig on 1/14/16 2:00 PM

One of NOLS founder Paul Petzoldt’s endearing habits was challenging students to explain their choices and the principles behind their decisions and techniques. He wouldn’t settle on one best way to do something, he sought the practical and effective way.

Unfortunately, it’s not uncommon for students of first aid and pre-hospital medicine to be taught in absolutes; practices that supposedly work all the time, practices framed as being based on solid evidence but in reality often founded on bronze, not gold standard, science.

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Topics: wilderness medicine, WMI, leadership, NOLS Wilderness Medicine Institute, Wilderness Medicine

Does the Lightning Position Really Keep You Safe in a Storm?

By Tod Schimelpfenig on 8/4/15 8:00 AM
Being in a building is the safest place when lightning is near, but what do you do when you're in the backcountry? Seek lower ground first, then use the lightning position. Photo by Brad Christensen.
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Topics: Expedition Prep, risk management, education, wilderness, backcountry

Hydration Tips for Camping

By Tod Schimelpfenig on 6/26/15 8:00 AM

Adapted from the 2005 issue of The Leader.

Now that summer has officially arrived, we can enjoy the hot temperatures, lush wildflowers and rivers full with snowmelt. It brings to mind the need to stay hydrated.

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Topics: WMI, Backpacking, backcountry, Wilderness Medicine

Snake Bites: Here's What to Do [Video]

By Tod Schimelpfenig on 6/19/15 9:23 AM

When the weather warms up, that means the reptiles are out of their winter dens and ready to enjoy some sunshine—just like you, your friends, dogs, and everyone in between.

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Topics: education, backcountry, Wilderness Medicine

Prevention and Self-Awareness: Medicine and Leadership Intertwine

By Tod Schimelpfenig on 5/26/15 2:00 AM

I once heard lightning expert Mary Ann Cooper, M.D. say that the primary risk factor in lightning danger is not the lightning itself; it's the inconvenience of risk mitigation, the unwillingness to change plans in the face of inopportune weather. I've heard altitude illness expert David Shlim, M.D. say that to prevent altitude illness, ambition and schedules must be tamed.

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Topics: leadership, wilderness medicine, WMI, backcountry

To Thaw or Not to Thaw

By Tod Schimelpfenig on 5/19/15 2:00 AM

What should you do if you have to spend the night in the field with frozen toes? Thaw the frostbite or keep it frozen?

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Topics: wilderness medicine, WMI, backcountry

Urine, a Fix?

By Tod Schimelpfenig on 5/1/15 12:00 AM

Rarely does a wilderness medicine class go by without someone asking about using urine as a wound irrigating solution, to cool hot people and for who knows what else.

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Topics: wilderness medicine, WMI, backcountry

Two People in a Sleeping Bag

By Tod Schimelpfenig on 4/24/15 1:00 AM
Snuggling is better when used for fun rather than as a treatment for hypothermia.
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Topics: wilderness medicine, WMI

Handwashing, Giardia and Old Tales

By Tod Schimelpfenig on 4/14/15 1:00 AM

There was once a time when we didn’t worry about wilderness water quality. We drank anything flowing clear and cold without disinfecting, and worried only about dark, murky water in the foothills. These halcyon days ended in 1976 when a tale circulated of backpackers in Utah who became ill with “beaver fever” caused by Giardia. The story was founded in an article in a medical journal, making it hard to ignore. We argued, but resistance was futile.

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Topics: wilderness medicine, WMI, backcountry

Are You Hypothermic, Or Just Cold and Grouchy?

By Tod Schimelpfenig on 4/6/15 1:00 AM

If you read the medical literature on hypothermia, it’s common to see a threshold for hypothermia at 95°F (35°C). The best I can figure is that this norm was described by British researchers in the 1960s.

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Topics: wilderness medicine, WMI, backcountry

Backyard Experiment: Armpits and Frozen Autoinjectors

By Tod Schimelpfenig on 3/30/15 12:00 AM

I recently exchanged emails with a fellow who asked if it was acceptable to freeze the auto-injector in his first aid kit. I told him of course not, you may not have time to thaw the medication. Now curious, I intentionally froze four expired EpiPens® on a minus 22ºF night and timed how long it took to thaw the autoinjectors in my armpit. This is what I found:

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Topics: wilderness medicine, WMI

3 Things that Drive Me Nuts in Wilderness Medicine Education

By Tod Schimelpfenig on 3/22/15 11:00 PM

What drives me nuts in wilderness medicine education?

A real splint on a Wilderness Course, circa 1976

1. Classroom medicine. This is advice that makes sense in the classroom but fails in the reality of the field. Years ago, we taught—I taught—not to apply warmth to a severely hypothermic patient. These people were in a "stable metabolic icebox." Then, I knelt next to my first profoundly hypothermic patient in the wilderness and this advice melted. I had no illusions I would warm this patient in the field, but not applying heat to stabilize his temperature made no sense.

I once read advice to keep frozen toes frozen by sleeping with the foot outside of the sleeping bag. This fell to the axe of reality when I stared at my own frozen toes in a tent on a cold winter's night. We used to think tourniquets implied amputation and that open chest wounds needed to be sealed with three-sided dressings to allow air to escape. This classroom advice did not survive the test of the battlefield.

2. Inaccurate statements of frequency. Hearing something once and acting upon it, no matter how thin the supporting evidence is.

With all the cheese NOLS courses consume, it's good that the data supports strains and sprains, rather than cheese slicing, as the most common cause of injury.

If I acted upon all the dramatic tales I’ve heard from someone who heard from someone who knew a guy, I would not leave home without an auto-injector of epinephrine in a hip holster, locked and loaded. When I read the NOLS incident data history, solid enough to generate multiple medical papers, I can argue that anaphylaxis is rare in the wilderness. But I won't make that argument (and I’m from NOLS). A snapshot is not the entire picture. Data is often a matter of context, and the bottom line is that we don't know the incidence of anaphylaxis in the outdoors. I have epinephrine in my first aid kit. I don’t imagine I will ever use it.

In the same vein, I recently read about the high risk of a lawsuit from reducing a shoulder dislocation in the field. Based on documented cases or data? I think not. I've also heard outdoor experts say that the most common injury on NOLS courses is a laceration from slicing cheese. The real answer, sprains and strains, is easily accessible in the published literature.

When you see or hear numbers, ask for the source, and ask for the conflicting evidence. If the educator is worth his salt, he will be able to tell you the breadth of science on this question. Consider any unreferenced number to be junk.

3. And then there are those who claim expertise in wilderness medicine, but whose wilderness experience is limited to conference rooms and catered trips. How can you talk the walk when you don’t walk the talk?

Am I innocent? Probably not, but I have the good fortune of working in a community of colleagues who will call me to task if I slip into the traps of classroom medicine, deceptive statistics, un-factual facts, or when I spend too little time out of doors.

Read more posts from Tod Schimelpfenig, our Curriculum Director, in our Wilderness Medicine section.

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Topics: wilderness medicine, WMI, backcountry

Backcountry Decision-making

By Tod Schimelpfenig on 3/18/15 11:00 PM
WMI students engage in patient care. Photo by Brad Christensen
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Topics: outdoor, wilderness medicine, backcountry

Origins of Wilderness Medicine Programs

By Tod Schimelpfenig on 3/12/15 2:00 AM
Students learn how to utilize different kinds of litters in wilderness medicine on a NOLS course in the 1980s
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Topics: wilderness medicine