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Wilderness First Aid: 5 Steps of a Scene Size-up

By Tod Schimelpfenig on 8/19/19 8:30 AM

Photo by Jared Steinman.

You’re out for a hike, enjoying a beautiful day in the mountains. Pausing to take a sip from your water bottle, you survey your surroundings—and suddenly notice the fallen hiker up ahead. You put your water bottle away and start walking toward the crumpled figure beside the trail.

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Topics: patient assessment, first aid, wilderness medicine, Wilderness First Aid, NOLS Wilderness Medicine

ABCs of Wilderness Medicine: The Initial Assessment

By Tod Schimelpfenig on 8/19/19 8:18 AM

NOLS Wilderness Medicine students participate in a hands-on scenario. Photo by Lena Conlan.

Your weekend adventure in the mountains takes an unexpected turn when you spot a fallen hiker beside the trail. Fortunately, after a brief moment of panic, your wilderness medicine training kicks in and you complete a thorough scene size-up.

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Topics: patient assessment, first aid, wilderness medicine, NOLS Wilderness Medicine

Case Study: When Heat Stress Hits an Entire Group

By Tod Schimelpfenig on 7/23/19 8:17 AM

Photo by Pascale Gulick
 

The Setting

You’re the supervisor for several crews doing volunteer trail maintenance in a local national forest.

Since your crew leaders are new, you decide to head out to their work sites to check on their work. (Plus, it’s a good reason to get out of the office, away from email, and enjoy a hike in the hills.)

The weather has been unusually hot and humid, with daytime temperatures in the 90s °F (30s °C).

You find one of your crews around lunchtime resting under a few trees. They look lethargic and tired.

One crew member is lying on his back with his feet elevated and a wet bandanna on his forehead. Your crew leader gives you a SOAP report on the patient.

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Topics: first aid, summer, wilderness medicine, case study, heat illness

Case Study: Treating a Feverish Patient

By Tod Schimelpfenig on 6/13/19 3:57 PM
Photo by Nicholette Hilbrich.

The Setting

You’re a biologist working out of a remote ranch on the sagebrush plains of southern Idaho. It’s early May. You ride and walk daily to survey herds of pronghorn as part of a research program. One of your classmates goes to bed feeling lousy—achy, nauseous—and wakes up feeling worse.

Knowing you have training as a Wilderness First Responder (WFR), your colleagues ask you to take a look at this poor fellow.

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Topics: Wilderness First Responder, first aid, wilderness medicine, case study, NOLS Wilderness Medicine, flu-like illness

Case Study: Bucked off a Horse

By Tod Schimelpfenig on 5/15/19 12:15 PM
 
 
Photo Credit: Kelsey Wicks

The Setting

You and a companion, both proud and confident Wilderness First Responders (WFR), are hiking a wilderness trail when you are passed by a horse pack string led by a young cowboy. You exchange pleasantries and fishing tips.

Suddenly, one horse nips at another, a horse kicks, and then horses seem to be going everywhere. The rider’s horse rears and bucks; he falls off and lands on his head and shoulder.

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Topics: decision making, Wilderness First Responder, first aid, wilderness medicine, case study

Case Study: An Abandoned Patient High in the Alpine

By Tod Schimelpfenig on 4/18/19 9:05 AM

Photo by Ashley Wise
 

The Setting

You are on a Search and Rescue (SAR) team whose members are Wilderness First Responders (WFRs). You and your team members hike on a rugged trail into Wyoming’s Wind River Range, responding to a vague report that came in at midnight of a “very sick person” camped “near the trail near tree line.” Your team’s role is to sweep the trail in the dark in the hopes of finding out exactly what is going on. A second SAR group is gathering to hike up the trail later in support.

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Topics: Wilderness First Responder, first aid, wilderness medicine, case study

Case Study: A Blow to the Head

By Tod Schimelpfenig on 3/14/19 6:37 AM

Photo by Matt Heaton

The Setting

You are the leader of a hiking group at a summer day camp. Today, you allowed some of your campers with good navigation skills and expedition behavior to walk 3 miles back to your camp on a well-marked trail without a camp leader present.

When the campers arrive, you notice one of them has a bandage on their forehead. You learn that about an hour ago and a mile back on the trail this camper tripped, fell, and knocked their head.

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Topics: Wilderness First Responder, first aid, wilderness medicine, case study, NOLS Wilderness Medicine

9 Wilderness Medicine Acronyms You Need to Know

By Ben Lerman on 3/11/19 12:44 PM
NOLS students practice skills during a scenario on their course. Photo by Kyle Wilson.
 

You’ve taken your WFA, WFR, or WEMT and learned about PAS, ABCDE, and MOI. So many abbreviations, so little time!

Whether you’re filling out a SOAP note for a real-life patient or reviewing your skills with a NOLS case study, wilderness medicine’s plethora of abbreviations and acronyms can be a lot to remember.

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Topics: patient assessment, first aid, wilderness medicine

Case Study: A Backcountry First Aid Mystery from the ’80s

By Tod Schimelpfenig on 2/13/19 11:23 AM

Fashion trends might change, but some things don't! NOLS students backpacking in the mountains. Photo from the NOLS Archives.


This is a tale from the early 1980s. Reagan was President, the internet and cell phones only a dream, and disco thankfully on its last legs. Two friends and I had recently learned wilderness medicine skills through an advanced first aid course, which was an early generation of the Wilderness First Responder (WFR).

Read along to see how you would react to a similar first aid situation today.

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Topics: Wilderness First Responder, first aid, wilderness medicine, altitude illness, case study, NOLS Wilderness Medicine

Case Study: Is That Frostbite?

By Tod Schimelpfenig on 1/24/19 9:13 AM

Rescuers practice giving patient care. Photo by Aron Gooch.
 

The Setting

You’ve been leading an outdoor skills course for young adults, most of it taught indoors or on day hikes. This weekend is the culminating overnight snowshoe trip where you plan to sleep in hollowed-out snow shelters, called quinzhees.

The snowshoe hike went according to plan and you and your group arrive at your planned campsite. Everyone appears weary, happy, and healthy. You note that it is much colder than any previous trip you’ve led, with temperatures hovering near 0°F (-18°C).

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Topics: Wilderness First Responder, first aid, wilderness medicine, case study, winter, frostbite

Your 8 Favorite Wilderness Medicine Posts of 2018

By NOLS on 12/19/18 4:43 PM

While wilderness medicine is a constantly evolving field, some things stay the same—like people wondering whether it’s really ok to suck out snake venom, or the steps of the Patient Assessment System.

As 2018 wraps up, our team gathered this year’s most popular wilderness medicine topics from the NOLS Blog. Take a look to refresh your skills and get ready for whatever comes your way in 2019!

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Topics: first aid, wilderness medicine, Live the Dream

Real-Life Scenario: Stuck on a Climbing Route

By Jake Blackwelder on 11/26/18 8:02 AM

The rescue team. Photo courtesy of Jake Blackwelder.
 

The 911 call: A climber was stuck in a crack on a classic multi-pitch trad route at a well-known sandstone climbing area near Moab, Utah. The incident happened near the top of a large chimney, a crack wide enough to fit a climber’s entire body into. The climber was about 100 feet from the ground and 40 feet below the pitch anchor, the next opportunity to attach securely to the wall.

My wilderness rescue team, consisting of myself, another Wilderness EMT, and three Rope Rescue Technicians, were the ones to receive the call and respond to the incident.

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Topics: rock rescue, first aid, wilderness medicine, rock climbing, scenario

Case Study: A Hard Fall While Skiing

By Tod Schimelpfenig on 11/7/18 1:14 PM


Photo by Brian Fabel.

Editor’s Note: This case study is based on an actual incident that NOLS Wilderness First Responder and Wilderness First Aid graduates responded to.

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Topics: Wilderness EMT, Wilderness First Responder, first aid, wilderness medicine, case study, winter

Real-life Scenario: A Surfing Rescue in Baja California

By Lisa Kosglow on 10/22/18 9:48 AM

Photo courtesy of Lisa Kosglow
 

My NOLS Wilderness First Responder course made a real difference in my life—and someone else’s.

Six months after my course, I was on vacation in Baja California, Mexico, where a south swell lured my family and me to a popular beach to go surfing. At the beach, a few people were in the water, including a small group of surfers and one stand-up paddle boarder. As I paddled over a breaking wave, I saw the next one about to break with one surfer paddling over it and the stand-up paddle boarder dropping in. What happened next played out like a horrible car wreck.

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Topics: first aid, wilderness medicine, case study, rescue

Case Study: Is Hydration Always the Answer?

By Tod Schimelpfenig on 10/10/18 12:35 PM

Photo by Liz Schultz.
 

The Setting

You and three friends are hiking through a sandy wash in the desert. Even though it is fall, daytime high temperatures have been 100°F (37.7°C) with no clouds in the sky.

Your group encounters another party of two hikers, one of whom is lying on the ground under the only small juniper in the area. The other hiker seems worried. You ask if everything is ok. One hiker is fine but asks if you can help with the patient, who he worries is dehydrated or having a “heat stroke.”

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Topics: Wilderness First Responder, first aid, wilderness medicine, case study, hydration