Hiking to Head Injury

During the summer of 2017, when I was 14 years old, I took part in a 21-day NOLS backpacking course in the Bighorn Mountains of Wyoming. Just halfway through the course, I watched what (at the time) I considered to be an incredible feat of medicine. Another student on my course tripped and fell while walking across a burned-out section of forest and—under the heavy weight of his pack—hit his head on a rock. In the days that followed, I watched my two incredible instructors treat a possible concussion.

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

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.

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

At age 41 I have repented of some of the bad behavior of my youth. No longer will I leave fish around the tents of my friends when we camp in bear country. Nor will I begin my pre-trip safety talks with the phrase, “What could possibly go wrong?” And, if possible, I will read the rapids and then run them instead of running them and reading about them later in camp when I finally find the guidebook. 

To this end, or rather, new beginning, I enrolled in a Wilderness First Responder course with NOLS this spring.

Topics: Wilderness First Responder, wilderness medicine, NOLS Wilderness Medicine

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.

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

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.

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

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.

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

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.

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

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).

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

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.

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

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.”

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

Editor’s note: NOLS’ Patient Assessment System is designed to be used by individuals with appropriate training. Only provide care within the scope of your training.

Imagine yourself kneeling beside a fallen hiker, deep in the wilderness. You aren't sure if they are sick or hurt, and you don't see anyone else around. It’ll be up to you to respond to this situation and assist this person who is clearly in need. As you survey the scene and your patient, you realize you’ll have to gather information to help you determine how best to care for and transport them. To do this, you’ll use the Patient Assessment System to help inform your decision making and the first aid you will provide.

Topics: Wilderness First Responder, wilderness medicine, drawing

“To my knowledge, none of the climbers I was with were formally trained in the way of wilderness medicine and with only a medical kit and no radio communication, I felt very out there. I knew that if anything went wrong or if someone needed help, we couldn’t do much of anything.”

Topics: Behind the Scenes, Wilderness First Responder, wilderness medicine

On a recent camping trip, I saw a group of young boys using sticks as swords, throwing rocks, and flinging algae from the tiny creek that ran adjacent to the campground—not ideal Leave No Trace behavior. I went over to their trip leaders and introduced myself as a naturalist and expressed my discomfort with what the boys were doing. I wasn't sure how the leaders would react—would they ignore me, a black woman, and let “boys be boys”? Instead, one of the leaders called the boys over and told them to have a seat because they were about to learn a lesson on stewardship.

Topics: Alumni, Wilderness First Responder, wilderness medicine, Live the Dream

I've just exited the mountains: 12 days with rain and wind and existing trails turned into rivers. Any unmarked terrain had turned into swampy, waterlogged areas; boulder fields had turned into a Russian roulette for injuries; and the higher alpine areas were completely in fog. It was difficult to climb higher without losing orientation and visibility.

Topics: Wilderness First Responder, Wilderness Medicine, hypothermia

This course was by far the most diverse NOLS Wilderness Medicine course I've ever taught.

There was geographic diversity, with students from as far away as Slovakia, Puerto Rico and Florida, as well as those just a few miles down the road.

Topics: wfa, WFR, diversity and inclusion, Wilderness First Responder, wilderness medicine, Wilderness First Aid, education, NOLS Wilderness Medicine, Wilderness Medicine