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.

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

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.

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

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.

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

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

You love the outdoors. The beauty. The adventure. The chance to unplug. The quality time with family and friends, or even by yourself. Whether you choose to explore the wilds by hiking, on the water, with a fishing rod in hand, or up a mountain road with your camper, the remoteness and rawness of it all is likely part of the appeal.

Topics: wilderness medicine, Wilderness First Aid, Wilderness Medicine

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

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.

Topics: patient assessment, first aid, 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

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!

Topics: first aid, wilderness medicine, Live the Dream

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.

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

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