Small pack – check. Right clothing and layers for the weather forecast (and worse) – check. Water and extra food – check. Headlamp – check. Current wilderness medical training and appropriate kit – ?

I enjoyed working as a mountain guide internationally for over a decade. A key responsibility of my job was managing the health and safety of my clients in the face of an overwhelming number of possible medical and logistical issues. Over time in the field and with training including Wilderness First Responder (WFR) and Wilderness EMT I learned how to be prepared on the medical side while balancing the rest of my duties.

Planning for the unexpected is part of every experienced outdoorsperson’s preparation regardless of destination, activity or time spent out. Common medical issues in the backcountry range from cuts and scrapes and blisters. Serious scenarios include broken bones, shock, or anaphylaxis from an insect sting. In the frontcountry we have the luxury of a rapid EMS system response- help is here within 2-10 minutes of calling 911.

A twisted ankle hiking with a friend on the Cascadian Couloir of Mt. Stuart, for example, presents a very different set of circumstances. Let’s say that to go light and fast you brought only a daypack holding limited food and water, clothing, and no shelter. A light cold rain is rapidly rendering your partner hypothermic. If you happen to have a cell phone and can get reception help can be on the way in 4-6 hours at best, though SAR will typically wait until first light to deploy.

In these conditions your very basic injury could put you and your partner at serious risk. But with the right planning, training and preparation your ability to respond to the scenario can change the outcome from a bad ending to a manageable mini-epic that makes for a good story and learning experience.

Wilderness medicine refers specifically to training and protocols designed to manage the unique requirements of delivering medical care in the backcountry. “Backcountry” typically includes locations one hour or more from a road or trailhead, and presents challenges including:

  • Extended time to definitive care
  • Limited resources including medical kit and trained help
  • Environmental challenges including weather, terrain, and altitude

Here’s the good news (finally!): living in the Seattle area we enjoy access to year-round wilderness medicine training options, quality outdoors shops and suppliers of medical kit, and experienced outdoorspeople to learn from.

Over the coming months, this column will cover topics including wilderness medicine training options, building an appropriate med kit, and advice for managing hypothermia, altitude issues, frostbite, shock and more. Whenever possible focus will be on issues or considerations specific or common to the Northwest. The goal is to raise awareness, share knowledge and resources, and ultimately enhance your ability to enjoy the outdoors more safely (while understanding that risk is an inherent part of outdoor activity). The goal is not fear-mongering- getting out is fun, and whenever possible should stay that way. Being prepared on the medical side gives you a plan and tools in case something comes up, allowing you to focus on what you’re really out to do.

Next Month: Wilderness Medicine Training

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