Curious to know here how many people have any wilderness/backcountry medical training. I started training with my local EMS in Alaska when I was in high school, then did a 16 hour first aid/cpr course in college. After about 18 years of no further training or refresher, I did WFA in February last year, WFR in June, then finally W-EMT this January-February. A big motive for training was after I quit smoking about 2 years ago, I got back into hiking and mountaineering. I kept running into people in the backcountry that to me seemed ill prepared. People who where hours from even the closest vehicle who maybe had a water bottle and nothing else. I figured, if I was better trained and was willing to carry the first aid gear, I could help those less prepared and it morphed from there. So, what kind of training does everyone have in emergency medicine?

Also, if you feel like it, tell me about who you trained with and what kind of experience you have.

Family physician with experience in ER, community health and urgent care. Completed NOLS Wilderness Upgrade for the Medical Professional, participated in rescues, fractures (including my own), hypo/hyperthermia, altitude sickness. ER experience with snake envenomations, fractures and multisystem trauma. Take a stethoscope and duct tape into backcountry, and a small kit with epinephrine, bandaids, moleskin etc. Also a PLB.

EMT-Basic 1992
W-EMT 1993 (Pitkin, Colorado)
Residency-trained emergency physician 1998

Frankly, the W-EMT is the best training out there for wilderness medicine

I'm eventually working toward EMT-P, and have my first meeting tonight with my local mountain rescue unit to see about volunteering with them eventually. Also, signed up for a 5 day rope rescue course next month which mostly will benefit with urban rescue, but gives me a head start on the mountain rescue training.

philoparts wrote:I'm eventually working toward EMT-P, and have my first meeting tonight with my local mountain rescue unit to see about volunteering with them eventually. Also, signed up for a 5 day rope rescue course next month which mostly will benefit with urban rescue, but gives me a head start on the mountain rescue training.

Check with the mountain rescue unit you want to volunteer with. They may have specific course recommendations or preferences. Also - level of care you can provide may be dictated by the local agency. BLS care may be the limit for a paramedic if they are working with an agency only working at the BLS level.

CMRU pretty much just wants you to be a proficient mountaineer and have trad climbing experience. They gave me some awesome pointers on which direction to go with further training and education. The funniest thing was in their new volunteer brochure about the "Gear List". It says something like, please review the gear list, and if you don't have most of or don't know what some of this stuff is, then mountain rescue may not be for you, lol. I'm pretty set there, only a few things I need to get like a bivy, snow picket, and a rescue pulley, otherwise I'm doing good.

In this area, the protocols are set by county at what level you can provide care. In our local department, EMT-Ps can intubate, read 12 leads, IV/IO and such, but the department doesn't keep controlled substances, so that limits your scope just based on resources available. We also don't transport, as that is bid out by the county, and right now the Corvallis Fire Department, which is 6 miles away, does all the transports. They also are fully ALS stocked ambulances and mostly EMT-P trained.

I'd always encourage anyone who wants to get more medical training, and I admire your enthusiasm. But EMT-P is more than a title, it's a comprehensive knowledge base and the real world experience to back it up. I know many of the local Paramedic schools won't allow someone to even register for the class unless you have at least 1 year of FULL TIME experience as a working EMT on either an ambulance or fire engine. I'm in complete agreement with this requirement.

Having worked on an ambulance for several years, and with many different paramedics, the thought of a medic who wasn't already a proficient and skilled EMT scares the crap out of me. ALS means you have enough invasive treatment, meds, and protocols to REALLY screw someone up if you make a mistake. Being a wilderness EMT on a SAR team is outstanding, but it would in no way give you the amount of ALS contacts needed to make a decent medic, even if you did it for many years.

Just my .02 cents for what it's worth. And so I don't come across as negative, kudos to you for the interest and effort to improve your skills. The world (and the wilderness) needs more people like that.

My background so you don't think I'm just talking out of my a$$.

EMT-B: 16+ years (3 of which were full time on the bus, 4 years part time on a fire engine)
EMT-T: 4 years "Tactical Medic" on SWAT (and entry guy)
Wilderness SAR team: 13 years (3 as a volunteer, 10 as an officer)
Paramedic school: Didactic, clinical internship, PHTLS, PALS, ACLS (but never got my license or completed my field internship)

PS- I'm in agreement with Sierra Ledge Rat. I think that W-EMT is probably the best bang for your buck if your EMS interrest is centered around SAR or the winderness. Docs are comforting to have around, because they can suture, and have such a vast knowledge of the body. But there are extremely few things that a paramedic is going to be able to do on a typical wilderness rescue team that an EMT could not. Keep in mind that NS IV's and ET tubes can be EMT skills in many counties, as long as the EMS director is on board and skills are maintained.

In Oregon, you have to have an Associates Degree to even become an EMT-P, and anywhere from 700-900 hours of internship. I just started volunteering with my local EMS, and heading back to college next month. Fully aware that Paramedic is more than just a title, I'm just getting started. I'm also no spring chicken. I'm 38, went to college right out of high school and then totally lost my direction in life. Ended up in the airline industry, was halfway to a commercial pilots license, then gave up on aviation due to too much instability in the industry. Ended up managing a business for 8 years before I decided to throw it all away last year and go back to school. EMS is something I started 20 years ago, just got sidetracked by too much bs. The degree is also something I've been meaning to finish, but I'm essentially starting over. Once I finish the AA degree, then I can go on to Paramedic program if I want, which gives me two years of volunteering experience (and I live 4 blocks from the fire station). After that, on to Southern Oregon University for the Outdoor Leadership BA program. This is not going to be a quick "change of career", I'm looking at going from making a decent wage as a business manager to being a broke student again for four years. It is because these are things I started 20+ years ago, and finally re-found my direction. I'm just curious as to how many "mountaineers" have at least some medical training so if I were to get sick or injured in the backcountry, I know what the odds are that someone else around me knows at least something other than what they've seen on TV.

I wish you the best Philoparts. Sounds like you've got a good plan and are willing to work hard to achieve it. I think we're going to be surprised (as in a lot) how many folks that are into mountaineering have emergency metical training as well.

I've been seeing it just with the circle of people I still call friends from my various classes. I did WFR last June, and have kept in touch with many from the class. One has already gone on to WEMT, and another is attending in July. One of the guys in the WFR class is a climbing ranger on Rainier. In my WEMT class, there was another student who is friends with him that met him in Yosemite while climbing several years ago., Another guy from the WEMT class has a sister who went to college with one of my WFR class friends in New Hampshire. The circles keep getting smaller, with a common connection of some sort of emergency medicine training.

Why don't you go to nursing school? You can work in critical care then apply to be one of those helicopter nurses or work in the ER. I don't know about out west, but in Pennsylvania, EMT's and Paramedics get paid peanuts. There are plenty of grants, scholarships, and tuition payback programs to fund your RN education. Good luck.

Naw, no nursing school for me, too competitive out here, and I'm not looking at making a career of emergency medicine. Its just an adjunct to the degree I'm going for. What I'm really looking for down the line is expedition medicine, which falls in line with the Outdoor Leadership degree. One of my WFR and W-EMT instructors is an ER nurse in New Hampshire, and she's been spending more time instructing than actual ER work.

Former career Paramedic who worked both ground and air ambulance. Former member of SMC Cliff Rescue Team. Former certs and instructor certs within BCLS, ACLS, BTLS, PHTLS and ATLS... Yes, for you MDs, that's ATLS. And you guys didn't take all too kindly to a lowly Paramedic proctoring your practicals !!

twoshuzz wrote:Former career Paramedic who worked both ground and air ambulance. Former member of SMC Cliff Rescue Team. Former certs and instructor certs within BCLS, ACLS, BTLS, PHTLS and ATLS... Yes, for you MDs, that's ATLS. And you guys didn't take all too kindly to a lowly Paramedic proctoring your practicals !!

Don't be hating!

I am a full time career paramedic/firefighter. For most wilderness type emergencies I don't see much benefit over being an emt basic. It all comes back to the basics for trauma. We work in an area where there is a lot of interface with outdoor recreation areas and we are a fairly busy department. We are fully trained and our protocols allow us to work in the full scope of the paramedic certification with exception of RSI. Which may not be far away. As far as an outdoor kit, My kit would consist of epi, baby aspirin, ibuprofen, benadryl tape and one roll of kerlex and maybe a neosporin pain relief as well for those annoying cuts.