Wilderness First Aid Course

Pacific Northwest yetti

Expedition Medic
I have been hearing an increase of decreased scopes of practice and teaching for the WFR classes. To release liability. HACE and PACE are serious and something that a lot of people don't put much though into, let alone training. But are one of the most probable things you'll encounter. Sounds like you did a great job! RMI's course for Remote EMT, and MCPIC did a phenomenal job. Each student averaged 5 PT assessments a day, and we did multiple scenarios( daily) with muluage. Even covered sutures, ( including practicing), NG tube, Dental work, and U cath's. Extremely in depth, but also expensive and time consuming. As a company those are the services the instructors use for clients during field work. Oil, marine, military etc. I'm not sure what their only WFR courses entail though.
 

DieselRanger

Well-known member
Thanks. It's always scary as a lay person when bad things happen, especially when you're a group leader, but military experience plus training makes a huge difference. My other post in another thread in this sub describes in more detail the two HAPE incidents I was a part of.

I understand the liability concerns...I'm glad I took the course back when it was a little more content-rich - I still have the little spiral water/tear-proof book that they used to sell - it goes with me even if I'm mountain biking at my local trail.
 
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mezmochill

Is outside
Goodsamaritan laws have you covered as long as your not presenting yourself as more than your not.

Btw if it comes down to attempting to prevent someone from dying in the field, Im sure you'll do the right thing.

Do what needs to be done and ******** liabilty. Its their life and your conscience.
 

DieselRanger

Well-known member
Goodsamaritan laws have you covered as long as your not presenting yourself as more than your not.

Btw if it comes down to attempting to prevent someone from dying in the field, Im sure you'll do the right thing.

Do what needs to be done and **** liabilty. Its their life and your conscience.

I think my point and PNWYetti's is that the training organizations are seeing transfer of liability from good samaritans to other agencies, perhaps to the training organizations themselves. As a result they're dialing back their most basic courses, which cover situations where 90% of incidents occur, like local hiking trails, and moving/leaving the content required for deep backcountry or other typical overlanding scenarios to higher-tier courses. WAFA is what WFA used to be, and it seems to me WFR is really what most overlanders should be taking given where we tend to take ourselves and the activities we tend to be involved in.
 

mezmochill

Is outside
Lacerations, fractures ( include C-spine injury mechanism and stabilization with this category), burns, venomous stings/ bites (include anaphylaxis with these)...maaaaybe decompress a pneumothorax...and thats a big maybe.

Hypo and hyperthermia.

Maybe recognizing heart attack and stroke. Maybe CPR...but if your deep in the backcountry is CPR going to even help?

Carrying a sattelite phone or inreach/ personal locator beacon is ideal.

Thats about all that is needed really. No need to teach IVs, NG tubes, foleys...really nothing invasive except maybe pneumothorax decompression...forget the cricothyrotomy... too complex, too risky also rare circumstance.

It would be nice to maybe have an epipen for the anyphylaxis patient who didnt know of the allergy to begin with. Maybe a blanket law eliminating all liabilty for carrying and administering. Although epinephrine is a poweful drug. Unintended IV administration when going for subq can have serious consequences.


The organizations should focus on the above to teach lay persons. The rest just adds unnecessary info that will never be used.

If your leading a large group around the Congo or are a medic on an oil rig in the North Sea thats a different game altogether.
 

Pacific Northwest yetti

Expedition Medic
Goodsamaritan laws have you covered as long as your not presenting yourself as more than your not.

Btw if it comes down to attempting to prevent someone from dying in the field, Im sure you'll do the right thing.

Do what needs to be done and **** liabilty. Its their life and your conscience.

I will always error on the side of treatment, and justifying i did all I can do to save them.

As just a random lay person trying to help, good samartain law will protect you. Just not always as a licensed individual. ( EMT, PAramedic, etc) Or will, unless they go with negligence, abandonment, or battery in which case it wont. Regardless, whomever has the deeper pockets or best lawyer is probably going to win.

https://recreation-law.com/2014/05/28/good-samaritan-laws-by-state/

Just saying know the laws in your area. National Registry only allows paramedics to do chest decompression in the field. The scope for WFR classes being limited is probably a good thing. I would agree, CPR in a back country setting would most likely be a black tag, unless you can get a HELO EVAC quick. Even sutures, your going to need* a large broad spectrum antibiotic to go with them, not to mention dissolving sutures and layered if its deep.

And yes Diesel Ranger-Spot on. When i got my medic certifications, the instructors had to put their paramedic licences numbers on the application. So even as instructors, they have a lot of potential liability as does the medical director. And Yes, the MCPIC- Cert included very advanced procedures for long term care prior to evac- and is limited to where it can be used, Even then your practicing under a medical director.
 

mezmochill

Is outside
It is a great idea to take a good class, and more should do so.

Information is the best tool. I totally agree.

I just wonder, in a stessful situation where either a family member or freind is injured, if emotion + informstion overload of attempting to recall various treatment protocols could actually worsen outcomes.

Bare bones, repetitive teaching of only the most common injuries/medical issues may lead to overall better outcomes in a higher percentage of cases.

Focus on very basic stsbiliztion and evacuation ASAP. IMO, if its a major concern, a satellite phone should be on hand.

Just a thought. Ive never taken a course so I dont know what is stressed.
 

Pacific Northwest yetti

Expedition Medic
You are correct, the frontal cortex of your brain shuts off when your body is really stressed and trying to figure out to " fight or flight". As a survival mechanism so we cant overthink. That is why for lots of industries, Fire Fighters, EMS, LEO, Military; they require drills to do the same task over and over again until you cant get it wrong. Creating muscle memory, like reloading drills, or clearing the chamber. Putting on a your SCBA as a fire fighter, trauma packing a wound, or an airway, etc. In any training, you will have to practice to keep the skills sharp. Just doing a class once, and never revisiting, or practicing could lead to issues when it was time to use the skills.
 

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