Wilderness EMS Equipment



Wilderness EMS Equipment


Carl Weil



INTRODUCTION

Once we leave home and maintained roads, we are probably entering wilderness or “out of doors.” We are now hours or days or even weeks from traditional emergency medical services (EMS), which we would otherwise count on for care. We are no longer in the golden hour or range of reasonable response by a traditional ambulance team. We are now on our own, so we should be prepared with our own training, medical devices, and associated gear.

In the wilderness, we have three common considerations. First, few of the items the urban user would wish for are ever available in backcountry or wilderness location. Second, the need and opportunity to improvise is great. Third, today many items have been made smaller, more available, and now more affordable. The good news is that with a little preparation effort and for a few dollars more you can be better prepared to give care without noticeably increasing the weight of your medical kit or its cost. This chapter will help you look at these items. I will also cover items that may keep you out of trouble: the emergency survival gear often referred to as a part of the “ten essentials.” I have separated the medical items into the six categories Wilderness Medicine Outfitters (WMO) uses to teach medical kit contents. The fifth category of medicines is found primarily in its own chapter, Chapter 11. Categories seven (survival), eight (improvisations), and nine (evacuation) are outside of the six medical kit contents, but are so closely associated that we will cover them. Preplanning for these categories is far better before they may be needed. Remember the old line, “proper prior planning prevents pitifully poor performance.”1 We hope this chapter will help you chose your items wisely. Please note, a very few items will be marked with an asterisk * indicating we recommend they only be used after training and instruction with physician involvement and having a written authorization protocols from a physician.

Many other items are also more useful with competent training. The Wilderness First Aider (WFA, 16 to 32 hours) will have only basic training compared with the Wilderness First Responder (WFR, usually 72+ hours) or Wilderness Emergency Medical Technician (WEMT, usually 250+ hours). A “clinician” caregiver could be physician or highly trained and credentialed nonphysician with great improvisational, medical understanding and heavy trauma and illness coping skills. Other wilderness emergency medical services (WEMS) credentials include the Academy of Wilderness Medicine Fellow, with another 100+ hours. There may also be the rare Master Fellow, with many hundreds of hours of specific additional training in this genre, a degree established in 2005. Different educational and certification opportunities in WEMS are discussed in more detail in Chapter 2.

Wilderness is analogous to improvisation, which does not often lend itself to high-grade evidence. Hence, much shared here is acknowledged as opinion based on the author’s own 60+ years’ experience in wilderness medicine and WEMS.


Oct 16, 2018 | Posted by in EMERGENCY MEDICINE | Comments Off on Wilderness EMS Equipment

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