Wilderness EMT - WMI/NOLS 31Dec2012 - 25Jan2013

Summary: An excellent 200-hour class providing classroom and practical instruction leading to certification as an Emergency Medical Technician (EMT) with additional training devoted to providing EMS in a wilderness environment.

Course description: The WMI/NOLS description of the course can be found here: http://www.nols.edu/wmi/courses/wemt.shtml.

Location and facilities: The course was conducted at the "Wiss Wilderness Medicine Campus" located about 12 miles south of Lander, WY. The facility is sited on a large area consisting primarily of sagebrush, juniper, and sandstone. The campus consists of a central building and several cabins for student housing. All buildings are new. The central building includes 2 classrooms, kitchens, dining room, student commons, storage, conference room, and instructor space. The central building is presently plagued by roof leaks - hopefully to be remedied soon. All buildings are "green" with extensive use of solar and geo-thermal power, composting toilets, etc.

Weather: Temps ranged from -18F to +45F. Winds were zero to 5 mph. We had approximately 6" of new snow during the course.

Instructors: Three instructors were assigned full-time to the class. All had extensive urban EMS experience and backcountry time. All were qualified EMTs and excellent teachers. Additional staff were brought in as needed for scenarios, testing, etc.

Students: 29 students were enrolled. 23 men and 6 women. One is an active-duty USA Blackhawk medevac helicopter pilot. The rest were civilians - generally employed in the outdoor industry as trip leaders, guides, youth camp staff, etc. The students were well-educated and mostly fit. The average age was approximately 22.

Curriculum: The course lasted 4 full weeks - MO through FR. Weekends were usually spent practicing skills and/or studying. A typical day began at 0800 and concluded at approximately 2200. Instruction days were spent both in the classroom and outdoors. Every day featured one or more outodoor scenarios. We had two or three night rescue scenarios also. The outdoor scenarios ranged from the common/simple to the more difficult complex multiple casualties with numerous litter carries across broken terrain.

Textbooks: The two primary texts were "Wilderness Medicine Handbook" by WMI/NOLS and "Emergency Care and Transportation of the Sick and Injured" by AAOS (the "orange book"). Lesser used was "Wilderness Medicine" by Tod Schimelpfenig. The "orange book" is 1600 pages of pure bliss and is the foundation for many of the written test questions.

Med Gear: WMI/NOLS supplied all needed med gear. This ranged from the basic "red bag" which contained stethoscope, BP cuff, cravats, ace bandages, SAM spint, and dressings to O2 bags with tanks, masks, and regulators. We also spent much time with other common EMS gear such as traction splints, long boards, short boards, AEDs, C collars, etc. Emphasis was placed on using proper technique with whatever resources are available. Big white ambulances are seldom found in the backcountry.

Personal gear: Students were responsible for supplying clothing and other personal gear. At -18F, it's critical to have quality clothing to stay warm and dry. Some things that worked well for me: Black Diamond Storm headlamp, Moutain Hardware fleece cap, Moutain Hardware goose down jacket, multiple inner and mid layers, Patagonia Torrentshell jacket and pants, kneepads, Smartwool socks, insulated GoreTex Danner boots. A space pen and "Write in the Rain" notebook were also very handy.

Testing: We had approximately 8 multiple choice quizzes which composed 75% of our final grade. The multiple choice final was the other 25%. An average of 80% was required to pass. At least one student failed. We also had a psychomotor (practical) test with five stations: medical, O2, trauma, CPR/AED, and splinting/traction. Each student was given max 2 opportunities to prove competence. The wilderness portion of the class was tested via multiple choice with 70% required for passing. Finally, we all took the NREMT (national reg) test at Central Wyoming College.

Patient assessment system: The PAS was drilled into us relentlessly and was the most important takeaway from the entire course. The system taught differed slightly for trauma and medical patients. For trauma patients it goes: Scene size up 1 - 6, life threats A - F, head to toe, vital signs, history (SAMPLE), problem list, plan, and monitor. For med patients: Scene size up 1 - 6, life threats A - F, history (SAMPLE), vital signs, head to toe, problem list, plan, and monitor. Every patient gets a full PAS every time.

Comments and conclusion: This was an excellent course. Having suffered through many classes that just plain sucked or were barely adequate, I know the difference. Although WMI/NOLS is well known for its dedication to environmental causes, this was not preached during the course. Students were encouraged to put their trash in the appropriate recycling container but, that's as far as it went. The instructors were very, very good. Keeping a tent over a bunch of "kids" is no easy task. As far as course content is concerned, it was excellent albeit lacking in some mil content. My sense is that the military side of the house has learned a ton in recent years about trauma treatment (especially GSW, burns, etc.). This wasn't really taught. The wilderness/backcountry emphasis was great. I live, work, and recreate in a place where "the bus" is generally minimum 30 + minutes away. Knowing what to do before the cavalry arrives and with minimal resources is outstanding. I learned great respect for EMS providers. The mil guys doing this stuff under fire are my heroes. Conclusion::26_7_2:
 

1leglance

2007 Expedition Trophy Champion, Overland Certifie
That is one impressive write up, thanks.
As an ICU RN I really enjoyed my WUMP (Wilderness Upgrade for Med Prof) through WMI and it was only 40hrs....yours sounds intense.

My son is in school for EMT and I will direct him to read this.
 
Thanks!

Thank you for the kind words. It was a great experience. The academic side was more demanding than I anticipated. Whatever I learned about anatomy and physiology in high school had been long forgotten. Now it's a matter of keeping my skills fresh and learning more about ALS...
 

Forum statistics

Threads
185,531
Messages
2,875,588
Members
224,922
Latest member
Randy Towles
Top