Wilderness First Responders
are individuals who are trained to respond to emergency situations in remote settings. They are part of a wide variety of wilderness medical professionals who deal with medical emergencies that occur in wilderness settings.
Near the end of the 19th century, volunteer organizations such as St. John Ambulance
St John Ambulance, branded as St John in some territories, is a common name used by a number of affiliated organisations in different countries dedicated to the teaching and practice of medical first aid and the provision of ambulance services, all of which derive their origins from the St John...
began teaching the principles of first aid at mining sites and near large railway centers. By the dawn of the 20th Century additional organizations such as the Boy Scouts
The Boy Scouts of America is one of the largest youth organizations in the United States, with over 4.5 million youth members in its age-related divisions...
and the American Red Cross
The American Red Cross , also known as the American National Red Cross, is a volunteer-led, humanitarian organization that provides emergency assistance, disaster relief and education inside the United States. It is the designated U.S...
began teaching first aid to lay people. Over the years, these organizations trained hundreds of thousands of people in the elements of providing assistance until definitive care could be arranged. The training in these courses assumed that definitive care was nearby and could be delivered quickly. Eventually there was a realization that this training, while valuable, needed to be supplemented and/or revised to deal with the extended time and limited resources inherent when a medical crisis occurs in a wilderness setting. In the 1950s organizations such as The Mountaineers
The Mountaineers is an outdoor recreation, education, and conservation group based in Seattle, Washington and is the third largest group of its kind in the country. Its central Program Center located in Seattle's Magnuson Park is complete with education facilities for all aspects of the alpine...
began developing training programs that addressed these special needs. In 1966, the US Government, through the National Traffic and Motor Vehicle Safety Act
The National Traffic and Motor Vehicle Safety Act was enacted in the United States in 1966 to empower the federal government to set and administer new safety standards for motor vehicles and road traffic safety. The Act created the National Highway Safety Bureau...
, gave the Department of Transportation
The United States Department of Transportation is a federal Cabinet department of the United States government concerned with transportation. It was established by an act of Congress on October 15, 1966, and began operation on April 1, 1967...
(DOT) responsibility for creating a national Emergency management
Emergency management is the generic name of an interdisciplinary field dealing with the strategic organizational management processes used to protect critical assets of an organization from hazard risks that can cause events like disasters or catastrophes and to ensure the continuance of the...
System (EMS). From this program came the standardized curriculum for the position of Emergency Medical Technician
Emergency Medical Technician or Ambulance Technician are terms used in some countries to denote a healthcare provider of emergency medical services...
(EMT). Wilderness Medicine Outfitters director taught his first back country care course for ski patrolers at Colo State Univ in 1967. The first Wilderness EMT course was taught in 1976 to help EMTs in Colorado adapt their skills and knowledge when working with Search and Rescue teams. By 1977 organizations such as Stonehearth Open Learning Opportunities
Stonehearth Open Learning Opportunities is a school based in Conway, New Hampshire dedicated to wilderness medicine and outdoor leadership training. Founded by Dr. Frank Hubbell in 1976, it was one of the first schools to offer education on wilderness emergency medicine...
(SOLO) and National Outdoor Leadership School
The National Outdoor Leadership School , is a non-profit outdoor education school based in the United States dedicated to teaching environmental ethics, technical outdoor skills, safety and judgment, and leadership on extended wilderness expeditions...
(NOLS) were offering specialized Wilderness First Aid training to their instructors. Meanwhile the DOT EMS program recognized a need to develop standardized training for "first responders" such as truck drivers, policemen and fireman who could lend assistance during the initial part of "golden hour" until an ambulance with an EMT arrived. In 1984 SOLO developed and taught the first Wilderness First Responder course. The purpose of creating the course was to provide Rangers, outdoor leaders, and guides the necessary knowledge to provide care in crisis situations in the wilderness. In 1985, SOLO began providing WFR training to Outward Bound
Outward Bound is an international, non-profit, independent, outdoor educationorganization with approximately 40 schools around the world and 200,000 participants per year...
instructors in Florida. Today WFR certification is frequently a pre-requisite for professional positions that involve work in the outdoors.
A wilderness first responder is trained to deal with many situations that may be encountered in the wilderness. While a standard Department of Transportation defined First Responder course as taught by an organization such as the American Red Cross may require 40 hours of training, the typical Wilderness First Responder Course involves 70-80 hours of training. Wilderness first responder training courses focus on teaching the students to assess a situation, improvise solutions using available resources to stabilize the patient and identify the best way to get the patient to definitive medical treatment. In many courses, students are encouraged to develop the habit of systematically thinking through and documenting their assessment decisions/plans using a SOAP note
The SOAP note is a method of documentation employed by health care providers to write out notes in a patient's chart, along with other common formats, such as the admission note...
. Topics covered usually include, but are not limited to, the following principles
- Basic Life Support
Basic life support is the level of medical care which is used for patients with life-threatening illnesses or injuries until the patient can be given full medical care at a hospital. It can be provided by trained medical personnel, including emergency medical technicians, paramedics, and by...
- Responding to results of trauma
Trauma refers to "a body wound or shock produced by sudden physical injury, as from violence or accident." It can also be described as "a physical wound or injury, such as a fracture or blow." Major trauma can result in secondary complications such as circulatory shock, respiratory failure and death...
- Management of signs and symptoms of Shock (circulatory)
- Management of soft tissue injury
A Soft tissue injury is the damage of muscles, ligaments and tendons throughout the body. Common soft tissue injuries usually occur from a sprain, strain, a one off blow resulting in a contusion or overuse of a particular part of the body...
such as a burn or wound
- Prevention and/or treatment of blood-borne pathogen
A pathogen gignomai "I give birth to") or infectious agent — colloquially, a germ — is a microbe or microorganism such as a virus, bacterium, prion, or fungus that causes disease in its animal or plant host...
- Treatment of infectious diseases
- Management of bone and joint injuries such as fractures, sprains, strains and dislocations
- Management of suspected head and or spinal injury
- Responding to the onset of sudden illness
- Transport/evacuation planning and implementation
The course usually entails 70–80 hours of work and may or may not include certification.
Leading providers of wilderness medicine are:
Wilderness Medical Associates
Wilderness Medicine Institute
Wilderness Medicine Training Center
Wilderness First Responder is usually abbreviated as WFR. Many students who successfully complete a WFR course learn to refer to themselves as "Woofers."
- Wilderness First Aid
- First Responder
- Wilderness EMT
Wilderness Emergency Medical Technician, or WEMT, is the second highest level of wilderness emergency medical training available in the USA , or other courses for advanced providers such as AWLS, and RMAP...
- Certified First Responder
A certified first responder is a person who has completed a course and received certification in providing pre-hospital care for medical emergencies. They have more skill than someone who is trained in basic first aid but they are not a substitute for advanced medical care rendered by emergency...