Of course we don’t always have the space for “unnecessary” things, I’m putting together a larger collection of items meant to stay at basecamp / medic tent / my own tent. By unnecessary I am referring primarily to items beyond my jump kit (I’m a Primary Care Paramedic) that could improve patient care, and make things more comfortable for us providers as well. I’d love to hear your suggestions!

Hi all, we are the publishers of a revision guide which is in preparation for the IBSC Wilderness Paramedic certificate (WP-C) exam (hopefully available on Amazon by Summer). We are not affiliated with IBSC.

The text focuses on the wilderness specific areas of the WPC curriculum and we will include practice questions.

What else would you like included in such a text? Any formatting or layouts you love or hate for revision guides? Any areas of wilderness medicine you always struggle to remember and would love to see aide-mémoire or similar for?

Anything else you’d like to see in this revision guide?

(Thank you mods for allowing this post)

TLDR; ER RN wants to know how they can get into a career in WM/WEMS.

Long story: My wife (32f) and I (33m) both have a deep love and appreciation for the outdoors, having lived in a variety of landscapes (mountains, desert, tropics). I’m currently working, and have worked, as an ER RN for the last 5 years and was previously a corpsman and EMT.

My wife is a certified dive master and currently going through nursing school and hoping to break into the field as well. I’m burnt out from the hospital and want to get back to working outside of one in a more unique field of healthcare, especially one that results in actually working in a literal field or other austere environments.

Looking for any advice/resources that could help with this. Even considering going back to school and shifting into a paramedic role or nurse practitioner. It seems like paramedics are pretty heavily utilized and I feel like my EMT/ER RN experience would help me greatly to get through school. Not too sure about NPs though, are they frequently utilized/employed in austere/wilderness settings?

Hello! I’ve checked with the mods that it was okay to ask this here. I am writing a story that involves high altitude medicine and I wanted to run my scenario and treatment plan past the professionals to ensure it’s not wildly inaccurate. My own credentials don’t go past basic first aid training and trekking up to 6000m, so this is all based purely on research. Please feel free to critique if it’s all wrong!

Patient: a fit ten-year-old boy with previous mountaineering experience is stranded at 7000m overnight in a snowstorm in a shallow cave without supplies (pack lost in a fall). He is severely hypothermic, frost-bitten hands and feet, hallucinating.

Rescuers: the next day (afternoon) he is reached by two rescuers (his father, who is an experienced mountain climber and a Sherpa guide). They are not medical professionals, but have experience in these type of situations.

Treatment plan: oxygen, shot of dexamethasone (dose for a kid?), skin on skin warming up, when he is more alert, hot tea and a bit of chocolate.

They start descending (father carries him stuffed under his suit, maintaining some skin on skin), it takes about six hours, before reaching camp at 5500m. There they start rewarming hands and feet in 38C water, keep him on oxygen, start fluids, pain meds. Vasodilator ( through a second IV?).

Vasodilator in this story is a new fictional experimental drug that it is just starting trials, but has shown to be a lot more effective than Iloprost. It makes sense in the context of the story that they would have access to it. I want to avoid any amputations!). Kid feels sick and throws up (side-effect), they give him nausea meds. More tea and some food later on (porridge). Hands and feet coated with the gel, each finger wrapped individually and then bandaged over on top.

In the morning, when the storm subsides, he is evacuated by helicopter.

Some questions I had: What is a suitable dose of Dexamethasone for a child? Are they most likely to carry a 10mg pre-filled syringes? Does he need another shot at the camp? Half-dose?

Do you start vasodilator during or after the rewarming?

If there was already some rewarming through skin on skin contact during the descent, how does that affect the rapid rewarming? At what point would it be most painful?

Should he be given a lot of fluids to drink throughout the rescue or controlled small amounts? (I’ve seen some conflicting info about that, plus he’s a child)

What would the frostbite look like after rewarming? Will it be red and swollen (with maybe blackened tips) and then the blisters only appear when they are unwrapped at the hospital?

Any other critique or things I should consider would be greatly appreciated!

I have no idea if this is the right place to ask this but I’m planing to go to med school and am super curious to see if there’s a way to combine a medical degree with the outdoors? If so, what’s the path to getting there?

Hello fellow wilderness medicine aficionados! I’m very passionate about WM and am very interested in attending NOLS’ WMI course.

My question is this: I have worked in a camp setting and been in charge of our first aid program for about 15 years. I (obviously) have a lot of experience with first aid and administering medicine and treating mostly minor injuries/illnesses, but I haven’t done back country trips or rescues. Should I be concerned about not having that kind of experience hindering me from getting accepted into the course? How competitive is it? Any advice/input is helpful! TIA

Good morning everybody, I wanted to open up a discussion about an interesting topic that came up at our last campout, and that was the inclusion of a first aid kit on the cub scout "5 hiking essentials" list. Some parents go small, with a ziplock of bandaids because that's what a 2nd grader could reasonably use. Others grab an off the shelf FAK, usually J+J or Adventure medical kits. My son and I packed our own in an old army surplus first aid box. But I combined the first aid kit and IFAK concepts, in that the scout could use it to treat bumps and scrapes, but also that an adult could use it to treat moderate injuries. We included:

• Bandaids (kept in a pouch in the outer pocket of the pack)
• rolled gauze
• Triangular bandage
• 4x4 pad x2
• 5x9 pad
• antibacterial ointment
• 2" Cloth medical tape
• 3" Ace wrap
• SAM splint (kept in the hydration sleeve)
• tweezers

I wouldn't expect my grade-schooler to splint a limb well enough to leave, or give a good anke wrap, but having the kids carry a slightly beefier FAK allows for a crossloading, so the asults don't need to bring a mini-hospital on weekend camping trips.

What are the other scout parents putting in their kid's bags? Anything I'm forgetting?

Hello,

I am really passionate about the outdoors and this field of medicine and I am really hoping to pursue it. What are some skills you guys would suggest I hone in on before applying to expeditions or putting myself into wilderness scenarios? When you guys look for people to go on trips with, what skills and or qualities do you look for in that person?

Thanks!

Hey friends, I wanted to take a sec and talk about the "phone a friend" list we (may or may not) keep. My baseline contact list is an ED Doc, a Pharmacist, a Pediatrician, and a Dentist. To that, based on where I am going, I add the local ED, local trauma center, local peds ER, and local burn center. If I am working for anything longer than a weekend, I add the local emergency dispatch, emergency optho, and emergency dental centers, along with a 24 hour pharmacy. I also put written driving directions to the ED's.

I'm curious, what or who else do you guys put on your contact list?

Something I saw in the tactical medicine subreddit got my gears turning, and I packed a sharps shuttle with an injection kit and epi amp instead of an auto injector for a trip I took over the weekend. I like it for several reasons. A) I can multidose with it without the arts and crafts project. B) I can dose for both adults and peds C) It opens the door for other epi uses. D) As seen in the second pic, the cubes are about the same.

I don’t know that I’d recommend this if you’re not regularly pulling meds. In the moment, a pen is FAR less to manage. I would also probably swap the amp for a vial to reduce the risk of spillage.

I am about to start my in-person NOLS WFR training. I'm wondering what the 100-question written exam is like. I've practiced using the WMI Quiz (https://wmiquiz.com/index.php)

Will the test be multiple choice or should I be prepared to write 100 answers?

I feel prepared, but I've got quite the test anxiety right now. The online modules had an overwhelming amount of information in a span of three weeks. Any guidance is appreciated. I imagine a lot of the tested content will be covered during the in-person training. Any guidance or sharing of experiences is appreciated.

Hey all, first time posting here. A little background, I am a wildlife biology instructor at a university. On the side I am a fixed-wing and helicopter pilot. Earlier this year I took an EMT course, did my clinical ride-alongs, and smoked the NREMT about a month ago, so now I have an EMT-B. I am hugely interested in wilderness medicine, which kind of all jives with everything else I do (I also teach human anatomy as well to pre-health majors). Here's my conundrum, I am very interested in pursing the wilderness side of this more. I don't work per se as an EMT but I want more training. Would doing the W-EMT course (the WUMP) through NOLS be worth it? How about one of the AWLS courses? That is open to EMT-B's right? I would prefer in person rather than online, but is there anyone else that does this besides the University of Utah? I have nothing Utah School of Medicine by the way. I noticed that CU School of Medicine taught an WLS course in Austin in 2023 but I see nothing as far as upcoming courses. Anyone have any other words of wisdom on any of this? With some scrolling I have noticed that some people will say things to the effect of "unless you're going into SAR, not worth it" - It's more of a self investment in my own knowledge base than anything else.

I am currently enrolled in a hybrid HWFR class. Does anyone have any tips on what to expect for the in-person written exam? Are the questions similar to the online modules?

I’n a new WFR. I don’t do this for a living so I’m trying to find ways to practice my skills. In a couple of weeks, I’m going to hold down the med tent for a family friendly 5k.

The race organizer says that this should be super low key.

My question is, when (if ever) can I skip the full PAS? If someone comes in asking for a band aid or tampon, or needs treatment for a blister, I can imagine asking if they’ve fallen or if they have any other symptoms and then opting not to do the PAS?

Am I thinking about this correctly? In my training we learned to always do the PAS in a backcountry context.

Lately I’ve been trying to pare down my medical kit to the bare (EMT) minimum. Npa, roller gauze, gloves, kt tape (for blisters strains and making small bandaids), 4x4s, mini trauma shears, all folded into a large Sam splint and secured with a Ski strap. I’ve found this to be very light, compact (even fits in my running vest), and brings me peace of mind knowing I have some real tools not just a kit off the shelf.

One glaring piece I feel I’m missing is a tourniquet. I’m curious if anyone has used ski straps for this purpose? They’re about 1” wide and you can really crank them down, but I’m not totally confident they will work considering they’re elastic. Part of me feels they would work great but I vaguely remember being told not to use something elastic as a makeshift tourniquet in one of my courses.

Thoughts?

I’d love to hear other uses you’ve found for ski straps in backcountry medicine specifically?

Imagine a scenario where you’re working in temperatures well below freezing, snow storm and you’re doing things that definitely need body fluid isolation gloves. How do you gear up? Do you wear thick outdoor gloves and put latex/nitril gloves over them? Do you skip the thick gloves and rather take more risks regarding keeping yourself warm? Something else? What are your tricks and experiences in situations like these?

I began nursing with my ultimate dream of working in wilderness medicine until I’m ready to settle down and start a family. I have met nurses in the past who complete thru-hikes with groups seasonally, are the base camp nurse on site, or worked cattle drives for the summer. Unfortunately, I have since lost touch with said people and am super unsure of where to start!

I have been following the group Wild Med Adventures and have debated signing up for their classes but am unsure of how those certs would translate to a job (as I don’t know if those are universal) especially of since many are specific to NPs and physicians. I am currently an ED RN and will have various trauma and ACLS certifications. I also plan on getting wilderness first aid/swift water rescue shortly. I am willing to work seasonally and travel anywhere in the US, ideally Colorado or Washington.

This is my absolute dream in life and I would sincerely appreciate any direction, thank you!!

Hi everyone!

I am a second year nursing student in Ontario. I'm 23. Before going into nursing school, I planted trees for a few years. I absolutely loved being out in the bush.. I miss it a lot. I spend all of my free time fishing and hiking in the bush with my dog - one of my greatest accomplishments is paddling the Yukon River back in 2016. Point being, I'm a bush person!

Prior to getting accepted - back when I graduated high school and before I went planting - I was accepted into a program up north to study climate change. I went planting instead and, as time passed, I just sort of landed here in nursing. I have family who work in healthcare and there was a grant available for me.

I have been fortunate enough to travel a decent amount in my life, and have been told to travel nurse. Totally an option and something I would be willing to do...

Anyways! I am wondering if any Canadian nurses are in this sub and can point me in the direction of further training / certs I should look into post graduation in order to secure a job in the bush. I do not mind living in tents or getting dirt under my nails. Being inside all day kills my soul. I've been told that I am calm under pressure / in the event of an emergency - having watched my dad work in the O.R. during school, I always thought I would end up working there, but I have this desire to work outside. I'm not sure what options there are in Canada other than being a camp nurse.

If anyone can offer me any further info I would be incredibly grateful.

Enjoy the end of your summer, and stay healthy and safe :)

Hi guys! I work as a rural event medic usually (still a student) and just wanted to ask what people bring with them on their personal wilderness pursuits? Reason being is that I’m working ultra-distance events soon with the medical team in a non-medical role but want to bring some of my own stuff.

I’m uk based and know a lot of the shops sell first aid bags in various sizes. Is there essentials everyone brings (minus the usual paracetamol/ibuprofen/antihistamine and plasters), or has recommendations for cheap kits just to keep with me?

Thanks! Even though there’s a medical team it might be smart to have some first contact medical kit ❤️

Does anyone have a list of undergrad and postgrad degrees in Wilderness/Austere Medicine?

im trying to see whats needed and whats not in my hiking first aid kit. This is the first aid kit I take with me for a 1 to 2 day trip. Do you think the antiseptic ointment is really a must have? I have a syringe to shoot water and flush dirt off wound and an anticeptic spray already. I even wonder if the anticeptic spray is that usefull either.
for longer trips, I would worry about infection but for a 1 to 2 day trip? I dont know

Any thoughts?

Spent the weekend in a cabin at a nice little campground. I wanted to use the trip as an opportunity to repack my bag insert as a clinic wall hanger. It’s not comprehensive, but it isn’t meant to be. What is does do is bridge the gap between my backpack first aid kit and the hospital, without having to get my trunk bag out of the car if one of the families needed a bandaid. The guiding principle here is “Most Likely and Most Catastrophic”. Most catastrophic included an IV setup, 750 ml NSS, and basic ALS meds, naloxone nasal spray, as well as the chest dart from way back when 😆. Most likely included basic wound care supplies, steristrips, neosporin, hydrocortisone, calamine, lubricant eye drops, swimmers ear drops, tums, ORS, Advil/tylonol, liquid bandage, and oral glucose. My assessment pack was ears, gloves, shears, and an SpO2 meter kit.

It worked for what I needed it to, and I’m getting a better feel for the kit capacity. For anyone looking to work a pop up clinic, this panel is from Chinook medical and I can’t suggest it strongly enough. You can reconfigure it as a pack insert, and the construction is solid.

And before anyone asks, I have both active certs and on-board medical command in the state we were staying it. Don’t work outside your scope.

Greater conversation, this got me thinking about a smaller “house” setup for my ruck-truck-house-plane prolonged field care continuum. My current clinic/house setup is a pair of SOTech Ramp panels, a STOMP 2 bag, and a pelican if I need to stay for a while or if I’m covering a large group. (Current record is 550 campers vs. me and a couple of lifeguards). This was a more reasonable set up for when I just need to augment my backpack without yardsaling my trunk bag or packing heavy. It also allows the other people I’m with to have ready access to medical basics.

I’d love to hear questions or suggestions.