Any Wildness First Responders-have you used the skills?

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WalkaboutTed

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Of course, as a 26 year RN, I've got a fairly comprehensive medical kit, knowledge, experience and other Items (pulse oximeter , otoscope,  etc)  and plan to carry much of it with me.   We plan to be way out there much of the time, away from medical facilities.  The wilderness first responder courses teach some things not taught for use in urban settings (reducing dislocations, fractures, trauma, medical emergencies and others).  Not to mention if I do anything under my current, out of state RN license, anything I do would be legally outside my scope of practice. Good Samaritan laws or not, there could be legal issues. 

My question is, is it worth the time and $700+ to take the course for already licensed medical professionals?  Have any of you already on the road, have you or anyone that you know needed emergency medical help hours away from medical facilities? 


It's a lot of money, and I would prefer not spending it if the likelihood of needing it is slim to none. 
Ted
 
Take wilderness first aid, buy first responder book and read it, and be done ; ). My understanding is it is more for those working as a paid guide. There is more scenario training for rescue than wfa obviously. I have not taken wfr but wfa only in the past.
 
Do you have experience as a trauma nurse? If so you should have most of the skills and common sense to handle most medical issues. Read up on wilderness medical to fill in any gaps, but I think $700 would be a waste if you are a competent, experienced nurse. Are you current on ACLS, BTLS, etc? It's not like you're trying to establish a medical practice, you just want to be prepared to treat people in an emergency, correct? Shouldn't be worried about liability for emergency care as long as you  don't work outside your scope of practice .
 
I have taken WEMT and it is a good course. Teaches some facts and improvisations that you may not have for some front country work. I would agree with the statement that you only really need it if you have to have the cert for employment. Have to realize that most problems in backcountry are solvable by either normal first aid/simple medical ie booboos and hydration, or can only be solved by evac. You really cannot do advanced interventions in backcountry because you won't have the material and it needs to be done for too long of time.
 
WalkaboutTed said:
Of course, as a 26 year RN, I've got a fairly comprehensive medical kit, knowledge, experience and other Items (pulse oximeter , otoscope,  etc)  and plan to carry much of it with me.   We plan to be way out there much of the time, away from medical facilities.  The wilderness first responder courses teach some things not taught for use in urban settings (reducing dislocations, fractures, trauma, medical emergencies and others).  Not to mention if I do anything under my current, out of state RN license, anything I do would be legally outside my scope of practice. Good Samaritan laws or not, there could be legal issues. 

My question is, is it worth the time and $700+ to take the course for already licensed medical professionals?  Have any of you already on the road, have you or anyone that you know needed emergency medical help hours away from medical facilities? 


It's a lot of money, and I would prefer not spending it if the likelihood of needing it is slim to none. 
Ted

I was going to add that I think you're overthinking the need for this on the road. The odds that you ever use other than basic first aid are slim to none, and in the unlikely event you happen upon a major event (code, life threatening trauma, etc) you won't have the advanced equipment and drugs needed to make a major difference. It all falls back to basic medical skills until first responders arrive on scene to administer advanced care and transport.
 
WalkaboutTed said:
Of course, as a 26 year RN, I've got a fairly comprehensive medical kit, knowledge, experience and other Items (pulse oximeter , otoscope,  etc)  and plan to carry much of it with me.   We plan to be way out there much of the time, away from medical facilities. 
Ted

I took the course.  My cert is expired but the lessons I learned are priceless.  My big take away was risk assessment and management.  Seriously... I thought I was paranoid before!  For part of our final exam we carried the spinal specialist (6'3') for 3 miles on a stretcher... Compound fracture...it was harder than it sounds.
   The only thing special about the cert is that we could clear someones neck/spine injury and let them move/walk out.  Which has is huge by the way.  Most outdoor activities have potential for head/spine injuries.  I don't remember much about the Samaritan laws...
 
I've worked in 9 different nursing disciplines, but not ER or adult ICU. That's why I would need to take such a course to do more than basic triage and first aid for injuries. My question is, has anyone in this big forum community or someone they know had a life-threatening experience where they need such care? I'm not rock climbing or even mountain biking, but will be out in remote areas where people do get injured, hours from traditional first responders. My main concern is trauma and neck /spine injuries. I can handle most other medical emergencies with my experience.

As far as scope of practice, there is a reason why I had 27 nursing licenses (the non-compact states) in my last job - just to talk to patients on the phone, much less lay a finger on them! And the nursing scope of practice is different in every state. Even with more education, nurses have less latitude than EMTs. Except for nurse practitioners, we must work under doctors/NP orders. We aren't even legally permitted to diagnose anything, though we all do. Every flight nurse that I have worked with was also an EMT because of the autonomy issue. The legal issues can be huge. Maybe I've had too much medical -legal education.

Yeah, I'm overthinking it, but there is a reason why my nickname is "the Queen of Contingencies". More input, please? If no one in this tribal community has been in such a type of emergency, I wouldn't feel a great need for the education. But I'm not someone who can say "It's not my job" and stand by doing nothing, or worse, causing more harm with inadequate knowledge. Good or bad, I never freeze in an emergency and that can dangerous if I'm the only one moving.
Ted
 
I did a WFA course just a couple months ago (Canadian Red Cross) and agree that it's very much worth the knowledge and the certification. I don't fully understand your existing knowledge base from your posts but if you are yet to learn spinal rolls etc. it's very handy. As you say, any treatment you provide outside of certified training you are liable for, so you gotta decide whether you want to help someone and run the risk of getting sued or just help someone no matter what.
 
I backpack a lot in the remote back country. Before that I rode horses in the back country. I have done a WFA course, albeit a long time ago. In all my weeks and months in the wilderness I have used my knowledge a total of twice in 20 years. Once was for a broken wrist, the other a minor concussion and bruising.

WFA is more about basic knowledge, a few basic supplies and a whole lot of common sense and innovation. I don't carry a huge FAK when I'm hiking...if I can't handle something with what I'm carrying with me then it's likely an injury or situation that needs an evac and a hospital anyway which is why I carry an emergency SOS device.

As far as liability goes...if the Wilderness First Responder course and certification would cover you in the event of a liability issue, then maybe the $700 is worth it.
 
To answer your core question I have not used my wilderness emt skills for real. Front country EMT yes, but volunteered for that. 

I think your chances of needing the skills are limited. Further, I think (though the nursing certs if current may complicate it) if you came across someone and cared for them you would be covered as much as anyone under good samaritan laws. 

I am sure that an additional cert from NOLS or SOLO will not change that situation unless you came under the direction of an agency. 

So long story short no matter what you do (short of volunteering for a SAR group) you will only be covered by good samaritan which is pretty good though not perfect. 

 As mentioned above you will get the benefit of  learning a nexus like spinal protocol to "clear" a spinal immobilization. Can be very useful as holding c-spine when moving a person even short distances over rough terrain is problematic.  That said I would be very reluctant to actually use in on a "stranger" ie not in my party due to liability. If given the choice at all I would let the person "self clear" and/or let someone from an agency take the liability. This isn't too much of a stretch, if I can help them walk out they are A+Ox4 and I cannot stop them from walking if they want, if not alert and oriented, I can't clear the spine and I certainly cannot get them out without phoning a bunch of friends. 

Again the courses are great if you have the $$ you will learn good and interesting things. I hope that you would never need the skills and would place a small bet on that outcome, but you really never know.
 
One last thought. I did help a friend out in the front country but it was pretty out in the country, probably actually an hour from definitive care.

 He had a bad cut on his hand --metal roofing sliced him open pretty good--  but did not want stitches. I had quite a bit of wound care including steristrips. The first couple of sessions no problem but later in the week ran out of supplies to change bandages. Most rural drug stores have little beyond some tape and 2x2 gauze. I stock more in the camper now due to that experience.

 Hopefully enough on thread to not be drift and still helpful.
 
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