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Wilderness Medicine

Any outdoor adventure activity which involves indulging in the wilderness, comes with great risks, especially in the aspect of health. It could be a Natural Hazard or even a blister on the feet. It can happen to you or any of your group members. In such a case, it is always safer to have proper knowledge of wilderness medicine before doing the activity.

Today I am going to share my experience on the Wilderness First Responder course conducted by NOLS (National Outdoor Leadership School).

What is NOLS?

NOLS is a non-profit wilderness school that began in 1965. They offer various courses about wilderness leadership and medicine. They have schools in various parts of the world now. In India, their head office is in Ranikhet.

In order to enroll yourselves in the course, you need to apply well ahead because they have limited batches in India. If not NOLS, there is another organization that teaches wilderness courses called HANIFL which is mainly for the Himalayan outdoor activities. They are an India centric organization based in Mussoorie.


Why do you need to know about Wilderness Medicine?

What do we lack when we are trekking on a trail? Well, I would say firstly, that we don't have an Urban setting Hospital on the trails of a trek. We lack the proper communication channel for help in case of a medical emergency. Also, we are restricted to the resources that we have during the trek which either you or your trek mates must be carrying. Another major factor of concern is the unreliable weather conditions in the wilderness. Given such a situation, with these four major drawbacks, we have to make the best out of the possible. In such a situation, one must also be aware of the right way to treat or diagnose the issue to provide the best possible medical assistance.

During my 10 day course, I was given the insights of most of the scenarios that could go wrong during any wilderness adventure. Honestly, it was scary! But at the end of the course, I was confident that I would be able to assess any given situation and make the right call. The whole course was about how to face a situation without panic and handling it as if it had happened with them before.

Phill (Instructor) explaining a scenario

So, you must be wondering that if a Trek Leader is aware about wilderness medicine isn't that enough? No. It wouldn't be just enough because there would be certain times when the trek leader needs help from his/her trekkers to understand and react to the situation. Sometimes, there would be a situation even you would have witnessed that the Trek Leader needs medical attention. It's always better to be prepared for the worst when it comes to the wilderness.


How does the course work?

Let me just brief you on the coursemates of my batch. Our batch had a total of 30 students, of which we were around 14 trek leaders. Our course was conducted at Lohajung, Uttarakhand at India Hikes Base Camp. The course duration was 10 days and we had a break on the 6th day of the course too.

The everyday class was divided into two sections. One was theoretical and the other one was for scenarios. Phill and Prasad (Instructors) made sure that there was a balance between these two sections as both were equally important for us to understand. For me, I loved the scenarios and so did many others too. For each scenario case, the 30 of us were made into groups of 3 and this group was dynamic. This made sure that not always the same people fall in the same group to bring in more coordination amongst the students.

This is a improvised splint for a broken arm in the wilderness
A mock splint session

The scenarios were made very realistic by the NOLS team to make us feel that it was almost as real. This ensured that we are getting used to adverse conditions and once it happens for real, we would be able to handle it better than ever as we had already practiced it in the class.

Apart from the everyday scenarios, there was a day of Mock Rescue session that covered a whole day of rescue session in a remote setting which was a surprise mission for us.

The theory sessions were also very informative. Imagine having a classroom setting in the Himalayas. It was another dream come true for me. We could always be in the lap of nature and learn survival skills. Since our batch was in the month of February, we were also welcomed with an amazing snowfall when we woke up on the rest day of ours.

Phil and Prasad on a theory session

What along with WFR?

Along with the WFR certificate, we were awarded two other certificates:

  1. CPR

  2. Epinephrine Auto-Injector

CPR (Cardiopulmonary Resuscitation) is an emergency procedure that combines chest compressions with artificial ventilation to a person who is in a cardiac arrest to revive the natural breathing and brain function of that person. The proper procedure is very intense and tiring. It would be more advisable if two people (who know CPR) perform it in any case of requirement. Our CPR sessions were very interesting as well.

It wasn't sensible to perform CPR on a healthy human. So were given these rather expensive dummies called Manikins to perform CPR on it. In order to perform CPR with the correct rhythm, Phill played music so that we get in sync to the rhythm.

Epinephrine Auto-Injector is a medical device for injecting epinephrine in a measured dose for people who have anaphylaxis. Anaphylaxis means a very extreme allergic reaction to something. We were given training on these two additional aspects of wilderness medicine as well.


How do you get certified?

Like any other certification, at the end of the course, we had an examination to assess our level of understanding of the course. The exam was on paper as well as a practical situation where the Instructors would be asking questions based on the scenarios practiced earlier during the course. Apart from this, the instructors keep a tab on each individual during the course as well. They monitor the whole performance of the individual before finally declaring that he/she is a certified Wilderness First Responder. You get your certification after 3 weeks of completion of the course. One other thing important about this certification is that it is valid for 2 years. After the 2 years of validity, we need to re-cert for the course and we get 1 year to do so. If one fails to re-cert then after the 3rd year, his certification is invalid. He/she needs to do the entire course again.

They have this concept of re-cert because in the medical field there are many vast discoveries and inventions with the new technology. Hence any WFR candidate must be up to date with the new advancements every 2 years.


What are my personal favorite moments?

At the end of the course, the Instructors also present some awards for the students who have performed beyond expectations. Awards for persistent performance throughout the course, commendable acting during the scenarios, systematic analysis of the situation, best SOAP report. The exciting thing in these awards is that we would be given gifts or goodies from the NOLS store which is informative as well very useful for the one's working in the wilderness.

I had received an award for the acting skills in one of the scenarios during the course. The award, as well as the scenario, has been so far the best moment for me throughout the course.

This guide has all the scenarios with the systematic approach of how to assess the situation along with graphical representation.
WFR Pocket Guide

I had received this Pocket Guide, which contains all the wilderness related issues and their cure, how to do the analysis, stepwise instructions of how to approach the situation, and finally a Radio call procedure for evacuation.

Mock setting of broken Shin bone

The scenario that helped me get this appreciation was scary as well as the best thing in the entire course. One of my feet was dressed up like shown in the image. I was the patient in the scenario. The whole plot and the scenario was the best experience I had in the course. It was how intensely they had tested us to make us understand that in a live setting, we should not panic and work on the stepwise analysis and make the call.

Also during the course, we had an off day as it was snowing very bad. But it was a very nice day for a game of football. As I said, we were 14 trek leaders in the course. It's not that often we all meet together at one base camp since we are posted at different slopes. Unless we join for a yearly meeting, it was not possible for us to meet like that. So we took the liberty of playing at our base camp in the snow. It was like the day could have not gone any better.

On the last day of the course, I had made new friends, new memories along with a huge amount of knowledge and confidence that I had gained to face many such intense situations in the wilderness. It was also an opportunity to figure out the possible avenues of outdoor fields that anyone can get employed in. By putting some efforts in the right direction, it was possible to live a life in the wilderness.



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