During December here at Eller Adventures we’ve taken some time to either recertify our current EMS credentials or gain new ones. One of the newest courses that we’ve taken was a Wilderness EMS Course called Wilderness First Responder. As the staff member who took it, I was already an EMT-I with over 5000 patient contact hours, but I wanted to take a course in Wilderness EMS because being out in the mountains and on the crag creates a different set of conditions under which patient care has to be taken than what I am used to. So I choose to take the Wilderness First Responder course offered by Remote Medicine International (RMI).
This turned out to be one of the greatest medical courses that I've taken and incredibly useful in our next big adventure. During the course I discovered the the Wilderness EMS has a much larger scope of practice than you do in the urban environment. This is mainly due to the distance and time away from a hospital that your patient is. In an urban environment on average once 911 has been contacted a patient will have firefighters and EMTs at their location usually within 5-10 minutes. However, in a wilderness environment a patient might not have access to that level of assistance for several hours to days. So a Wilderness EMS provider has to be able to handle a far greater amounts of treatments; from cleaning wounds to relocating dislocated limbs, and other long term patient care. But of course all of this is dependent upon what their Medical Director authorizes!
While out on a recent adventure to Joshua Tree NPS one of our climbers was learning how to crag climb on a great top rope set up on a classic route in Joshua Tree known as Effing Eight in the Echo Rock area outside of Hidden Valley. This climber had been up the route about five times when on the fifth time they stopped for a rest but suddenly came off of the wall and shouted that they hurt their arm! As I lowered him down off of belay I began my patient assessment and started by simply asking, “What hurts?”. Upon a quick explanation by the climber and then a rapid physical assessment I was able to determine that he had dislocated his shoulder. Now under any normal situation at Joshua Tree NPS we would have been able to simply stabilize his shoulder and arm and call the rangers for a medical evacuation. However, due to recent political movements all of the rangers in Joshua Tree NPS had been furloughed and medical evacuation was at least 3 hours away. However, with my new Wilderness EMS training, I knew what to do and how to best care for my climber.
I placed him in a position of comfort and using the methods that I had been taught- relocated his shoulder. His pain immediately decreased. We were then able to stabilize his arm and drive him to the nearest hospital to have them further check his shoulder for any additional damage. None of this would have gone as painlessly (for both climber and Wilderness EMS provider) had I not have taken that class!
None of us plan on being in a medical emergency situation on our adventures, but we do need to be as prepared for them as we are for the rest of the trip! I strongly encourage all of you to go out and take a CPR /AED and first aid course. Then if you really find that you like it- go take it a step further and visit RMI for a Wilderness First Aid or First Responder Course! There will never be a moment in which you look back after taking one of those courses and say, “Gee, I didn’t need to do that” because no matter what those courses are some of the best you can take….especially on your adventures!