Wilderness Medicine Institute of NOLS

WILDERNESS MEDICINE INSTITUTE OF NOLS

WILDERNESS MEDICINE INSTITUTE • 866-831-9001

WWW.NOLS.EDU/WMI

OFTEN IMITATED, NEVER DUPLICATED With more than 75,000 graduates around the world, the Wilderness Medicine Institute (WMI) defines the standard in wilderness medicine training. As an institute of the National Outdoor Leadership School (NOLS) our goal is to provide the highest quality education and information for the recognition, treatment, and prevention of wilderness emergencies. When 9-1-1 is not an option, the rules change. Our curriculum focuses on medicine for times when resources are scarce, there is no help on the way, and you have to make your own decisions. WMI empowers people to act with confidence in emergency situations by providing students with the tools and training to make complex medical decisions in remote environments. Our curriculum is evidence-based, relevant, and practical. We don’t just teach things that work in the classroom; we teach skills that work in the field. We seek out the best medical science to support our practices, and we work closely with a medical advisory panel to ensure our students are receiving the most up-to-date and accurate material available. Often imitated, but never duplicated, we offer a wide range of course and certification opportunities tailored to meet your needs.

Often imitated by other wilderness medicine organizations, WMI stands above the rest as the leader in wilderness medicine education.

Designed as a field textbook for the NOLS wilderness first aid curriculum, NOLS Wilderness Medicine (above), written by WMI curriculum director Tod Schimelpfenig, helps to train outdoor leaders to prevent, recognize, and treat common backcountry medical problems.


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NO ORDINARY CLASSROOM At WMI, you’ll participate in a challenging academic program augmented by realistic scenarios complete with simulated injuries. Our courses are designed to give you the confidence and decision-making practice you need to handle medical emergencies in remote settings. Days are filled with dynamic lectures and exciting, realistic scenarios to best model the kind of medical situations you might encounter, whether your work or play takes you hours or days from medical help. In the WMI classroom, you’ll get lots of personal attention, scenarios designed to enhance your ability to manage stressful situations, and plenty of fun. Medical scenarios are the highlight of any WMI course, and we make them so realistic you’ll feel like they’re really happening. You will feel the pressure and stress of treating a medical emergency that will prepare you for the real thing. WMI graduates around the world tell us every day that real emergencies they have handled were “just like the scenarios.”

“The curriculum was exceptionally well-sequenced to continually build upon prior learning. The pacing kept us alert by alternating informative lectures with carefully chosen hands-on scenarios. These first aid and rescue scenarios continually placed students in situations requiring thinking and analysis, rather than merely rote memorization. Furthermore, the variety and frequency of scenarios kept reinforcing our learning of important skills.” – WFR grad December 1997

WMI practice scenarios know no water, sand, or snow boundary. No matter where your backcountry work or play takes you, WMI can give you the practice and lessons you need to make informed medical decisions.


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STUDENTS WHO NEED TO KNOW Our students have one important thing in common: They are motivated because they know someday they might have to respond to a real emergency situation. They come to WMI from a wide variety of professional backgrounds; they are outdoor educators, guides, ski patrollers, urban EMS providers, remote researchers, military special operators, or simply people who spend their free time in the backcountry. Whether for work or play, students come to WMI because we set the standards in wilderness medicine today. WMI certification is accepted by guiding and educational institutions around the world. When you receive your education from WMI, current and future employers know that you’ve been trained by the best. In fact, many of our students discover a passion for medicine at WMI and go on to careers as healthcare professionals.

Our students come to us because they know that someday they will need to know enough to make competent, deliberate, and timely medical decisions in the backcountry.

“The knowledge and skills I gained at WMI have undoubtedly boosted my level of preparedness for my many outdoor adventure activities, and I look forward to applying these skills in a variety of situations. The experiential, practical approach that WMI espoused developed not only my skills in first response, but also my decision-making skills and resourcefulness in a greater sense.” – WFR grad June 1998


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SEASONED & PROFESSIONAL STAFF WMI instructors are the best wilderness medicine educators in the world. They know what it feels like to make tough decisions in remote places because they’ve been there. WMI instructors possess a mix of backgrounds ranging from wilderness expeditions to urban and wilderness patient care to teaching in a variety of settings worldwide. After a rigorous instructor selection and training process, they are well prepared to facilitate active, hands-on learning. All of our instructors go through an instructor course intentionally designed to polish their educational skills and to make them the best wilderness medicine educators in the world.

“From the get-go my instructors projected knowledge, competence, and approachability. They taught with a delightful mixture of seriousness and flair, often conveying critical points with memorable humor or vivid imagery. Their individual teaching styles were very complementary… their enthusiasm for the content never flagged and it was quite infectious.” –WFR grad December 2006

I N S T R U C T O R

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LAURA MCGLADREY GRIEBLING WEMT, RN, FNP Making the best of a bad situation: This is the mantra for Laura McGladrey Griebling when practicing wilderness medicine. “The wilderness can be anywhere we find ourselves with a need to improvise,” she says. “These skills could be applied by so many people, from mountain guides to village people in far away places, to nurses and doctors outside the ER who have to practice without their normal tools.” Laura, also known as “Glad,” works as a nurse practitioner in Portland, Oregon, and has been a WMI instructor for the past nine years. She first experienced wilderness medicine by stumbling onto a Wilderness First Aid course in 1996 while working in the Arkansas Valley as a guide. “I was finishing nursing school, trying to escape the hospital world, and fell in love with wilderness medicine,” she said. “I loved the application of medicine in the wilderness, I loved the teaching style and, later, loved the way that improvisational medicine could be applied where medicine and technology are not readily available.” Glad also teaches WMI curriculum in Spanish in Chilean Patagonia and the Dominican Republic, where she worked in a clinic and taught local guides and teachers how to respond to emergencies. “I was teaching the same curriculum, even though they lived in the city, because there was such limited health care there,” she said. “I realized then how effective it was, instead of taking care of people one at a time, to train others and multiply my efforts. That fueled a desire to apply wilderness medicine to the developing world.” When describing her overall experience and relationship with WMI, Glad appreciates the multifaceted skills she has learned and used to teach others. “Working for WMI has taught me to combine my hospital medical skills with the improvisation needed for search and rescue, ski patrol, guiding, expedition medicine, and international work.”

EVIDENCE-BASED CURRICU We pride ourselves on having a curriculum that is accurate, practical, and relevant, not only to someone learning in a warm, dry classroom, but to the person providing care in the wilderness.

ACCURATE At the Wilderness Medicine Institute we seek the latest medical research and informed opinions to maintain the most current and accurate curriculum for our students. The NOLS incident database, the largest and longest running outdoor program dataset in the outdoor industry today, gives us a snapshot of what medical incidents we are likely to encounter. Not only is the WMI curriculum accurate, it is the most usable training available for people who work and travel in remote locations.

WMI Curriculum Director Tod Schimelpfenig

“I've gone through training in the past as a lifeguard, diver, and environmental engineer and I've never had as good an experience as I had with WMI of NOLS. There was never a single moment during the course of that class that I questioned weather or not I was getting literally the best training available in the US.” – WEMT grad September, 2004


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ULUM PRACTICAL Would you put two people in a sleeping bag to treat hypothermia? It doesn’t transfer as much heat as we might think; most patients are treated with dry insulation, warm fluids and food, and allowed to shiver until they are warm.

Do you need to boil water for several minutes to disinfect it to drink? No, the water only needs to come to a boil. The advice to boil water for 2–3 minutes, or more, is conservative, unnecessary in most cases, and burns precious fuel.

What is the most common dislocation in the outdoors? 80% of backcountry dislocations involve the shoulder, a statistic familiar to river guides. Our curriculum prepares you to manage these injuries by attempting reduction or immobilization.

RELEVANT It’s day 5 of a 12-day wilderness trip for teenagers in a western U.S. wilderness area. The closest road is 12 miles away. You’re one of the trip leaders with current Wilderness First Responder training. The patient is one of your participants. It is 8:30 a.m. You have a 17-year-old male who is complaining of severe abdominal pain. The patient’s tentmates woke you at 6:30 a.m. and said the patient had severe belly pain. Patient states the pain began yesterday at 10:00 a.m. as “a bad belly ache, cramping-like” but it is now “sharp.” He thought it was indigestion. It persisted all night and became “really uncomfortable” at about 10:00 p.m. last night. Would you stay or go? Do you have the knowledge to decide with confidence? To learn more go to www.nols.edu/wmi/curriculum_updates.

Wilderness medicine certification is required for a wide variety of outdoor jobs worldwide.

BUILDING A WILDERNESS M CORE COURSE OFFERINGS

Wilderness EMT (180 hours)

Wilderness First Responder (80 hours)

This is the ultimate WMI experience. The WEMT course is the most intensive combination of urban and wilderness medicine training available. If you seek National Registry EMT-Basic certification along with WMI’s outstanding wilderness medicine curriculum, this is the course for you. Our monthlong WEMT program includes classroom education, ambulance-based medical practices, extensive wilderness scenarios, and clinical rotations at local hospitals. Many graduates use their WEMT certification as a springboard to employment as medical professionals in both urban and wilderness environments. Firefighters, search and rescue technicians, military operators, ski patrollers, and ambulance teams all have raved about their WMI WEMT training. College credit is available.

Pursuing a professional career in the outdoors? The Wilderness First Responder (WFR) course is for you. Essential for outdoor professionals, the WFR course will increase your medical knowledge, skills, and confidence and make you an asset to any team. Expect to complete your course with a newfound ability to make tough medical decisions in remote places. This 10-day course includes a comprehensive wilderness medicine curriculum that focuses on extended care and unique wilderness therapies. Our WFR course is pre-approved for 70 hours of EMT CEUs, and college credit is available.

WFR Recertification (24 hours) Time to recertify? Join us for a three-day scenariobased course to review and practice evacuation and decision-making guidelines for current WFRs. Our dynamic, experienced instructors will refresh you on current techniques, protocols, and controversies in the wilderness medicine field. Our WFR Recertification course is pre-approved for 18 hours of EMT CEUs, and will also serve to recertify the wilderness portion of current WEMTs.


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MEDICINE FOUNDATION

Wilderness First Aid (16–24 hours)

Wilderness Advanced First Aid (40 hours)

Are you an outdoor enthusiast? Maybe you work at a summer camp, or just love going hiking with your friends and family. If you plan to spend time in the backcountry you need to be prepared. Fast paced and hands-on, this two- or three-day Wilderness First Aid (WFA) course covers a wide range of wilderness medicine topics for people who travel and work in the outdoors. If you need this certification professionally, you’ll also be happy to know it is pre-approved by such organizations as the American Camping Association, the United States Forest Service, and other governmental agencies.

Need to find a course that’s longer than a WFA but less than a WFR? River guides and certain trip leading staff may be required to have a level of training that falls in the middle. This five-day Wilderness Advanced First Aid (WAFA) course focuses on stabilization, treatment, and evacuation guidelines for patients in backcountry environments. More emphasis is placed on long-term patient care management and specific injury evaluation. Those who seek a more extensive refresher than the WFR Recertification course may also use the WAFA for recertification. Our WAFA course is pre-approved for 32 hours of EMT CEUs.

For course dates and locations, to learn more about college credit and scholarships, or to sponsor a course, please visit us at www.nols.edu/wmi or call (866) 831-9001.


WWW.NOLS.EDU/WMI

EXPAND YOUR MEDICAL HORIZONS CONTINUING EDUCATION FOR PROFESSIONALS If you are already a medical professional and you want to challenge your medical skills in the realm of wilderness medicine, we have courses for you. These courses are specifically designed to help physicians, nurses, and EMTs apply their urban medical proficiency in remote settings where equipment is minimal and the ability to improvise is crucial. WMI will provide you with the latest information on decision-making principles guiding wilderness treatment and evacuation decisions, as well as ample opportunity to apply your improvisation skills.

Course Types: • Wilderness Medicine Practices and Protocols (24 hours) • Wilderness Upgrade for Medical Professionals (48 hours) • Medicine in the Wild (26-day medical student elective) These activities have been planned and implemented in accordance with the essential areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through joint sponsorship of the Wilderness Medical Society and the Wilderness Medicine Institute of NOLS. Category 1 CMEs are available. Additionally our courses have been accredited through the Continuing Education Coordinating Board for EMS (CECBEMS) to provide continuing education for EMTs.

“The scenarios were the most fun and educational for me. They allowed me to step outside the box of the way I think at work in a hospital and use critical thinking skills in a different way.” – WUMP grad February 2008

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BECCA PARKER-JOHNSON RESIDENT SURGEON The Gila Wilderness provided WMI grad Becca Parker-Johnson a backdrop to work with coursemates to transfer their urban medical knowledge into backcountry practices. As a resident surgeon in Seattle and graduate from Drexel University’s medical program, Becca found her WMI training to be a valuable additional asset. "[WMI’s] Medicine in the Wild was an excellent course at the end of four years of medical school,” Becca said in the 2007 fall edition of Wilderness Medicine magazine. “I had the chance to review and adapt the practices that I'd learned, focus on the teamwork skills that will make me a better resident and doctor, and think critically about how I learn and teach. WMI has the best outdoor wilderness medicine program in the country.” Becca had grown up loving NOLS “from afar” and inevitably discovered WMI when she was looking to combine outdoor skills and medical training. She first came to WMI in 2001 as a student on a Wilderness EMT course, later following up with the Wilderness Upgrade for Medical Professionals course in 2003 and Medicine in the Wild in 2007. “What keeps me coming back to WMI is that they can turn something extremely complex into basic concepts that you can practice. They use the method of teaching and doing, which has helped me to teach others,” she said. “The training I received from WMI is invaluable because I gained the background knowledge to be an innovative problem-solver, as well as the knowledge that helps in triage where I need to focus and prioritize.” While Becca’s experience with WMI has added value to her professional career, it has also benefited her in recreational pursuits. Of having to stabilize a dislocated finger during a recent hiking venture, she said, “WMI provided me with the mental training that helped me to stop and think about the situation, what I needed, and how to handle the problem.”

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KATHY FERRARO RECREATION SUPERVISOR AT UCSC The University of California at Santa Cruz (UCSC) has one of the nation’s leading recreation programs and sponsors a variety of WMI courses offered to students and members of the community. UCSC’s Recreation Department and WMI began their partnership in 1996 when the university hired WMI to teach two Wilderness First Aid (WFA) courses. Since then, the program has grown and UCSC now offers three Wilderness First Responder (WFR) courses, three WFR Recertification courses, and six WFA courses through WMI. “The growth was slow in its beginnings,” said Kathy Ferraro, UCSC’s Recreation Supervisor, “but the classes have been filling so quickly with 25 to 30 students in each. WMI has been great to work with. We wanted an organization that was nationally recognized and we really appreciate the opportunity to host their classes. It has allowed hundreds of our staff over the years to get the necessary training at affordable prices.” Kathy is one of those staff members to benefit from the UCSC partnership with WMI, having taken several WFA courses and a WFR course, which she states was an invaluable educational experience. “WMI provides the kind of support and professionalism you can’t trade in,” she said. “They’re outstanding.” Kathy, who was formally a Red Cross instructor, remembers how her first experience with WMI helped hone her skills and sees firsthand how it helps dozens of students every year in the same way. “The final night scenario in a WFR is so real because you’re dealing with major injuries and having to evacuate the patient. It was a really powerful experience because you’re in the moment,” she said, noting the importance of scenarios. “I’ve really appreciated WMI’s use of scenarios as a teaching method because I am more engaged and learn more than I would in a classroom.”


WWW.NOLS.EDU/WMI

AROUND THE GLOBE The Wilderness Medicine Institute offers approximately 500 courses each year in 35 different states and a wide variety of international locations. To date, we have run courses in Australia, Brazil, Canada, Colombia, Costa Rica, Chile, Ecuador, Hong Kong, India, Japan, Great Britain, Kenya, Mexico, Malaysia, Nepal, New Zealand, Norway, Peru, Uganda, South Africa, Sri Lanka, Sweden, Thailand, and Tanzania. Students have received their WMI education not only in English but also in Spanish, Swedish, and Japanese. Additionally, WMI conducts courses regularly on the continent of Australia with its peers in Swan Hill, Victoria (www.wmi.net.au/wmi). In 2007, historically known for its presence in the western United States, WMI entered into a partnership with Landmark Learning of Cullowhee, N.C. to provide WMI’s wilderness medicine curriculum in the American Southeast (www.landmarklearning.org). Founded in 1996 by Justin and Mairi Padgett, Landmark Learning provides a wide range of rescue and medical training including swiftwater rescue, wilderness lifeguarding, and EMT courses in addition to a full range of wilderness medicine training. In 2005, Landmark Learning created a Relief Medic program that takes WFR and WEMT graduates to South America to provide clinical coverage for underserved villages in the Amazon Basin and Southern Andes. During these 18-day programs, WMI graduates get the chance to practice a wide range of wilderness medicine in a truly remote setting.

Scandinavia (above) and Uganda (below) are only two of many international locations that have hosted WMI courses.


WWW.NOLS.EDU/WMI

WMI IN ACTION Chris Nielsen, WMI Wilderness Emergency Medical Technician “Last summer, I was fighting fire for the Bureau of Land Management in eastern Idaho. I had the opportunity to spend 16 days with the Snake River Hotshots and also had the opportunity to use my wilderness medical skills. One of our sawyers had a snag strike him on the helmet. When I arrived on scene, he was responsive, alert, and well-oriented (A&Ox4). I determined there was a definite mechanism of injury for spinal injury, so I had another EMT control the patient’s spine. We were many hiking hours away from an extraction point where a vehicle could reach us and at least a half hour hike from a helicopter landing zone. I determined we were at least one hour from definitive care, so I decided to perform a focused spinal assessment. This assessment would allow me to make a reasoned decision on whether my patient needed spine immobilization. If not, we could have him walk out rather than carrying him. This approach would also save resources that were needed elsewhere on the fire. The patient passed the focused spinal assessment and remained A&0x4; he was sober and reliable; he had normal circulation, sensation, and motion in all four extremeties with no distracting injuries; and he denied spine pain or tenderness. We released our control of the spine and slowly hiked to the helispot for extraction. My knowledge and actions permitted us to safely evacuate the patient without requiring a very complicated, dangerous, and expensive medevac. That’s the first time I’ve ever been in a situation where I was the most medically qualified and everyone looked to me to make the final decision on patient care. There was another EMT, but because of our location, he deferred to my wilderness training.”

WEMT grad Chris Nielsen (right) fights fires with the Bureau of Land Management.

T H E L E A D E R I N W I L D E R N E S S M E D I C I N E E DUCATION

The Wilderness Medicine Institute of NOLS 284 Lincoln Street Lander, WY 82520-2848 www.nols.edu/wmi • [email protected] (866) 831-9001

Photos front cover: David Anderson (top) and Shana Tarter (bottom) Photos back cover: Kevin Kerr (top) and Brad Christensen (bottom)

Wilderness Medicine Institute of NOLS

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