Wilderness First Responder, designated as WFR, are specifically trained to respond to emergency situations in remote wilderness areas, however this does not mean they cannot apply that knowledge to any setting. Becoming a WFR is not for everyone, you should be able to assess emergency situations, calm the patient, think clearly under stress, and take a leadership role in a possible chaos situation when you arrive. You might be in an emergency situation where you are so far from physicians or hospitals that the closet thing to any medical care could be YOU. It can be difficult at times and very demanding, and sometimes small emergencies can quickly turn into big emergencies in the wilderness. Being a “Woofer” (a nickname given to a certified Wilderness First Responder), can be one of the most rewarding experiences you will ever have!
When you travel beyond the trail-head you are accepting the responsibility for your own health, as well as the health of those you lead or travel with. You should know how to travel safely through the wilderness, how to dress appropriately, how to drink and eat properly, and to choose your gear.
You may have to make independent decisions on patient care regarding not only treatment but also whether or not to evacuate (and how), without any communication with the rest of the world. If you do not have the confidence to do that then you should re-think if you want to be a WFR, because an injured, sick, or even dying patient will depend on you to do the right thing. Training, knowledge, and common sense can help give you that confidence!
You will be trained to manage many emergencies in the wilderness including but not limited to; cleaning and closing wounds, reduction of dislocations, heat, cold or any other environmental problems, an assessment of spine to determine if there is a possible spinal injury and whether you need to take long-term spinal precautions, anaphylaxis, and also CPR. Your most valued First Aid Kit is your brain!
Legal Issue for the Wilderness First Responder
Before any care is given, if the patient is conscious, you must obtain informed consent to care, and if at all possible should be witnessed by a third party. If the patient consciously refuses consent to care, do not touch the patient, if you do it can be considered “Battery” under law.
“Never do more or less than you are trained to do” The law will consider you at fault and liable for any and all damages to an injured person if you have not performed as a reasonable person would with your background and training, in the same or similar situation. So what does this mean? Do what you are trained to do, and do it to the best of your abilities. An example could be misreading obvious vital signs, or not splinting an obvious fracture.
If you ever find yourself in a situation with a minor, and there is no parent or guardian present, and you have no per-arranged consent, then you should go ahead and treat the minor to the best of your abilities. But remember if this is someone in your group, you should have already obtained written parental/guardian consent before the trip.
Do not share information about the patient inappropriately, or with inappropriate parties. For example you treated an injured hiker that had fallen due to dizziness possibly caused by a new medication the patient was taking, after the rescue a local reporter wants to ask you questions about the patient, what happened, etc. You should refuse based on patient privacy, provide no information about the patient.
Good Samaritan Laws, everyone asks if this protects you. Yes and No. Let me explain, in order to encourage trained people to give care to others, most states have a Good Samaritan Law that provide that a person who voluntarily gives emergency assistance will not be held liable for simple carelessness. Good Samaritan care must be voluntary and performed in an emergency. No in a wilderness situation such a statue might control your voluntary care of a stranger you find injured, but if you have a duty to act Good Samaritan laws do not protect you. If you know that a person is relying on you for assistance, and you have the training to provide assistance, then you have a duty to that person and a duty to act.
Keep in mind that as a Wilderness First Responder you are certified to provide care, you are not licensed to practice medicine! Also the authority of a medical adviser still DOES NOT mean care beyond the scope of training is legal.
Training to become a WFR
Training to become a WFR is typically a five to seven day course, depending on the company/organization providing the training. No previous first aid training is required, but it does help. You can expect the course to pack in 80 hours of training in the five to seven days so be prepared to work hard and study hard. The training is both classroom and in the field (no matter the weather conditions, rain, snow, mud, etc..), so come prepared and dressed for it. You don’t get to give up in the wilderness just because the weather isn’t cooperating and you don’t in the training either. The National Outdoor Leadership School is one of the most recognized training organizations and have courses available all across the U.S. All WFR’s have to re-certify every two years, BEFORE your current certification expires.
Get the book “Wilderness First Responder – How to recognize, treat, and prevent emergencies in the backcountry” written by Buck Tilton (This is normally provided as part of class courses but I advise you to read it before training.
Training covers these subjects in depth, and you will have to pass both written and practical examinations:
- Patient Assessment System
- Medical Legal
- Spinal Cord Injuries
- Long-term Patient Care
- Chest Injuries
- Head Injuries
- Wilderness Wound Management
- Athletic Injuries
- Fracture Management and Traction Splinting
- Cold Injuries
- Heat Illness
- Altitude Illness
- Cardiac, Respiratory and Neurological Emergencies
- Abdominal Emergencies
- Mental Health Emergencies
- Bites, Stings and Poisoning
- Allergies and Anaphylaxis
- Search and Rescue
- Leadership, Teamwork and Communication
- Communicable Disease
- Urinary and Reproductive System Issues
- Medical Decision-Making
- Common Wilderness Medical Problems
- Wilderness Drug and First Aid Kits