Wilderness First Responder
Whether you're a seasoned wilderness enthusiast, a dedicated outdoor educator, or an aspiring wilderness guide, this WFR course is designed to empower you with the experience and practical skills required to stay calm and responsive in disaster relief and medical emergency scenarios.
Delve into the essential principles of wilderness medicine, learning how to perform a comprehensive physical examination, gather critical patient history, and evaluate vital signs – crucial elements of proficient wilderness medical care. You'll acquire the prowess to administer emergency treatments, manage musculoskeletal injuries, and navigate the intricacies of medical evacuations.
A wilderness first responder is trained to deal with many situations that may be encountered in the wilderness. The training is principally geared towards lay providers, with little to no actual medical experience, though they are often already professionals in other aspects of the outdoors industry, like park rangers, climbing instructors, and guides. A standard Department of Transportation-defined emergency medical responder (EMR) course, which focuses on urban medical emergencies, requires approximately 60 hours of training, while its backcountry counterpart, wilderness first responder course, typically involves 80 hours of training, covering much of what is taught in an EMR course, but with the additional hours spent putting it in a wilderness context.
Wilderness first responder training courses focus on teaching the students to assess a situation, improvise solutions using available resources to stabilize the patient and identify the best way to get the patient to definitive medical treatment. In many courses, students are encouraged to develop the habit of systematically thinking through and documenting their assessment decisions/plans using a SOAP note. Topics covered usually include, but are not limited to, the following principles:
responding to results of physical trauma:
management of signs and symptoms of circulatory shock
management of soft tissue injury such as a burn or wound
prevention and/or treatment of blood-borne pathogens
treatment of infectious diseases
management of bone and joint injuries such as fractures, sprains, strains and dislocations
management of suspected head and or spinal injury
responding to the onset of sudden illness
transport/evacuation planning and implementation.
Wilderness First Responder is abbreviated as WFR. Those with the certification are often called "Woofers". The 21st-century EMS equivalent of Wilderness Emergency Medical Responder is abbreviated as WEMR and those with the certificate are usually described as "Wemmers".
The Faculty of Pre-Hospital Care at the Royal College of Surgeons Edinburgh produced a Consensus Paper on Medical Provision for Wilderness Medicine. This was published on 1 December 2015 in the Extreme Physiology and Medicine Journal.
The guidance was updated in February 2020. The updated guidance emphasizes a blend of skills for medics operating in remote areas (which makes complete sense - those providing treatment need to be able to look after both themselves and the casualty, in the context of the location and environment they find themselves in) which includes (but not limited to):
Medical skills
Wilderness Medical Training
Wilderness Skills
Risk Management knowledge (we run expedition/wilderness-specific risk management courses that are Royal Geographical Society accredited).
For some of the higher grades, a trauma course is indicated. We run a remote area emphasis Pre-Hospital Trauma Life Support course (delivered in 64 countries - delivered by us in the UK as a UK localised edition, endorsed by the College of Paramedics and JRCALC compliant). We allow our WFR delegates to progress to PHTLS.
The guidance continues to mirror our views that training some way above and beyond a standard, basic 2-day outdoor first aid course (usually an Emergency First Aid at Work in an outdoor context plus an additional day of practice and content) is highly desirable/necessary for anything but the lowest risk expeditions within fairly short timescales to definitive treatment (well equipped ER, not an ambulance). The guidance refers to ‘Advanced First Aid’ at the lowest level. A standard outdoor first aid course is not ‘Advanced’.
The guidance for wilderness medical expertise band 1 (lowest) on the skills framework refers to a need for ‘Advanced First Aid Training’ - ‘A minimum of 16 hours is essential, 2-4 days course specific to a wilderness environment.’ This is for the lowest-risk expeditions. Our analysis is that this means a basic 16 hours of essentials plus 2-4 days on specific wilderness medical/environment-specific content. That interpretation would make sense given that most well-regarded level D courses on the Pre-Hospital Emergency Medicine framework take 4-5 days - without wilderness content. A 6-7 day training period to encompass all the content would fit with our delivery experience. There is only so much that can be taught in a day and a quality learning day can only last so long.
We have honed our course over many years and we have huge knowledge and understanding of the needs of those operating in diverse environments - because we have operated in these environments and because we have field reports from our clients that the training is fit for purpose for the environments they operate in. We know that the minimum time for a meaningful course is 7 days - plus pre-study and evening study during the course.
The guidance is simply that - guidance - but would be a document waved around in court to demonstrate what a panel of experts considered to be ‘good practice’. Medic provision should be guided by expedition-specific risk assessment. We have espoused our (widely supported) views for several years that many organisations are not equipping their medical role-fulfilling leaders with training that meets good practice for the risk level and remoteness of the activities they are delivering.
