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The Practice of Wilderness First Aid (WFA)...

2/29/2016

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Source: NOLS WMI Pocket Guide PAS triangle. Use as a reference only. Not a substitution for any training or first aid certification course.
​This February I was fortunate to be able to take a Wilderness First Aid course sponsored by the Wilderness Medicine Institute of NOLS and the University of Arkansas, Fayetteville. It was taught by Amy Shambarger and Ben Tettlebaum. I thought I would share a bit about what I learned in this blog.
​

The first basic step to wilderness first aid is called the Patient Assessment System (PAS), which is used to decide if the injured can STAY & PLAY or LOAD & GO (quick or slow), and is symbolized by a triangle where you work your way down the image taking the different steps summarized.
PictureDr. Sarah Hammonds of Chaetura, LLC, one of my field work collaborators.**
You will note the use of lots acronyms throughout the system and course which are used to help summarize lots of information in a small space and assist your learning. For instance, MOI stands for Mechanism Of Injury; BSI means Body Substance Isolation [WEAR GLOVES!]; CSM stands for Circulation, Sensation and Motion; LOR means Level Of Responsiveness; SCTM stands for Skin Color, Temperature and Moisture. When finding out the patient history, you use the acronym SAMPLE (after noting chief complaint and age of patient) which stands for Symptoms (in addition to chief complaint), Allergies, Medications, Pertinent medical history, Last fluid/food intake/output, and Events (story before and during the event).

As Mr. Tettlebaum stressed, every person deserves to be given all the steps of the Patient Assessment System. Using the PAS will help you be thorough in your assessment. Regardless of the possibly apparent simplicity of an injury, working through all the questions leaves no stone unturned and helps remove personal hesitation in asking (or answering) all the questions needed for the best diagnosis possible (given the absence of a doctor or an emergency medical technician).

Part of the course material was a WFA Pocket Guide which is a small cheat sheet that lists all the different aspects to consider and questions to ask the patient to help determine the next steps to take in their care. I decided to put this pocket guide in my all-weather zippered folder where I keep my state scientific collection permits (required to be on my person at all times while I am doing biological field work), and is always in my field bag.

Lastly, I would highly recommend taking this course from NOLS Wilderness Medicine Institute*. I was very impressed with the teachers’ professionalism and use of time. The practice scenarios were most helpful in learning the information and mimicked the possible situations you might encounter in the back country. One thing I had not considered when in a scenario (real or practiced) is the influence of group dynamics on a situation. Very interesting to witness, but fodder for another day!

Stay safe out there!

-JMB 

*Just FYI, the cost was $240 for a 2-day course through the University of Arkansas, Fayetteville. At the end, you are considered Wilderness First Aid certified and NOLS WMI recommends you re-certify every two years. I am thinking of re-certifying on a 3-year cycle though due to the costs and plan to review the material annually as part of my pre-field season preparations.

**This was our practice splint for a broken arm using a clip board, field safety vest, and some American Burying Beetle field tape, along with a jacket for the arm sling.

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    Field Safety 101

    Short essays on safety topics for those who conduct fieldwork "in the wild".

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