April 07, 2010Wilderness First Aid

You're in the Appalachian wilderness. It's early winter and you've been hiking since day break. You took a wrong turn somewhere and wasted half a day going in circles. Now you're finally back on track, but the car is still three hours away and night is falling. "That's OK, you tell yourself, we'll make it back by moonlight and flashlight, no big deal." And that's when your friend collapses.

He was complaining earlier about the hike being too long, about the day being too cold, about pretty much everything, but he had fallen silent lately until he staggered a few drunken steps and fell unconscious. Now it's cold, the sun is setting, you're a long way from the car and to make matters worse, most hikers have long since left the trail and it's unlikely that you'll bump into help now. What do you do?

Stormy indeed

You grab his hands and they are cold to the touch. Someone says he must be hypothermic. You put a blanket over him and send someone else to start a fire. You try to remember if it's safe to give hot liquids to a hypothermia victim. "Better not risk it…" You tell yourself that if you can just warm him up, and keep him warm, he will be able to make the walk back. But little do you know, you're treating the wrong condition.

You're friend is hypoglycemic, and badly needs to raise his blood sugar level. He also hit his head falling down, but nobody thought of checking to see if he's injured. He needs sugar water and, eventually, a meal. The blanket would protect him from the cold except that his body is lying on the frozen ground, which will slowly suck away all his heat. And he needs to be checked for head trauma.

This situation is unlikely to end with a fatality, but the severity and discomfort of the situation could have been greatly reduced by the simple application of wilderness first aid knowhow.

So what is wilderness first aid? The term “wilderness” can be slightly misleading; when we think wilderness, we often think of remote barren lands, jungle and hardcore alpine settings. In reality, from a first aid standpoint, you are in the wilderness as soon as you are more than one hour away from medical assistance. That means that while you’re hiking on your favourite Laurentian trail or canoeing up to an island in front of your cottage, if an ambulance cannot reach you in one hour or less, you are technically in the “wilderness” as far as first aid is concerned.

When help is far away, your approach to managing distress must be adapted accordingly. For the most part, the skills of wilderness first aid (WFA) are largely similar to regular first aid skills: in a WFA course, you can expect to learn how to splint fractured limbs, manage tissue trauma, and treat a patient for shock, for example. But you also learn how to deal with unique situations that only arise in the wilderness.

Whereas in the city you can expect an ambulance to reach you wherever you are, in the wilderness, you may have to transport a patient to the closest road access for the paramedics or you may also be faced with long waits, lack of medical tools and unfriendly weather conditions. Even comfortably familiar outdoors settings may impose trying challenges in the event of a medical distress.

While types of emergency you may face in the wilderness may be similar to those that can occur in the city (cuts, allergies, malaise, etc...), being “out there” forces you to make certain judgement calls: Do you wait for help or do you evacuate? Can you contact help from here or must you seek help out? Do you send a part of your group to seek help, or do you stick together?

Beyond the technical know-how of dealing with medical conditions, wilderness first aid also involves an application of situational analysis and decision-taking. And that’s where a WFA goes beyond regular first aid techniques and requires a bit of leadership. Thankfully, the skills involved can be learned, and a WFA course can drastically improve your readiness to deal with an emergency when it arises.

Every year thousands of outdoor enthusiasts venture out without any wilderness first aid knowledge. I was one of them myself until I took my first WFA course this year. Before this experience, I was intimidated by this unknown that first aid was to me and I signed up for the course expecting it to be technical, gory and complicated. I also half expected it to be waste of time since I thought I could “figure it all out” if I ever was in a real emergency.

I was wrong on both counts. The WFA course I took was simple and fun, and easy to follow. And at the same time, I learned a lot of new things I couldn’t have known before, and earned the confidence to apply them if need be. This experience really opened my eyes to the importance of first aid training and I plan to continue to educate myself and refresh my knowledge on the matter throughout life.

And it’s important to have a bit of first aid know-how. When we’re out enjoying the outdoor activities with other people, we tend to expect that our friends can help us if we get hurt. Maybe they’re expecting the same from us; in any outing, every group should have at least two people that are trained in first aid. But the more the better.

There are many reasons why you might want to get trained in first aid. Maybe you have a leadership mentality and you feel a responsibility towards your fellow outdoorsmen. Maybe you hike with your close ones and you want to make sure you can help them if need be. Or maybe you think you might enjoy learning more about the human body. Whatever your reasons, educating yourself in WFA is unlikely to be a decision you’ll regret.

Gettin' educated

There are several ways to educate yourself in WFA. My approach was to take a course, and I found it very effective. My introduction came in a course organized by the McGill Outdoors Club and offered by Sirius Wilderness Medicine. Our course was two-days and was taught by instructors J.S. Berlinguette (berlinguette@hotmail.com) of Sécurisoins (www.securisoins.com) and Yannick Sisla. We covered a broad range of topics, our time being split between theoretical courses and practical simulations. I found that the simulations really helped put the theory in perspective and also made remembering it easier. For this reason, I recommend lessons to others.

Things can get messy out there

Others might choose to learn using official text books or, most economically, reading up on it online. Even if you do take a course, periodically reviewing first aid literature might be a good way to stay up-to-date and keep the knowledge fresh.

Overall, learning some wilderness first aid was enriching, and it was a fun and interesting way to spend some time. The skills I learned could come in handy one day, but even if I never need to apply first aid, and I hope I don’t, it was a worthwhile experience.

If you have any questions regarding the First Aid program described herein, you may contact J.S. Berlinguette at berlinguette@hotmail.com

-Jean-Yves Domenjoz