An Introduction to the Medical Wilderness Adventure Race (MedWAR)

Abstract

First-aid competitions have a long history. For example, the American Red Cross helped publicize its first-aid classes (which began in 1910) by holding first-aid contests all over the United States.1.American Red Cross. Brief History of ARC First Aid Program. Information Letter #6; revised November 1964.Google Scholar These contests are still held in some states, though they have become much less common. St John Ambulance also has a long tradition of first-aid competitions, going back more than a century. St John Ambulance, like the Red Cross, is a volunteer-based organization that provides first-aid services and training. It was founded in Canada in 1882 and now has branches in many other countries, including Great Britain, Australia, and Austria. Volunteers from St John Ambulance and the Red Cross participate in both national and European first-aid competitions. These competitions are much more popular and better publicized than the relatively few remaining competitions in the United States. (For more information about this topic, do Google searches on first-aid competitions and St John Ambulance.) The Medical Wilderness Adventure Race (MedWAR) revives an old tradition and gives it a new context. Wilderness emergency care courses often include realistic scenarios in an outdoor setting, and any role-playing scenario includes a competitive element, though participants are generally competing against a standard of performance rather than each other. Scenarios also usually require teamwork, which instills camaraderie in the participants. MedWAR not only puts emergency care competition into a wilderness setting, it also adds to the challenge by having the simulated emergencies occur during a wilderness activity, such as hiking, mountaineering, or canoeing. Thus, participants are tested on wilderness as well as emergency care skills. This strategy has already attracted several wilderness organizations, such as the Boy Scouts, and should lead to alliances with many other organizations. For example, the National Ski Patrol, the Civil Air Patrol, mountain rescue teams, search and rescue teams, park medics, survival schools, and wilderness guides are all potential participants; collaboration with such organizations could also lead to cross-training. MedWAR events can be made very realistic by the use of moulage (accident make-up).2.Donelan S. The wilderness instructor. Staging simulated accidents.Wilderness Environ Med. 2000; 11: 52-55Abstract Full Text PDF PubMed Scopus (7) Google Scholar Realistic simulation of injuries, along with effective acting-out of symptoms (and the real wilderness setting) can give MedWAR problems the physical and psychological impact of real wilderness emergencies. Moreover, effective acting by well-coached victims can largely eliminate the need for written exams. For example, a victim can simulate many of the symptoms of altitude illness (eg, fatigue and shortness of breath for high-altitude pulmonary edema) with the disembodied voice of a monitor supplying the data that cannot be simulated (eg, “Pulse is 110” [when the rescuer checks pulse] and “You hear crackles” [when the rescuer listens to lung sounds]). And if the scenario is not actually at high altitude, the scene can be set with a sign on a hill top (eg, “Mt Whitney, 14 000 feet”). In other words, whatever the victim cannot simulate can be provided by visual or auditory cues, which enable the rescuers to stay in their roles and the monitors (by convention) to remain invisible. In summary, MedWAR events have the potential not only to test the skills of wilderness rescuers, but also to stimulate interest in wilderness emergency care, create alliances with many wilderness organizations, and even generate publicity that can greatly enhance both recruiting and fund raising for volunteer organizations.