One theme of all wilderness emergency care training, from the first-aid to the medical level, is that in order to take care of other people in the wilderness, you must be able to take care of yourself. Most mountain medicine courses in Europe, therefore, include training in mountaineering skills. These courses, which Dr Peters has described in several previous articles (references 1 and 3 in his following article), are generally designed for physicians. Many of the courses lead to an International Diploma in Mountain Medicine, recognized by the Union Internationale des Associations Alpinistes. This diploma helps qualify physicians to be expedition or mountain rescue doctors. In Europe, unlike in the United States, mountain rescue is usually done by professionals, including physicians who have earned a Diploma in Mountain Medicine. There is a demand for professionally trained and certified rescue teams because climbers (and accidents) are far more concentrated in the Alps than in the mountains of the United States. There are more than enough incidents to keep professional rescue teams busy. In the United States, however, wilderness rescue is usually done by volunteers, and physicians are rarely involved. With rare exceptions, only the pilots and crew of aeromedical transport are paid professionals. Sheriffs’ deputies and park rangers with rescue responsibilities usually serve as coordinators. When physicians do volunteer for a mountain rescue or search-and-rescue team, their role in training other members of the team is usually at least as important as the medical skills they may bring to a rescue. Rescue team members in the United States are typically trained to the First Responder level, with some EMTs. But usually, each team sets its own training standards in emergency care as well as in wilderness skills. Although there are many programs in wilderness emergency care and wilderness medicine, such programs provide medical professionals with only continuing education units at most. They do not lead to a generally recognized certification to practice wilderness medicine. It will be interesting to see how much influence the European system of training for and professionalizing mountain rescue has on wilderness rescue in the United States. It would also be interesting to learn more about training for wilderness emergencies and rescue in other countries, such as Great Britain, Canada, Australia, New Zealand, the South American countries straddling the Andes, Russia, Turkey, and Japan. What kinds of courses are offered, who teaches them, whom are they for, and how do graduates use the training? Readers who have experience with wilderness training and rescue in these countries should consider sharing their knowledge by submitting articles for The Wilderness Instructor. By reading about other courses and other approaches to wilderness emergency training, we can get ideas for improving the training that we do. When we can compare training with the performance of course graduates in real situations, we will get an even better sense of what kind of training is effective. This will require surveys of people who have used their training to cope with wilderness emergencies as well as surveys of training programs like those of Dr Peters. There have been many attempts to reach a consensus and set standards for wilderness emergency care training in the United States.1.Wilderness Prehospital Emergency Care (WPHEC) curriculum. In: Forgey WW, ed. Wilderness Medical Society Practice Guidelines for Wilderness Emergency Care. Merrillville, IN: ICS Books Inc; 1995:60–67.Google Scholar,2.Forgey W.W. Wilderness Medical Society Practice Guidelines for Wilderness Emergency Care. 2nd ed. The Globe Pequot Press, Guilford, CT2001Google Scholar Perhaps the diversity of wilderness environments and the dependence on volunteers make it unlikely that training and certification will ever be as standardized here as they are in Europe. But the more we know about what kinds of wilderness training have been tried and what results they have in rescue performance, the better job we can do as instructors.
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Oct 1, 2007
S S Alexanin + 3
Open Access