Emergencies in the Outdoor Recreation Setting

April 07, 2011

What Level of Training is Required?

David Patton, Assistant Director, Outdoor Recreation
Wayne Fett, Sr. Associate Director of Recreational Services
Molly Gable, Graduate Assistant, Outdoor Recreation
University of Iowa

Imagine yourself walking through a high alpine meadow in July: beautiful mountains rise up towards postcard blue skies; red, yellow and purple flowers paint the landscape with color as you hike in and out of green pine forests. You cross a stream and splash some glacial melt water in your hat to keep you cool as the afternoon sun beats down on you. Suddenly, one of the students that you are leading falls to ground. What do you do?

At the University of Iowa’s ‘Touch the Earth’ Outdoor Recreation and Education program, this is a very real scenario. Outdoor recreation programs like ‘Touch the Earth’ have become very popular within recreational departments on campuses across the country. As the industry grows, the need for standards increase, and trip leaders must be trained to specific levels of wilderness medicine care to meet the needs of the students in the event of an emergency. Program administrators or risk managers for classes, trips or other outdoor activities must be aware of the various instructor training certifications and how they can apply to different programs.

A major consideration in emergency planning and training is the location of the activity. Most outdoor recreation practitioners have heard the term “the golden hour”, referring to the first hour following an accident. This time period is important for the patient, but it also helps determine the level of training required for the trip leader. For example, in the scenario described above, the group was hiking in the mountains. Most likely they were more then one hour from definitive care, meaning that there was no way possible to get the person to a hospital within one hour.

This type of activities would require the leader to be current in Wilderness First Responder (WFR). The University of Iowa hosts a course each spring which is open to the general public (we provide a discount to our staff members). This particular WFR class is taught by the Wilderness Medical Institute (WMI) of the National Outdoor Leadership School (NOLS), and courses generally last 10 days and cost between $500-$600.

Most professionals would agree that WFR is the most appropriate level of training for outdoor recreation leaders. It builds confidence and empowers the leader to make decisions that can help during this golden hour and throughout the rescue process. The course is very hands-on; the participant develops skills on patient management issues ranging from blisters and bellyaches to broken legs and head trauma. They learn to plan ahead and to maximize the resources available.

However, many departments simply don’t have the resources to put staff members through a 10 day course. A shorter, more practical backcountry oriented certification is Wilderness First Aid (WFA). WFA is a sixteen hour course that is similar to WFR because it focuses on the wilderness component of medical emergencies. Participants are trained to provide care beyond the “golden hour” and with limited resources available. WFA courses are generally far less expensive, making the WFA more attainable for programs with limited resources. In addition, people that have previously completed a WFR course can re-certify by attending a WFA course.

To be able to work for most outdoor programs in North America, First Aid and CPR certifications are required as a very minimum – although most departments encourage or require all backcountry staff to be trained in WFR. Programs that require a lesser degree of wilderness medicine proficiency normally pre-establish a range in the locations where their staff members can teach. For example, staff trained only in First Aid and CPR must always be within one hour of definitive care. In the event of an emergency they call 911, then provide the best patent care they have been trained to provide.

In most backcountry emergencies, Automated External Defibrillators (AEDs) are not present nor are they considered very useful. AEDs are a great resource for recreation centers and public buildings in general. However, they are designed to “jump start” the heart and preserve a person until they can be hooked up to advanced life support. Fifteen miles into the backcountry is too far from any life support even if helicopter rescue is a possibility. AEDs are also large and bulky and it would be a difficult thing to carry. As a WFR, you have the necessary training and tools to help in this type of emergency.

The perceived risk associated with outdoor activities is part of the attraction, and people are interested in doing things that get the blood pumping! These activities can be facilitated in a safe and enjoyable manner. But this means planning ahead and ensuring that your outdoor leaders are properly trained.


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