Mnemonics in CPR and First Aid: A brief history & discussion A mnemonic is a learning technique that enhances information retention or retrieval by associating a concept or action with letters, words, or images. CPR and first aid commonly use letter mnemonics to describe the treatment order during your initial patient assessment; WMTC uses an image or visual mnemonic and builds it into a larger graphic that illustrates our complete patient assessment system. In 1957, Peter Safar, MD, a pioneer in resuscitation techniques, wrote the book ABC of Resuscitation. The ABC mnemonic—airway, brea ..read more

Erin Genereux, FNP-BC Garrett Genereux, WEMT While death in the backcountry is pretty rare, accidents happen. If the unthinkable occurs and you’re left with the seemingly impossible task of telling the rest of the group or those at home that their friend or loved one has died, the way you deliver the information will affect how it is received. While there is no perfect way to say someone has been severely injured or died, there is language you should avoid. Consider using these talking points: Give regular updates, especially if the patient’s condition appears to worsen. This may start to a ..read more

Introduction Numerous articles, podcasts, and letters have recently argued for regulating wilderness medicine certifications. At its root, regulation is about control—someone always benefits, and there are always associated costs. This article discusses the various forms of regulation that apply to wilderness medicine certifications and attempts to identify who benefits and at what cost. Once they are known, we can run a cost/benefit analysis and see where it leads us in the near and distant future. Three types of regulation apply to wilderness medicine: economic regulation, government regulat ..read more

Introduction ​A medical advisor who is an active member of your organization's risk management team can help prevent and reduce the severity of program-related injuries and illnesses. We recommend working with a medical advisor who is familiar with your program and an experienced outdoor person. A medical advisor can: Help program managers identify predisposing terrain, environmental, and clinical conditions that may contribute to program-related accidents, injuries, and illnesses and suggest strategies to prevent them. Write standing orders authorizing your staff to administer medicatio ..read more

All outdoor trips incur risk. Trip planners must balance the severity of a potential injury or illness with the expedition members' outdoor skills, equipment choices, and the availability of outside assistance. The planner must accurately assess each member's skills and other factors with: the risks inherent in the activity: rock climbing, mountaineering, trekking, whitewater, skiing, caving, ocean touring, etc. the potential for and the severity of a hazardous weather event: flash floods, lightning, wind events, storm surges, mudslides, high water and flooding events, and wildfires infectiou ..read more

Stress is inherent in outdoor trips and activities. People can often adapt to mild stress and return to their baseline relatively quickly; however, chronic, moderate, or severe stress may overwhelm an individual’s coping mechanisms and result in a mental health problem. S/Sx include increasing inability to cope with the challenges of the trip, activity, or group. The graphic below depicts the different levels of distress and their associated evacuation levels with respect to a mental health even To help avoid a mental health crisis on expeditions or trips, it is critical to identify and evalu ..read more

You are on a multi-day backpacking trip in the southwestern canyons with a friend and her partner. You haven't seen your friend Janey for a number of years, and this is the first time you spent any time with her partner, Jon. The temperatures on the trip have been in the mid 70s until today when they unexpectedly climbed to over 90º F by noon. You are in a fairly open part of the canyon and exposed to the direct sun. Everyone is sweating heavily and looking forward to reaching camp and water. By mid-afternoon Jon is noticeably tired and feeling nauseated. You are almost out of water, but camp ..read more

You are part of a hotshot crew responding to a wildfire in northern California. Temperatures are well into the triple digits close to the handline they were tasked with holding. James, one of the crew members, is complaining of the heat and it's difficult to keep him cool. During your patient assessment, you find that he has recently started taking Benadryl® for a newly developed allergy to juniper pollen. What do your think is wrong with James and what should you do? Click here to find out. Don't know where to begin or what to do? Take one of our wilderness medicine courses. Guides and ..read more

You are leading an interpretive day hike down the Bright Angel Trail of Grand Canyon National Park for a local concessionaire. People sign up for the hike online or at the concessionaire's Flagstaff office; they do not complete a medical form. It is a 9-mile out-and-back hike; water, shade and bathrooms are available at Indian Garden, which is the turn-around point. There is also water and a resthouse at 1.5 and 3 miles. It's mid-August and the temperature is expected to reach triple digits by early afternoon; the hike is scheduled to leave the Backcountry Information Center at 7 am. Participa ..read more

You are a paddle raft guide on the Salmon River during high water; the air temperature is 72º F and water temperature is 54º F. You are at the put-in waiting for your clients to arrive. The bus pulls up and the clients disembark in wetsuits and life-jackets and move to their assigned guides for a safety talk. Your clients all know one another, joined the trip after seeing a brochure during a planned holiday to celebrate the 70th birthdays of two group members, and have never been whitewater rafting before. The entire group is retired, in their late 60s or early 70s, and appear to be in good he ..read more