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Wilderness first responders are individuals who are trained to respond to emergency situations in remote locations. They are part of a wide variety of wilderness medical providers who deal with medical emergencies that occur in wilderness settings.
Near the end of the 19th century, volunteer organizations such as St. John Ambulance began teaching the principles of first aid at mining sites and near large railway centers. By the dawn of the 20th Century, additional organizations such as the Boy Scouts and the American Red Cross began teaching first aid to lay people. Over the years, these organizations trained hundreds of thousands of people in the elements of providing assistance until definitive care could be arranged.
The training in these courses assumed that definitive care was nearby and could be delivered quickly. Eventually it was realized that this training, while valuable, needed to be supplemented and/or revised to deal with the extended time and limited resources inherent when a medical crisis occurs in a wilderness setting. In the 1950s, organizations such as The Mountaineers began developing training programs that addressed these special needs.
In 1966, the US Government, through the National Traffic and Motor Vehicle Safety Act, gave the Department of Transportation (DOT) responsibility for creating a national Emergency Management System (EMS). From this program came the standardized curriculum for the position of emergency medical technician (EMT).
Wilderness Medicine Outfitters' director taught his first back-country care course for ski patrollers at Colorado State Univ in 1967. The first wilderness emergency medical technician course was taught in 1976 to help EMTs in Colorado adapt their skills and knowledge when working with Search and Rescue teams. By 1977, organizations such as Stonehearth Open Learning Opportunities (SOLO) were offering specialized wilderness first aid training to their instructors.
Meanwhile, the DOT EMS program recognized a need to develop standardized training for first responders such as truck drivers, policemen and fireman who could lend assistance during the initial part of the "golden hour" until an ambulance with an EMT arrived. In 1984, SOLO developed and taught the first wilderness first responder course. The purpose of creating the course was to provide Rangers, outdoor leaders, and guides the necessary knowledge to provide care in crisis situations in the wilderness. In 1985, SOLO began providing WFR training to Outward Bound instructors in Florida.
Today, WFR certification is frequently a prerequisite for professional positions that involve work in the outdoors and students may take courses from numerous nationally recognized providers (see below).
A wilderness first responder is trained to deal with many situations that may be encountered in the wilderness. The training is principally geared towards lay providers, with little to no actual medical experience, though they are often already professionals in other aspects of the outdoors industry, like park rangers, climbing instructors, and guides. A standard Department of Transportation defined emergency medical responder (EMR) course, which focuses on urban medical emergencies, requires approximately 60 hours of training, while its backcountry counterpart, wilderness first responder course, typically involves 80 hours of training, covering much of what is taught in an EMR course, but with the additional hours spent putting it in a wilderness context. Wilderness first responder training courses focus on teaching the students to assess a situation, improvise solutions using available resources to stabilize the patient, and identify the best way to get the patient to definitive medical treatment. In many courses, students are encouraged to develop the habit of systematically thinking through and documenting their assessment decisions/plans using a SOAP note. Topics covered usually include, but are not limited to, the following principles:
- basic life support
- responding to results of physical trauma:
- management of signs and symptoms of circulatory shock
- management of soft tissue injury such as a burn or wound
- prevention and/or treatment of blood-borne pathogens
- treatment of infectious diseases
- management of bone and joint injuries such as fractures, sprains, strains and dislocations
- management of suspected head and or spinal injury
- responding to the onset of sudden illness
- transport/evacuation planning and implementation.
Wilderness first responder is usually abbreviated as WFR. Those with the certification are often called "Woofers".