Medical Training Considerations For Backcountry Users

Written By Justin Ibarra

Operations Manager & Lead Guide at Colorado Adventure Guides

Phantom Team Rider

It was a beautiful February morning in the Rockies. The skies were clear and the winds calm, and, more importantly, a storm had just dropped over a foot of snow the previous day. Prime conditions for an amazing day of backcountry splitboarding and so you and your main touring partner plan to head out to take advantage. Utilizing your previous experience and avalanche training, together you decide on a familiar zone to ski. With the plan to stick closer to the trailhead, completely avoid avalanche terrain and ski some mellow glades and tree shots you all meet that morning at the trailhead.

Pleasantly surprised you arrive to see an empty trailhead. The stoke is rising! A quick transition and reconfirming of the plan for the day, along with a departure check and your off. Breaking trail in well over a foot of new snow and you're both grinning from ear to ear the entire time. About an hour later you arrive at your spot and transition. Looking down at over 1k ft of pure bliss below with perfectly spaced trees and a consistent pitch near 28 degrees, it’s going to be a good one. With hollers of joy you both drop, leapfrogging down the run as clouds of cold smoke and faces plastered with snow disappear with every turn. This is what it's all about!

Then all of a sudden you hear a loud snap followed by a wretched scream from your buddy. Looking down you see your friend bent around a tree. As you ski down you know something is not right. A few seconds later you get to your buddy and he is screaming about his leg, pointing to his thigh. You do your best to get his leg exposed to check and upon examination you notice a disfiguration to his thigh and a swelling happening fast. What do you do now?

This could be a life or death scenario, and one that could happen to any of us. This is also something that you are not going to learn in an avalanche education course. I recently just recertified my Wilderness First Responder Course last weekend with Desert Mountain Medicine in Leadville. This is a training that I have held for 15 years, but one that requires a recertification every 3. Every time that I recertify, I am supremely happy that this is the case. These are perishable skills and hopefully ones that unless we are in the medical field, are not using very often. Wilderness medicine is also one that is ever evolving and there are many standards and protocols that have changed even in the past 5-10 years. While avalanche education has become a staple for backcountry education, I hope that people also understand the importance to the other “facets” of traveling into the backcountry such as medical training. Coupled with basic CPR training, there are a few different types of first aid courses that you can look for. (Wilderness Course Descriptions from DMM)

Basic First Aid:

Teaches how to recognize, treat, and stabilize basic injuries and medical issues in an urban environment.

Wilderness First Aid (WFA) 16-hours

Teaches how to recognize, treat, and stabilize basic injuries and medical issues in a wilderness setting, but never too far from the umbrella of the local EMS response.

Wilderness Advanced First Aid (WAFA) 40-hours

Geared towards outdoor leaders working in remote backcountry trip locations. They may not need to rely on their personal decision-making and/or judgement skills due to the access of sound communication and rescue responses. Students are taught to prevent, recognize, treat, stabilize, and organize an evacuation for common injuries and medical issues.

Wilderness First Responder (WFR) 80-hours

This is the standard in the outdoor recreation industry for multi-day trips in remote locations with unreliable communication where rescue is delayed or unavailable. The course is designed to address trauma injuries, medical illnesses, and behavioral issues common to extended backcountry trips. These leaders are trained to make life or death decisions about patient treatment, as well as organize and manage their own rescue that could last hours to days.

EMT Wilderness Upgrade 54-hours

Designed to add a wilderness module to a current EMT’s urban training. It focuses on the same principles of the WFR with the addition of oxygen, advanced air-way techniques, intravenous therapy and drugs.

Expedition Medicine 45-hours

A course for licensed medical practitioners (MD, PA, RN, ect.) who aspire to become primary medical personnel on wilderness expeditions.

Also great to note a new winter specific WFA that DMM has just started. You also get 10% off any of their courses if you are a CAIC member! Visit www.desertmountainmedicine.com for more info.

WFA For Winter Backcountry Users (WFA)

This course is designed for the winter backcountry user interested in bridging the gap between their avalanche education and medical response. The Wilderness First Aid (WFA) course is a great introduction to wilderness medicine and basic life support skills. This training focuses on prevention, assessment and treatment of injuries and illnesses common to winter backcountry recreation and includes wilderness medicine guidelines for the treatment of avalanche victims.

This specialty course is taught by Desert Mountain Medicine instructors who are employed as either professional mountain guides, or outdoor educators, in combination with emergency medicine (e.g., emergency department, mountain rescue, ski patrol or EMS).

Now that you know how to use it, what are you going to be carrying in your daily touring pack? What you carry in your kit can vary depending upon group size, length of trip, trip type, etc.. But below is a list of what I personally will always carry in my first aid kit.

Trauma Injuries

Antiseptic wipes

Antibacterial ointment (coconut oil)

Tincture of Benzoin (bandage adhesive)

Assorted adhesive bandages (band-aids)

Butterfly bandages / adhesive wound-closure strips

Non stick Gauze pads (4x4)

Hemostatic (blood-stopping) gauze

Tourniquet

2nd skin

Moleskin

Athletic Tape

Triangular bandages

Ace or Coban Wrap

Finger splint

SAM splint

Rolled gauze

Transparent film dressing

Medications

Aspirin

Benadryl or Clariton

Eye drops

Anti-Diarrhea medication

Antacid tablets

Salt Tablets

Sunburn relief gel or spray

Glucose or other sugar

Throat lozenges

Ibuprofen / other pain-relief medication

Insect sting / anti-itch treatment

Additional

Extra facial covering

Medical / surgical gloves (avoid latex)

CPR mask

OPA/NPA

Trauma shears

Tweezers

Safety Pins

Razor blade

Cotton-tipped swabs

Oral thermometer

Irrigation syringe

Small notepad with waterproof pencil or pen

Medical waste bag (plus box for sharp items)

Hand sanitizer

First-aid manual or information cards

While most pre-made first aid kits can be a great start, you will usually need to add or subtract certain items from the kit.

Well thanks for reading and hopefully this little write-up helps to solidify the importance of first aid training , or at least was a good refresher on the importance of remembering to check your kit. Again, visit Desert Mountain Medicine for all of your wilderness medical needs. And better yet, take an avalanche course with us to receive a discount on your medical training! Have a safe and fun season out there!

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