Wilderness Emergency Medical Technician

Wilderness Emergency Medical Technician, or WEMT, is the second highest level of wilderness emergency medical training available in the USA (second to Wilderness Advanced Life Support (WALS)), or other courses for advanced providers such as AWLS, and RMAP (Remote Medicine for Advanced Providers). In addition to an urban EMT-Basic course, WEMT places a greater emphasis on long term patient care in the backcountry where conventional hospital care can take days to reach. Some of the main providers of Wilderness EMT training in the United States include Wilderness Medical Associates (WMA), NOLS' Wilderness Medicine Institute, SOLO, and Remote Medical International.

History

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 there was a realization 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). The first Wilderness EMT 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) and Wilderness Medical Associates 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 "golden hour" until an ambulance with an EMT arrived. In 1984 SOLO developed and taught the first Wilderness First Responder course.cite book|last=Tilton|first=Buck|authorlink=Buck Tilton| year=1998|title=The Wilderness First Responder: a text for the recognition, treatment and prevention of wilderness emergencies | publisher = The Globe Pequot Press | location = Guildford Connecticut|pages = 314 ] 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 pre-requisite for professional positions that involve work in the outdoors. The largest providers of this training today are SOLO, Wilderness Medicine Institute (WMI) - affiliated with NOLS, Wilderness Medical Associates (WMA) - frequently associated with Outward Bound, and Remote Medical International.cite book|last=Isaac|first=Jeffrey|authorlink=Jeffery Isaac| year=1998|title=The Outward Bound Wilderness First Aid Handbook | publisher = The Globe Pequot Press | location = Guildford Connecticut|pages = 254 ]

Training

WEMT training is not standardized and varies by state and school but typically involves around 50 hours of wilderness medicine training in addition to traditional EMT-B certification. All WEMTs have valid National Registry EMT or state certified EMTs before joining a course, unless the course also incorporates the urban Emergency Medical Technician curriculum. Most schools also allow for other health care professionals, such as RNs, MDs, or Paramedics, to become wilderness certified, but the curriculum is the same. Often a student will have to travel a long distance to attend a WEMT class, and as a result, most WEMT classes involve taking classes 8-10 hours per day for one or more weeks (depending on whether the student is already an EMT).

There is a strong focus on rendering aid with improvised means (for instance, using a branch and some rope to splint an injured extremity rather than using commercially available splinting devices). In wilderness settings it is unlikely that the specialized equipment found in an ambulance will be available, so the focus is on using only what is at hand in your assessment and care for a patient. There is also a greater focus on long-term care, since a WEMT may have to be with a patient for many hours, while most urban EMTs are with each patient for no more than an hour (at the most).

Providing care in the wild can be a daunting task, since the golden hour is usually out of the question, and one may have to treat or stabilize a critical patient for hours until help arrives or you can get them the care they need. Backcountry medicine often speaks of the golden day -- a patient's survival chances for critical injuries drastically drop off around 24 hours without hospital care.

WEMT's and Wilderness First Responder can perform more advanced interventions, such as giving patients prescribed medications outside the scope of an urban EMT or First Responder with off-line medical direction. Some of these medications include Hydrocodone, Oxycodone, Keflex, Diflucan, and Diamox all depending on what standing orders the WEMT or WFR has. [(2006) Wilderness Medicine Handbook, 10th Edition. WMI of NOLS]

WEMTs also are allowed some acts outside the scope of practice of urban EMTs, such as stopping CPR after all efforts have been exhausted.

See also

*Wilderness first aid
*Wilderness First Responder
*Emergency medical technician

References


Wikimedia Foundation. 2010.

Look at other dictionaries:

  • Emergency medical technician - basic — (EMT B) is the entry level of prehospital emergency medical provider in the United States. EMT Bs are employed in a variety of industries. EMT Bs are not trained to provide definitive medical care, but instead focus on rapid in field treatment… …   Wikipedia

  • Emergency medical technician - intermediate — (EMT I) is a midlevel provider of prehospital emergency medical provider in the United States. The EMT I is not intended to deliver definitive medical care, but rather to augment prehospital critical care and provide rapid on scene treatment. EMT …   Wikipedia

  • Emergency medical technician — The Emergency Medical Technician (EMT) exists in many countries and is a health care provider trained to provide prehospital emergency medical care.cite web |url=http://www.bls.gov/oco/ocos101.htm |title= Emergency Medical Technicians and… …   Wikipedia

  • Emergency medical responder — Emergency medical responders are people who are specially trained to provide out of hospital care in medical emergencies. There are many different types of emergency medical responders, each with different levels of training, ranging from first… …   Wikipedia

  • Emergency medical services — A road ambulance of the South Western Ambulance Service in England …   Wikipedia

  • Emergency medical dispatcher — United States An Emergency medical dispatcher is a professional telecommunicator, tasked with the gathering of information related to medical emergencies, the provision of assistance and instructions by voice, prior to the arrival of Emergency… …   Wikipedia

  • New Orleans Emergency Medical Services — Established 1947 Headquarters New Orleans …   Wikipedia

  • Wilderness first aid — is the specific discipline of First aid which relates to care in remote areas, where emergency medical services will be difficult to obtain or will take a long time to arrive. Nursing care though not part of normal first aid is part of wilderness …   Wikipedia

  • Emergency bleeding control — Minor traumatic bleeding from the head Emergency bleeding control describes the steps or actions taken to control bleeding from a patient who has suffered a traumatic injury or who has a medical condition which has led to bleeding. Many bleeding… …   Wikipedia

  • Wilderness Medicine Institute — The Wilderness Medicine Institute of the National Outdoor Leadership School (WMI of NOLS) was founded in 1990 by Buck Tilton and Melissa Gray. WMI was originally headquartered in Pitkin, CO. Through August 1999, WMI offered the SOLO curriculum,… …   Wikipedia


Share the article and excerpts

Direct link
Do a right-click on the link above
and select “Copy Link”

We are using cookies for the best presentation of our site. Continuing to use this site, you agree with this.