WMS Cold Card Guide In the Assessment and Care of Cold-Exposed Patients

The Wilderness Medical Society has published a free ‘cut out and keep’ style double sided card, summarising the key elements of hypothermia evaluation and field care for laypersons, rescuers, and first responders. 

The full-text paper explains its design and evolution, alongside high-resolution printable images of the card.

Go to: Wilderness Medical Society Journal

NOLS Wilderness First Responder

 

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.

Go to: www.nols.edu

#WildernessMedicine #WildernessFirstResponder #CPR

Emergency Medicine Matters - Use of Adrenaline in Anaphylaxis

Image Credit: Backpacking Mastery

Anaphylaxis is a life-threatening emergency and is one of the most stressful medical conditions that an expedition medic could face. Fortunately, the condition is reversible with prompt administration of adrenaline by intramuscular injection.

Because the onset of anaphylaxis can be very fast, an adrenaline auto-injector can be very useful upon witnessing the first signs of a severe reaction.

Signs of a severe reaction include:

• Swelling in the throat (altered voice, difficulty swallowing or breathing) and extremities (if stung).

• Wheezing

• Dizziness, feeling faint, tiredness (symptoms of low blood pressure)

The most commonly seen auto-injectors are still EpiPen®. Certainly, this brand is most commonly carried by children and adults in the UK setting. Therefore it may be that some participants on expeditions may carry these.

Figure 1 - EpiPen® Auto-Injector

All auto-injectors should be injected into the muscle of the outer thigh.

There has been a recent slight change in the guidance for administration for EpiPen®.

There is no change to the device or the drug (adrenaline); the change is in the instructions for use as outlined below:

    • Reduced injection time from 10 seconds down to 3 seconds – this is based on research confirming the delivery of adrenaline for 3 seconds is sufficient.

    • Removal of the massage step after the injection – this step has been removed to simplify the process of administering EpiPen®.

The changes above are aimed to improve patient compliance.

Image Credit: Backpacking Mastery

Remember that anyone who uses an auto-injector must have had training in its use (as they are all slightly different). However, it is a drug that can be administered by a non-health care professional in the UK setting if required to treat a patient with anaphylaxis.

It is hoped that the manufacturers of the other auto-injectors (Jext and Emerade) available in the UK will also change their guidelines to match those of EpiPen®.

Wilderness Medical Training recommends the use of Emerade as the autoinjector of choice as each one contains 0.5mg adrenaline (Resus Council UK guideline dose) rather than the 0.3mg adrenaline dose in the EpiPen®.

The guidance for the Emerade auto-injector remains to hold the autoinjector against the thigh for 5 seconds.

Figure 2 - Technique for use of the Emerade Auto-injector

#BasicLifeSupport #FirstAid #EmergencyMedicine

AHA Stay Safe In The Water Campaign

Drowning is the third-leading cause of unintentional injury death worldwide, accounting for 7 percent of all injury-related deaths, according to the World Health Organization. The agency estimates there are 360,000 annual drowning deaths worldwide.

Go to: American Heart Association

NOLS Professional Instructor Course

The primary purpose of this course is to train and evaluate potential NOLS instructors who already have extensive experience teaching in the outdoors. 

Each participant’s skills and abilities are assessed and evaluated by the course instructors with the intent of determining their potential as an instructor. 

On this course, participants will develop and refine the teaching and leadership skills needed for professional positions at NOLS.

This course is conducted in Wyoming’s Wind River Range. Because the environment and terrain are representative of many NOLS programming areas, the Winds are ideal for introducing NOLS' field practices. 

The course includes three components: a three-day leadership module taught in town, an eight-day backpacking expedition, and a three-day section of top rope rock climbing training.

Go to: www.nols.edu

NOLS Wilderness First Aid

Wilderness first aid training courses focus on preparing students for the unexpected, taking a hands-on approach to learning about applying first aid skills in the backcountry. 

Participants are taught how to provide effective treatments for common injuries and illnesses in the outdoors, and how to make appropriate evacuation decisions.

If you like to take short trips relatively close to medical resources, work at wilderness camps, enjoy weekend family outdoor activities, or recreate outdoors, this course is for you.

Go to: www.nols.edu