Advanced Wilderness Life Support Course

Day Four

The morning began with the last lecture which was really more of a group scenario discussion in the lecture hall covering infectious disease in the wilderness setting. Following this lecture was another highlight of the course: the dissection of an Epi-pen. Ben took an expired Epi-pen and showed the class how to inject the initial dose, but then how to cut off the back half of the cartridge to gain access to the syringe which contains two to three extra doses of epinephrine. In the austere setting with hours of evacuation likely, this skill could be life saving with severe anaphylaxis. We also discussed theories on why there would be multiple extra doses that are inaccessible to the general population, but did not reach any definitive conclusions.

After lecture, we took the course final written exam and then assembled back outside for a few more group scenarios. One patient required initial C-spine immobilization and fracture splinting and slinging of his arm. Another interesting tidbit that I learned: after splinting a fractured upper extremity, if you do not have a sling, you can wrap the injured arm in the patient’s fleece or sweatshirt or shirt with a safety pin securing it in place. A different patient experienced anaphylaxis requiring treatment with an Epi-pen, and another was experiencing crushing, substernal, exertional chest pain while climbing a mountain – a scenario that emphasized the conundrum of medical evacuations.

Evacuation considerations are huge in the wilderness due to limited medical capabilities and the often remote locations. Medical evacuation can be very difficult or nearly impossible depending on the number of patients, the severity of injury, the number of rescuers, the distance to be traveled to further evacuation or definitive care, and the manifestation or progression of injury or illness. Deciding when or how to evacuate a patient from the wilderness was probably the most important point of this course, and a point that was emphasized excellently by the instructor staff.

After the scenarios, we ate our last lunch as a class and each team had one last competition playing corn hole. After determining the winning team, we all sat around the firepit for final discussions, handing out AWLS cards, and Wild Med Adventures swag going to the winning team  – hats and beanies and stickers, etc. After final goodbyes, we all dispersed, packed our gear, and headed our separate directions. It was an incredible weekend of learning and meeting new professional friends.

In Summary

The venue was perfect in the Adirondacks surrounded by a lake and the wilderness and living in tents away from the world with meals provided by camp staff and without access to the internet. It allowed the class to focus on each other, learning the material, and experiencing the wilderness in a way that would never be possible in an urban setting and a conference room.

The instructor staff was phenomenal. Ben recruited a world class team of experienced, professional instructors each with their own niche in the wilderness. But the best part was that each instructor was a normal person, informal in their approach, and willing to guide and teach and learn along with the students.

The lectures were an ideal balance of bird’s eye view but with appropriate details emphasized. This was important with such widely diverse student backgrounds. The practical labs and patient scenarios likely provided the best learning of the entire course since they covered material just learned in the classroom and again emphasized the important aspects of each subject. Additionally, this was a certificate course that is valid for four years and pluses up the resume for those pursuing wilderness medicine opportunities. It also provides 20.5 hours of continuing medical education credits for medical professionals needing CMEs, and it’s a blast. Additionally, this is incredibly valuable information if you are an adventurer and go to remote places frequently, do yourself a favor and take this course, it may save your life or the lives of your loved ones.

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Wild Med Adventures is a great company that is growing daily and offers many other opportunities for learning and CME. Ben and Jenni really set the tone for their company with their professionalism but informality and flexibility that is necessary for enjoyable hosting. Check out their website and strongly consider attending a course with them in the future.

-Brad

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