Wilderness Medicine

A Wilderness Medicine Class at the Nantahala Outdoor Center

A Wilderness Medicine Class at the Nantahala Outdoor Center

Adventuring in the outdoors often takes you to places far removed from hospitals where you might receive definitive medical care.

A response to any call for emergency help--assuming you have the means to make such a call--might be delayed considerably depending on weather conditions, and other challenges involved in getting to you.

Add to that the time it takes for EMS to transport you from the wilderness location to a hospital, and it may take hours, maybe days, before the patient is wheeled through the big double doors of a fully equipped Emergency Room.

In such times, having some training in wilderness emergency medical care can make a difference in a patient's outcome.

You may, for example, be able to:

  • reduce a dislocated shoulder thereby preventing permanent damage to the patient's limb.
  • provide knowledgeable long-term wound care to help prevent a severe infection.
  • build a traction splint out of a boat paddle, tree limb, hiking poles, or whatever is available, thereby easing the pain of a fractured femur, and preventing further damage caused by sharp bone ends.

Urban Medicine Compared to Wilderness Medicine

Urban Medicine

For EMTs and Paramedics riding an urban rescue rig, the time it takes to deliver a patient to the hospital emergency department is often less than one-half hour. In fact, for a trauma patient, the very idea is to "load and go" and deliver the patient to definitive care within an hour of his or her injuries--often called the "Golden Hour."

Available equipment generally includes backboards, commercial traction splints, oxygen, suction machines, and a host of other items that improve the delivery of emergency medical care.

Wilderness Medicine

In a remote wilderness setting, however, most such equipment is usually not available. Good emergency care often depends on a knowledgeable caregiver who properly
  • assesses and monitors the patient's condition.
  • develops an appropriate treatment plan.
  • improvises what is needed to carry out that plan.

Further, that caregiver may be responsible for patient care for hours or days, not just minutes. That challenge often includes protecting the patient from a harsh environment.

As you can imagine, the challenges of dealing with illnesses and injuries in the wilderness, where "load and go" is not an option, are somewhat different than picking up a patient on Main Street in a well-equipped ambulance, where the Emergency Room is only minutes away.

Specific Training in Wilderness Medicine


To meet the challenges of delivering pre-hospital care in the wilderness environment, Frank Hubbell and his wife Lee Frizzell founded in the early 1970s an organization called Stonehearth Open Learning Opportunities (SOLO), which specialized in teaching courses in wilderness medicine. Frank's keen interest in medicine, by the way, led him to become first a Physician's Assistant, and finally a doctor.

Today, SOLO's home base is in Conway, New Hampshire. There are also two satellite locations--one at the Nantahala Outdoor Center, near Bryson City, North Carolina, and another in Colorado.


Sort of a "spin-off" from SOLO was the Wilderness Medicine Institute (WMI), founded by Melissa Gray and Buck Tilton. Originally, WMI was located in Colorado. It is now owned by the National Outdoor Leadership School, and is headquartered at Lander, Wyoming.

Both Are Excellent

I've received training from both SOLO and WMI, and I've found both of them to be nothing less than excellent. In the United States, SOLO's presence is seen mostly east of the Mississippi, and WMI's presence is mostly out west. That could be changing, though, with time.

For training in Wilderness First Aid, Wilderness First Responder, or Wilderness EMT, you can't go wrong with either of these organizations.

In fact, I first got my Wilderness First Responder (WFR) training from WMI. Later, I got my Wilderness EMT (WEMT) Certification (via an urban upgrade) from SOLO. There's no way I could say one organization is better than the other. They both have excellent programs.

Improve Your Competence

The levels of training include:

Wilderness First Aid (WFA)

-- Usually about a 16-hour course.

Wilderness First Responder (WFR)

-- Usually about a seven-to-ten day course.

Wilderness Emergency Medical Technician (WEMT)

-- Usually about a four-week course, after which you take a test to be certified as a Nationally Registered EMT, and perhaps also attain a state license in some state.

Wilderness Upgrade for Medical Professionals

-- Usually about a five-day course to get nurses, doctors, Physician's Assistants, urban, First Responders, urban Paramedics, and urban EMTs up to speed on the challenges of wilderness medicine, and the solutions to those challenges. Urban First Responders are granted the WFR certification, and urban EMTs and those with higher medical training are granted the WEMT certification.

Check with each organization--SOLO, WMI, or both, regarding their specific requirements and certifications.

WFR Typically Fills the Bill

For many outdoors enthusiasts, the Wilderness First Responder course fills the bill. It involves more training than WFA, yet not as much as WEMT.In fact, the Wilderness EMT course may be "overkill" for most people.

If, however, you have a specific interest in emergency medical care, or if your job requires it, you may want to go all the way and become a WEMT. Both groups can help you do just that.

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