Wilderness Medicine Course Syllabus

“It was excellent to learn the skills of evaluating a
casualty in the real world before starting
clinical rotations. I feel much better prepared.” 
-MSIV 2007

INTRODUCTION

REVIEW OF MEDICINE ABD PHYSIOLOGY

• Exercise physiology
• Physiologic mechanisms of heat exchange
• Physics and physiology of altitude
• Physics and physiology of depth
• Nutrition in extreme environments
• CPR review

WILDERNESS MEDICINE PLANNING CONSIDERATIONS

• Weather
• Children, pregnant women and elderly in the wilderness
• Chronic medical conditions in the wilderness
• Death and dying in wilderness travel
• Planning for individual and group travel
• Immunizations for exotic travel

GEAR

• Clothing for extreme environments
• Medical kits for wilderness travel
• Foot gear
• Stoves
• Backpacking gear and skills
• Shelter and exposure control
• Vector control, repellants, and barriers
• Safety and security while traveling
• Compass and map reading

WILDERNESS PUBLIC HEALTH ISSUES

• Wilderness water procurement and treatment
• Field sanitation and hygiene

LAWS AND ETHICS IN THE WILDERNESS

• Standards of care
• Duty to act
• Good Samaritan Laws
• Negligence
• Patient Rights
  (Civil Rights, Consent and Implied Consent,
  Right to Refuse care, Minors)

WILDERNESS MEDICINE

• The basic approach to ANY emergency situation
• Medical assessment of the wilderness traveler
  ~~Scene size-up
  ~~Triaging
  ~~Initial Assessment (Primary Survey: A,B,C,D,E)
  ~~Focused Exam (Vital Signs, Hx, PE, Documentation)
  ~~Ongoing Assessment
  ~~Relaying Assessment and Plan
• The evaluation and management of trauma in the field
• Wound cleaning, closure, dressing, and infection treatment
• Shock/Homeostasis
• Sports medicine (sprains, strains, dislocations, and breaks)
• Field dentistry
• Foot care
• Environmental Illnesses
  ~~Anaphylaxis
  ~~Solar protection
  ~~Lightening strikes and burns
  ~~Near drowning and submersion
  ~~Heat related illness and dehydration
  ~~Cold related illness
  ~~High altitude disorders
  ~~Dysbarisms and barotraumas
  ~~Avalanche
• Infectious Disease
  ~~Traveler's diarrhea
  ~~Tick-borne illnesses
  ~~Viral hemorrhagic fevers
  ~~Malaria
  ~~Parasites and protozoa
  ~~Antibiotic selection
• Altered consciousness
• Pain management
• When Animals (and Plants) Attack
  ~~Marine creatures
  ~~Mammalian attacks
  ~~Reptile envenomations
  ~~Insect and arachnid envenomations
  ~~Plant dermatitis

COURSE CONCLUSION

• Course critique
• Final exam and review
• Final Practical: Search and rescue

PRACTICAL SESSIONS

• Group Dynamics
• Map and compass reading
• CPR and emergency resuscutation
• Physiology case discussions
• Planning for individual/group travel
• Wound management
• Splinting and improvised splinting
• Management of shock and trauma
• Environmental emergency situations
• Field bites and envenomations
• Multi-party disasters
• Search and rescue (day and night sessions)