Wilderness First Responder

[andrewbanandrew]

I am thinking about working at a summer camp sometime in the future and I thought it might be a good idea to look into a WFR course. I understand that they are relatively expensive ($550-700) but I would like to know if anyone has taken any courses with the following organisations, and if you have, what your impression of their teaching skill was.

 

I looked online and the only ones that really fit into my long-term schedule are through either the WWU Outdoor Center or an outfit in Leavenworth called Rescue Specialists. The WWU one is backed by NOLS and Rescue Specialists is endorsed by the Wilderness Medical Associates. I am not sure if this has any influence on the quality or breadth of the courses, I would assume that quality is mostly influenced by the particularly person who teaches it and scope of the course would hopefully be a standard set of skills put forth by whoever made up the WFR certification.

 

I know it might be a bit overkill but I've been wanting to do this for some time now anyway because it seems like useful knowledge/skills to have.

[Blake]

Work at the outdoor Center @ WWU for a while, or lead a few trips, and they will help pay for the WFR. PM users Alpinist_Andrew or Masternate32 for info and experience in this.

 

FWIW I took a WFA class from WMI/NOLS last fall in Bellingham. It was very good.

[chelle]

I took the class by Rescue Specialists in 2002. It was excellent and completely worth the cost.

[cj001f]

If you've scheduling issues look into taking an EMT course from your local community college or an OEC course from your local ski patrol. They also tend to be cheaper. like $1-300 bucks and evening classes a couple times a week vs. a week off whatever and $7-900 for WFR

[dkemp]

I took WFR at Rescue Specialists two years ago. Instruction is top-notch and the facility is fantastic. Recommended!

[Gary_Yngve]

I took WFR at WWU last year, and it was excellent.

[Gary_Yngve]

If you've scheduling issues look into taking an EMT course from your local community college or an OEC course from your local ski patrol. They also tend to be cheaper.

 

I don't know about the OEC course, but it sounds similar to the WFR.

 

I would strongly recommend against an EMT course.

 

1) Urban and wilderness medicine are so different.

Urban: all the equipment you can ever need, goal is basically to stabilize and transport to ER in around 20 minutes. You don't really clean and dress wounds, splint bones, etc. because the ER folks do that.

Wilderness: lack of equipment, could need to nurse the patient for days before evacuated to a hospital. You have to plan everything.

 

2) An EMT course is not likely to spend time on things such as altitude illness and more likely to spend time on things such as very old patients too sick to ever go outside.

 

3) A WFR course will consist of your peers. An EMT course will consist largely of underachieving folks who didn't go to college and are looking for a career of ambulance driving for $10 an hour. (Please contest this point here (I have sources who tell me this is true), and please save any flaming of my elitism for Spray.)

[cj001f]

3) A WFR course will consist of your peers. An EMT course will consist largely of underachieving folks who didn't go to college and are looking for a career of ambulance driving for $10 an hour. (Please contest this point here (I have sources who tell me this is true), and please save any flaming of my elitism for Spray.)

Dude, you are a fucking arrogant prick aren't you? Because the WFR courses I've seen consist of a bunch of young middle and upper class slackers looking to get a job in the "industry" to go with their soul patch, birkenstocks, carhartts and copiously stickered and brandname bedazzled paraphenalia.

 

EMT and WFR are at opposite ends of the continuum, with OEC in the middle. EMT is focused on quick transport, OEC transport with say 30 minutes, WFR longer. People still break in similar manners, I'd think a bright boy like yourself could come to terms with that.

[Gary_Yngve]

I know several folks who've taken EMT or WFR, one who's taken both separately, and a few folks who've driven for AMR.

 

Everyone recommended me for WFR and against EMT.

The folks who've driven for AMR were embarrassed by the apathy and lack of ambition of their colleagues. The folks who care about their jobs and want to improve themselves are the ones who become firefighters, paramedics, etc.

 

If you want the urban training as well and you can afford it, I would suggest the WEMT, which is basically EMT + WFR, and your classmates will all be outdoorsy.

[iain]

If you plan to use the medical training in a "professional" capacity (mountain rescue, ski patrol, etc) it should be noted that states like Oregon don't recognize a WFR "certification" at all. There are no official guidelines on what a WFR is, and anyone can teach a course and call it a WFR. Many of the things you are taught in your WFR could land you in trouble if you try to do them "on the job".

 

The EMT certification is fully recognized, and standing orders from a medical advisor can be made to establish what is and is not within their scope of practice.

[Gary_Yngve]

Good point, Iain.

[ketch]

Iain, you make an excellant point. There is one other thing in regard to that. Where I am at the fire dept. requires all volunteers to be first responder or EMT certified. What I discovered is that the FR is practicum based, the WFR is based on an understanding of physiology involved. End of a long story is that WFR does not cover emergency deliveries and ambulance based care. My WFR allowed me to challenge the entire rest of the certification and pass after a little tutoring (3 hrs) to cover the missed items.

[cj001f]

If you plan to use the medical training in a "professional" capacity (mountain rescue, ski patrol, etc) it should be noted that states like Oregon don't recognize a WFR "certification" at all. There are no official guidelines on what a WFR is, and anyone can teach a course and call it a WFR. Many of the things you are taught in your WFR could land you in trouble if you try to do them "on the job".

tangent: I don't believe most states "recognize" ski patrollers. Acceptable qualifications vary from patrol to patrol - some will only take EMTs, some OECs (a NSP administered program which WFR holders can challenge) some both. I've seen a somewhat similar patchwork for mtnrescue ops, but you probably know better than I. Your point about an accredited credential is good.

[Gary_Yngve]

In my WFR class, we pretty much neglected pediatric, geriatric, and obstetric care. Though we did use stethoscopes and BP cuffs and administer an intramuscular injection, we didn't use the other tools of a modern ambulance: O2, suction, EKG, etc. Our CPR also was just Adult CPR.

[goatboy]

While I understand all of the points and tangents being made, the original poster said he wants a medical training to work at a "summer camp" and a WFR would be considered industry-standard for that particular role. No need for EMT or any higher levels of training to work at a summer camp...

 

I'm wondering what an example is of a WFR-skill which would get you in trouble for doing it "on the job"?

[Gary_Yngve]

I'd imagine all of these without specific authorization from a higher authority:

 

reducing a dislocated shoulder

 

conducting a focused spinal assessment and deciding that immobilization is no longer needed

 

assisting a patient with epi or nitro

 

cessation of CPR after 30 minutes of a warm body with no signs of life

[cluck]

I recently took the WMI/NOLS WFR course and thought it was top notch (note WMI is different than WMA). The curriculum was very practical and seemed slightly geared toward camp counselors or wilderness group leaders.

 

Like Iain said, they did teach us some things that we're really not allowed to do without standing orders from a physician. For example, we were trained how to reduce dislocations but told it was outside of the scope of practice for a WFR.

[Gary_Yngve]

But cluck, if you had a WFR and were working for NOLS and had a standing order from their medical advisor that it's ok to reduce dislocated shoulders, patellas, or fingers when more than X hours from definitive medical care, then you would be in the green to perform it in the backcountry while working for NOLS.

[iain]

I'm wondering what an example is of a WFR-skill which would get you in trouble for doing it "on the job"?

 

Prescription injectables like epinephrine tend to be a particularly hot topic when it comes to scope of practice for WFRs, but it is entirely up to the protocols of the program under which you are operating.

 

Be sure to establish what your boundaries are on spine clearance procedures and document the hell out of everything you do if you decide there is greater threat to life if you don't move someone immediately.

 

The bottom line is to thoroughly understand what your organization's guidelines are, and how you are protected as an employee. The WFR is a solid certification for the job suggested in the original post, and if you are sued, I believe you could be protected to some degree by expert testimony if you follow WFR procedure, but I am NOT a lawyer! If you go outside the often narrow limits of practice set by your program, you're on your own!

 

Even if you cannot do some of the procedures taught in a WFR to your "clients", I'd wager your coworkers would be happy for you to administer epi, for example, if they were asphyxiating. I have certainly given the green light for anyone with a WFR to perform everything taught in that course. Perhaps this is the most likely scenario for which you would be using your WFR skills.

[John Frieh]

But cluck, if you had a WFR and were working for NOLS and had a standing order from their medical advisor that it's ok to reduce dislocated shoulders, patellas, or fingers when more than X hours from definitive medical care, then you would be in the green to perform it in the backcountry while working for NOLS.

 

Or more likely you would get on the horn and call for a chopper. (EDIT: depending on dislocation)

 

Fun trivia: what is the longest a student went without shitting before they had to be airlifted out with impacted stool.

Edited January 9, 2006 by John Frieh

[iain]

Just to add, strict protocols that limit your abilities as a WFR can be to your advantage as a trip leader. For instance, a policy that anyone who has experienced unconciousness must be evac'd makes your course of action very clear, and you can be protected by this. Sometimes it pays to have a pre-determined decision-making process in place, taking the burden of these extremely important decisions off of the individual leader.

[Gary_Yngve]

Yeah, if you can get an evacuation within a few hours, then sure, splint it as is, and call it good. But if it's going to be a while, the patient's prognosis will benefit from an early reduction with minimal risk (and of course document CSMs before and after).

[iain]

Just whatever you decide to do, document it w/the time, and get a witness if you can. If you don't document, it didn't happen. Just remember your knowledge about what is actually happening to the body is minimal.

 

Many people come out of WFR courses thinking they are joe rescuer. Kindof frightening the serious decisions you are making after only 80 hrs of instruction and zero hrs of experience.

[Stephen_Ramsey]

An EMT course will consist largely of underachieving folks who didn't go to college and are looking for a career of ambulance driving for $10 an hour.

Gary,

 

Why the hate, bro? Seems to me a lot of EMTs are smart hardworking folks. Probably many of our city's Medic One paramedics (who are highly trained professionals) started out as EMTs.

 

[corvallisclimb]

I took a Wilderness EMT, best of both. Just an EMT course with a WFR.