W I L D E R N E S S M E D I C I N E I N S T I T U T E O F N O L S

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OFTEN IMITATED,NEVER DUPLICATED

With more than 75,000 graduates around the world, the Wilderness MedicineInstitute (WMI) defines the standard in wilderness medicine training. As aninstitute of the National Outdoor Leadership School (NOLS) our goal is toprovide the highest quality education and information for the recognition,treatment, and prevention of wilderness emergencies. When 9-1-1 is not anoption, the rules change. Our curriculum focuses on medicine for times whenresources are scarce, there is no help on the way, and you have to make yourown decisions.

WMI empowers people to act with confidence in emergency situationsby providing students with the tools and training to make complex medicaldecisions in remote environments. Our curriculum is evidence-based, relevant,and practical. We don’t just teach things that work in the classroom; weteach skills that work in the field. We seek out the best medical scienceto support our practices, and we work closely with a medical advisorypanel to ensure our students are receiving the most up-to-date and accuratematerial available. Often imitated, but never duplicated, we offer a widerange of course and certification opportunities tailored to meet your needs.

Designed as a fieldtextbook for theNOLS wildernessfirst aid curriculum,NOLS WildernessMedicine (above),written by WMIcurriculum directorTod Schimelpfenig,helps to train out-door leaders toprevent, recognize,and treat commonbackcountry medicalproblems.

Often imitated by other wilderness medicine organizations, WMI standsabove the rest as the leader in wilderness medicine education.

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NO ORDINARYCLASSROOM

At WMI, you’ll participate in a challenging academic program augmentedby realistic scenarios complete with simulated injuries. Our courses aredesigned to give you the confidence and decision-making practice youneed to handle medical emergencies in remote settings.

Days are filled with dynamic lectures and exciting, realistic scenariosto best model the kind of medical situations you might encounter,whether your work or play takes you hours or days from medical help.In the WMI classroom, you’ll get lots of personal attention, scenariosdesigned to enhance your ability to manage stressful situations, andplenty of fun.

Medical scenarios are the highlight of any WMI course, and we makethem so realistic you’ll feel like they’re really happening. You will feelthe pressure and stress of treating a medical emergency that will prepareyou for the real thing. WMI graduates around the world tell us every daythat real emergencies they have handled were “just like the scenarios.”

“The curriculumwas exceptionallywell-sequenced tocontinually buildupon prior learning.The pacing kept usalert by alternatinginformative lectureswith carefully chosenhands-on scenarios.These first aid andrescue scenarioscontinually placedstudents in situationsrequiring thinkingand analysis, ratherthan merely rotememorization.Furthermore, thevariety and fre-quency of scenarioskept reinforcingour learning ofimportant skills.”

– WFR gradDecember 1997

WMI practice scenarios know nowater, sand, or snow boundary.No matter where your backcountrywork or play takes you, WMI cangive you the practice and lessonsyou need to make informedmedical decisions.

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STUDENTS WHONEED TO KNOW

Our students have one important thing incommon: They are motivated because theyknow someday they might have to respond toa real emergency situation. They come to WMIfrom a wide variety of professional backgrounds;they are outdoor educators, guides, ski patrollers,urban EMS providers, remote researchers,

military special operators, or simply people who spend their free timein the backcountry.

Whether for work or play, students come to WMI because we set thestandards in wilderness medicine today. WMI certification is accepted byguiding and educational institutions around the world. When you receiveyour education from WMI, current and future employers know that you’vebeen trained by the best. In fact, many of our students discover a passionfor medicine at WMI and go on to careers as healthcare professionals.

“The knowledgeand skills I gainedat WMI have un-doubtedly boostedmylevel of preparednessfor mymany outdooradventure activities,and I look forward toapplying these skills ina variety of situations.The experiential,practical approachthat WMI espouseddeveloped not onlymy skills in firstresponse, but alsomy decision-makingskills and resource-fulness in a greatersense.”

– WFR gradJune 1998

Our students come to us because they know that someday they willneed to know enough to make competent, deliberate, and timelymedical decisions in the backcountry.

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WMI instructors are the best wilderness medicineeducators in the world. They know what it feels liketo make tough decisions in remote places becausethey’ve been there. WMI instructors possess a mix

of backgrounds ranging from wilderness expeditionsto urban and wilderness patient care to teaching in a

variety of settings worldwide. After a rigorous instructor selection andtraining process, they are well prepared to facilitate active, hands-onlearning. All of our instructors go through an instructor course intentionallydesigned to polish their educational skills and to make them the bestwilderness medicine educators in the world.

“From the get-go myinstructors projectedknowledge, compe-tence, and approach-ability. They taughtwith a delightfulmixture of seriousnessand flair, oftenconveying criticalpoints with memo-rable humor or vividimagery. Theirindividual teachingstyles were verycomplementary…their enthusiasmfor the content neverflagged and it wasquite infectious.”

–WFR gradDecember 2006

SEASONED &PROFESSIONAL STAFF

Making the best of a bad situation: This is the mantra for LauraMcGladrey Griebling when practicing wilderness medicine. “Thewilderness can be anywhere we find ourselves with a need toimprovise,” she says. “These skills could be applied by so manypeople, from mountain guides to village people in far away places,to nurses and doctors outside the ER who have to practice withouttheir normal tools.”

Laura, also known as “Glad,” works as a nurse practitioner in Portland, Oregon, andhas been a WMI instructor for the past nine years. She first experienced wilderness medicineby stumbling onto a Wilderness First Aid course in 1996 while working in the ArkansasValley as a guide.

“I was finishing nursing school, trying to escape the hospital world, and fell in lovewith wilderness medicine,” she said. “I loved the application of medicine in the wilderness,I loved the teaching style and, later, loved the way that improvisational medicine couldbe applied where medicine and technology are not readily available.”

Glad also teaches WMI curriculum in Spanish in Chilean Patagonia and the Dominican Re-public, where she worked in a clinic and taught local guides and teachers how torespond to emergencies. “I was teaching the same curriculum, even though they lived inthe city, because there was such limited health care there,” she said. “I realized then howeffective it was, instead of taking care of people one at a time, to train others and multiplymy efforts. That fueled a desire to apply wilderness medicine to the developing world.”

When describing her overall experience and relationship with WMI, Glad appreciatesthe multifaceted skills she has learned and used to teach others. “Working for WMI hastaught me to combine my hospital medical skills with the improvisation needed for searchand rescue, ski patrol, guiding, expedition medicine, and international work.”

LAURA MCGLADREYGRIEBLING WEMT, RN, FNP

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EVIDENCE-BASED CURRICU

ACCURATEAt the Wilderness Medicine Institute we seek the latest medical research andinformed opinions to maintain the most current and accurate curriculum forour students. The NOLS incident database, the largest and longest runningoutdoor program dataset in the outdoor industry today, gives us a snapshotof what medical incidents we are likely to encounter. Not only is the WMIcurriculum accurate, it is the most usable training available for people whowork and travel in remote locations.

“I've gone throughtraining in the past asa lifeguard, diver,and environmentalengineer and I'venever had as good anexperience as I hadwithWMI of NOLS.There was never asingle moment dur-ing the course ofthat class that Iquestioned weatheror not I was gettingliterally the besttraining availablein the US.”– WEMT gradSeptember, 2004

We pride ourselves on having a curriculum that is accurate, practical, and relevant, not only tosomeone learning in a warm, dry classroom, but to the person providing care in the wilderness.

WMI Curriculum DirectorTod Schimelpfenig

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ULUMPRACTICALWould you put two people in a sleeping bag to treat hypothermia?It doesn’t transfer as much heat as we might think; most patients are treated with dryinsulation, warm fluids and food, and allowed to shiver until they are warm.

Do you need to boil water for several minutes to disinfect it to drink?No, the water only needs to come to a boil. The advice to boil water for 2–3 minutes,or more, is conservative, unnecessary in most cases, and burns precious fuel.

What is the most common dislocation in the outdoors?80% of backcountry dislocations involve the shoulder, a statistic familiar to river guides.Our curriculum prepares you to manage these injuries by attempting reductionor immobilization.

RELEVANTIt’s day 5 of a 12-day wilderness trip for teenagers in a western U.S. wilderness area.The closest road is 12 miles away. You’re one of the trip leaders with current WildernessFirst Responder training. The patient is one of your participants. It is 8:30 a.m.

You have a 17-year-old male who is complaining of severe abdominal pain.The patient’s tentmates woke you at 6:30 a.m. and said the patient had severe bellypain. Patient states the pain began yesterday at 10:00 a.m. as “a bad belly ache,cramping-like” but it is now “sharp.” He thought it was indigestion. It persisted allnight and became “really uncomfortable” at about 10:00 p.m. last night.Would you stay or go?

Do you have the knowledge to decidewith confidence? To learn more go towww.nols.edu/wmi/curriculum_updates.

Wilderness medicine certification is requiredfor a wide variety of outdoor jobs worldwide.

BUILDING A WILDERNESS MCORE COURSE OFFERINGS

Wilderness EMT (180 hours)This is the ultimate WMI experience. The WEMTcourse is the most intensive combination of urbanand wilderness medicine training available. If youseek National Registry EMT-Basic certificationalong with WMI’s outstanding wilderness medicinecurriculum, this is the course for you. Our month-longWEMT program includes classroom education,ambulance-based medical practices, extensivewilderness scenarios, and clinical rotations atlocal hospitals. Many graduates use their WEMTcertification as a springboard to employment asmedical professionals in both urban and wildernessenvironments. Firefighters, search and rescuetechnicians, military operators, ski patrollers, andambulance teams all have raved about their WMIWEMT training. College credit is available.

Wilderness First Responder (80 hours)Pursuing a professional career in the outdoors? TheWilderness First Responder (WFR) course is for you.Essential for outdoor professionals, the WFR coursewill increase your medical knowledge, skills, andconfidence and make you an asset to any team.Expect to complete your course with a newfoundability to make tough medical decisions in remoteplaces. This 10-day course includes a compre-hensive wildernessmedicine curriculum that focuseson extended care and unique wilderness therapies.Our WFR course is pre-approved for 70 hours ofEMT CEUs, and college credit is available.

WFR Recertification (24 hours)Time to recertify? Join us for a three-day scenario-based course to review and practice evacuationand decision-making guidelines for current WFRs.Our dynamic, experienced instructors will refreshyou on current techniques, protocols, and contro-versies in the wilderness medicine field. Our WFRRecertification course is pre-approved for 18 hoursof EMT CEUs, and will also serve to recertify thewilderness portion of current WEMTs.

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MEDICINE FOUNDATION

Wilderness First Aid (16–24 hours)Are you an outdoor enthusiast? Maybe you work ata summer camp, or just love going hiking withyour friends and family. If you plan to spend timein the backcountry you need to be prepared. Fastpaced and hands-on, this two- or three-day Wilder-ness First Aid (WFA) course covers a wide range ofwildernessmedicine topics for people who travel andwork in the outdoors. If you need this certificationprofessionally, you’ll also be happy to know it ispre-approved by such organizations as the AmericanCamping Association, the United States ForestService, and other governmental agencies.

Wilderness Advanced First Aid (40 hours)Need to find a course that’s longer than a WFA butless than a WFR? River guides and certain tripleading staff may be required to have a level oftraining that falls in the middle. This five-dayWilderness Advanced First Aid (WAFA) coursefocuses on stabilization, treatment, and evacuationguidelines for patients in backcountry environments.More emphasis is placed on long-term patient caremanagement and specific injury evaluation. Thosewho seek a more extensive refresher than the WFRRecertification course may also use the WAFA forrecertification. OurWAFA course is pre-approved for32 hours of EMT CEUs.

For course dates and locations, to learn more about college credit and scholarships, orto sponsor a course, please visit us at www.nols.edu/wmi or call (866) 831-9001.

EXPAND YOURMEDICAL HORIZONSCONTINUING EDUCATION FOR PROFESSIONALS

If you are already a medical professional and you want to challenge yourmedical skills in the realm of wilderness medicine, we have courses foryou. These courses are specifically designed to help physicians, nurses,and EMTs apply their urban medical proficiency in remote settings whereequipment is minimal and the ability to improvise is crucial. WMI will provideyou with the latest information on decision-making principles guidingwilderness treatment and evacuation decisions, as well as ample opportunityto apply your improvisation skills.

Course Types:• Wilderness Medicine Practices and Protocols (24 hours)• Wilderness Upgrade for Medical Professionals (48 hours)• Medicine in the Wild (26-day medical student elective)

These activities have been planned and implemented in accordance withthe essential areas and policies of the Accreditation Council for ContinuingMedical Education (ACCME)through joint sponsorshipof the Wilderness MedicalSociety and the Wilderness Medicine Institute of NOLS. Category 1 CMEsare available.

Additionally our courses have been accredited through the ContinuingEducation Coordinating Board for EMS (CECBEMS) to provide continuingeducation for EMTs.

“The scenarios werethe most fun andeducational for me.They allowed me tostep outside the boxof the way I think atwork in a hospitaland use criticalthinking skills ina different way.”– WUMP gradFebruary 2008

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The Gila Wilderness provided WMI grad Becca Parker-Johnson abackdrop to work with coursemates to transfer their urban medicalknowledge into backcountry practices. As a resident surgeon inSeattle and graduate from Drexel University’s medical program,Becca found her WMI training to be a valuable additional asset.

"[WMI’s] Medicine in the Wild was an excellent course at theend of four years of medical school,” Becca said in the 2007 fall editionof Wilderness Medicine magazine. “I had the chance to reviewand adapt the practices that I'd learned, focus on the teamwork

skills that will make me a better resident and doctor, and think critically about how I learnand teach. WMI has the best outdoor wilderness medicine program in the country.”

Becca had grown up loving NOLS “from afar” and inevitably discovered WMI whenshe was looking to combine outdoor skills and medical training. She first came to WMIin 2001 as a student on a Wilderness EMT course, later following up with the WildernessUpgrade for Medical Professionals course in 2003 and Medicine in the Wild in 2007.

“What keeps me coming back to WMI is that they can turn something extremely complexinto basic concepts that you can practice. They use the method of teaching and doing, whichhas helped me to teach others,” she said. “The training I received from WMI is invaluablebecause I gained the background knowledge to be an innovative problem-solver, as wellas the knowledge that helps in triage where I need to focus and prioritize.”

While Becca’s experience with WMI has added value to her professional career, it hasalso benefited her in recreational pursuits. Of having to stabilize a dislocated finger duringa recent hiking venture, she said, “WMI provided me with the mental training that helped meto stop and think about the situation, what I needed, and how to handle the problem.”

BECCA PARKER-JOHNSONRESIDENT SURGEON

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The University of California at Santa Cruz (UCSC) has one of thenation’s leading recreation programs and sponsors a variety ofWMI courses offered to students and members of the community.

UCSC’s Recreation Department and WMI began their part-nership in 1996 when the university hired WMI to teach twoWilderness First Aid (WFA) courses. Since then, the program hasgrown and UCSC now offers three Wilderness First Responder(WFR) courses, three WFR Recertification courses, and six WFAcourses through WMI. “The growth was slow in its beginnings,”

said Kathy Ferraro, UCSC’s Recreation Supervisor, “but the classes have been filling soquickly with 25 to 30 students in each. WMI has been great to work with. We wanted anorganization that was nationally recognized and we really appreciate the opportunity tohost their classes. It has allowed hundreds of our staff over the years to get the necessarytraining at affordable prices.”

Kathy is one of those staff members to benefit from the UCSC partnership with WMI,having taken several WFA courses and a WFR course, which she states was an invaluableeducational experience. “WMI provides the kind of support and professionalism you can’ttrade in,” she said. “They’re outstanding.”

Kathy, who was formally a Red Cross instructor, remembers how her first experiencewith WMI helped hone her skills and sees firsthand how it helps dozens of students everyyear in the same way.

“The final night scenario in a WFR is so real because you’re dealing with major injuriesand having to evacuate the patient. It was a really powerful experience because you’re inthe moment,” she said, noting the importance of scenarios. “I’ve really appreciated WMI’suse of scenarios as a teaching method because I am more engaged and learn more thanI would in a classroom.”

KATHY FERRARORECREATION SUPERVISOR AT UCSC

S P O N S O R P R O F I L E WWW.NOLS.EDU/WMI

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AROUND THE GLOBE

Scandinavia (above) and Uganda(below) are only two of manyinternational locations that havehosted WMI courses.

The Wilderness Medicine Institute offers approximately500 courses each year in 35 different states and a widevariety of international locations. To date, we have run coursesin Australia, Brazil, Canada, Colombia, Costa Rica, Chile,Ecuador, Hong Kong, India, Japan, Great Britain, Kenya,Mexico, Malaysia, Nepal, New Zealand, Norway, Peru,Uganda, South Africa, Sri Lanka, Sweden, Thailand, andTanzania. Students have received their WMI educationnot only in English but also in Spanish, Swedish, andJapanese. Additionally, WMI conducts courses regularlyon the continent of Australia with its peers in Swan Hill,Victoria (www.wmi.net.au/wmi).

In 2007, historically known for its presence in thewestern United States, WMI entered into a partnershipwith Landmark Learning of Cullowhee, N.C. to provideWMI’s wilderness medicine curriculum in the AmericanSoutheast (www.landmarklearning.org). Founded in 1996by Justin and Mairi Padgett, Landmark Learning providesa wide range of rescue and medical training includingswiftwater rescue, wilderness lifeguarding, and EMTcourses in addition to a full range of wilderness medicinetraining. In 2005, Landmark Learning created a ReliefMedic program that takes WFR and WEMT graduates toSouth America to provide clinical coverage for under-served villages in the Amazon Basin and SouthernAndes. During these 18-day programs, WMI graduatesget the chance to practice a wide range of wildernessmedicine in a truly remote setting.

WMI IN ACTIONChris Nielsen, WMI Wilderness Emergency Medical Technician

“Last summer, I was fighting fire for the Bureau of Land Management in eastern Idaho. Ihad the opportunity to spend 16 days with the Snake River Hotshots and also had theopportunity to use my wilderness medical skills.

One of our sawyers had a snag strike him on the helmet. When I arrived on scene,he was responsive, alert, and well-oriented (A&Ox4). I determined there was a definitemechanism of injury for spinal injury, so I had another EMT control the patient’s spine.We were many hiking hours away from an extraction point where a vehicle could reachus and at least a half hour hike from a helicopter landing zone. I determined we were atleast one hour from definitive care, so I decided to perform a focused spinal assessment.This assessment would allow me to make a reasoned decision on whether my patientneeded spine immobilization. If not, we could have him walk out rather than carryinghim. This approach would also save resources that were needed elsewhere on the fire.

The patient passed the focused spinal assessment and remained A&0x4; he wassober and reliable; he had normal circulation, sensation, andmotion in all four extremeties with no distracting injuries;and he denied spine pain or tenderness. We releasedour control of the spine and slowly hiked to thehelispot for extraction. My knowledge and actionspermitted us to safely evacuate the patient withoutrequiring a very complicated, dangerous, andexpensive medevac.

That’s the first time I’ve ever been in asituation where I was the most medically qualifiedand everyone looked to me to make the final decision onpatient care. There was another EMT, but because of ourlocation, he deferred to my wilderness training.”

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WEMT grad Chris Nielsen (right)fights fires with the Bureau ofLand Management.

THE LEADER IN W I LDERNESS MED I C INE EDUCATION

The Wilderness MedicineInstitute of NOLS284 Lincoln StreetLander, WY 82520-2848www.nols.edu/wmi • wmi@nols.edu(866) 831-9001

Photos front cover: David Anderson (top) and Shana Tarter (bottom)Photos back cover: Kevin Kerr (top) and Brad Christensen (bottom)