This past weekend, I enrolled in a fantastic course on Wilderness First Aid, taught by instructors from the National Outdoors Leadership School (NOLS). I had heard positive things about NOLS from one of my best friends, which is why I couldn’t quite believe my luck when I saw that REI Pittsburgh was sponsoring this course in my city. Conveniently, it was only being offered on the weekend of June 3rd and 4th. I spend a monstrous proportion of my time in the outdoors, either hiking, backpacking, trekking, or just exploring the backcountry, both in India and the USA, and learning how to administer first aid to myself and to any fellow hikers struck me as a good idea.

After six years studying the environment, I thought I had seen everything possible in course teaching style and curriculums. I have taken classes in geology that involved scaling rock faces above highways, mucked about in wetlands while wearing a cotton skirt because I was too lazy to wash my field pants, and I have had professors ranging from meek and mild to dominating and chauvinistic. The instructors on this NOLS course were perhaps the best I have ever experienced in my many years of education. There were two instructors: a man and a woman. Both were employed by NOLS and both had the instinctive charisma and knack for conversation that are so many teachers lack.

Our curriculum was as diverse as it was intensive – which means I was exercising my brain far more than I have this past month since graduate school ended. It started off with the Patient Assessment System (PAS), which is basically an upside-down equilateral triangle of emergency medicine detective-work. Of course, given that our training is geared towards wilderness/backcountry medicine, we started off with surveying the scene, i.e. if the patient was mauled by an irritated grizzly bear, we wanted to make sure that said bear would not be waiting for its next meal in the bushes. We learnt how to assess life threats, conduct a head-to-toe assessment (note: if you are ticklish, this can be traumatic for you), and how to take vital signs. It was drilled into us multiple times that skipping even one step in the PAS could cost the patient his or her life. So naturally, we were a little more than stressed. Which, it turns out, is the prime method of ensuring that you do forget one or more steps…

Other topics covered were head and spine injuries, shock, wound management, burns, musculoskeletal injuries, heat and cold illness, dehydration, lightning, anaphylaxis, and animal bites. I turned out to be extraordinarily good at splinting, which makes sense since it’s very similar to stuffing a suitcase full of clothes, and I’m very efficient at packing. I also thoroughly enjoyed the animal injuries unit; no, it’s not because I’m morbid, but because I found out that I react well in emergency situations.

To practice our skills, we underwent a variety of scenarios, i.e. one-third of the class would be patients with various maladies and injuries while the rest of us would pair up and be responders. Our instructors proved to be adept at the art of moulage, and decorated us prettily with gruesome-looking bruises, cuts, lacerations, and even a very realistic amputation simulation. I returned home the first day with three large bruises painted onto my ribs and wrist, plus a gory wash of fake blood dripping down from my forehead. My father was less than thrilled to see the state of the car.

The scenarios were the best part of the course. For each unit, we underwent a variety of role-plays so that we could practice our new skills. I particularly enjoyed the detective work that went into these role-plays; one of my “patients” was lying on her back unconscious for no apparent reason, until I found fang marks on her neck. Upon moving her, I found a coral snake (a toy, not a real snake, don’t worry) underneath her. This taught me the importance of being thorough and trusting my instincts, values that anyone who spends time in the outdoors needs to cultivate.

Overall, I learned a lot of useful emergency medicine for situations that are remote and not within access of medical facilities. I may not be able to operate an x-ray machine or operate on a patient, but I can use an epinephrine auto-injector and bind a broken ankle now! And what’s more, I have never felt quite so empowered and capable as I do now that I have this certification under my belt.


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