Before I launch into who and what NOLS is. . . enjoy some photos of friends, clients, and me over the years (they go as far back as 2008, when I was but a wee one) in beautiful and remote places, partaking in what my mom would consider dangerous activities. Ok, she would think only some of them were dangerous. Now when you look at these, I want you to imagine “What could possibly go wrong?” (Absolutely nothing went wrong in any of these, by the way. . . except for one of them. More on that later. But I still want you to imagine, just to get in the mood for this blog;)

If you’re like my mom (or grandma) you’re probably feeling a bit nervous looking at some of these photos, even though I already assured you that nothing went wrong in any of them (except for that one. . more on that later). But if you are feeling nervous, that’s good! That means you followed directions and thought “What could possibly go wrong?” The truth is that any number of things could have gone awry in any of these photos. Some of them involved awfully sharp objects. . . some mighty long falls. . . some coooold water. But another truth is that there’s a lot of fun to be had in amazing and remote (or not so remote, nor so amazing) places. I’m not gonna stop doing this stuff! However, there are many ways that I, as a professional guide, can commit to mitigate the risks and consequences if something were to go awry. One of these ways is to educate myself in the wonderful ways of wilderness medical training.

And now there’s this:

Now for a little background: NOLS stands for National Outdoor Leadership School. Founded in Wyoming in 1965, it is a global nonprofit wilderness school that educates students around the world in leadership, wilderness skills, and risk management. You can participate in courses anywhere from 6 days Canyoneering in Utah, to 135 days in Patagonia. Rock climbing, sailing, backpacking, ski touring, sea kayaking, mountaineering, ice climbing. . . the list goes on.

(Don’t worry. I haven’t forgotten to get back to that one photo.)

I participated in a 3-month NOLS Semester Program in 2008 in Patagonia, Chile. Prior to embarking on consecutive month-long remote mountaineering and sea kayaking expeditions, we started off with a ten-day (80-hour) Wilderness First Responder (WFR) Course to learn the best practices for responding to medical situations (and emergencies) in a wilderness setting. For most of that program, we were more than a days travel to definitive care (and that would be if the horses could gallop!). A WFR course teaches students invaluable skills in how to prevent, determine, and take care of almost any medical situation “in the field” with the limited resources available (think of you with a med kit the size of a loaf of bread, ski poles, ice axes, and sleeping bags in lieu of a hospital filled with doctors, unlimited medical supplies, crutches, and a hospital bed). I’ll never forget the lesson on how to relieve testicular torsion. Unfortunately, no photo available. Yikes!

I also learned in my WFR course how to make good decisions regarding evacuations and group/risk management. In a wilderness setting I’m dealing with a lot more than simply a client with a belly ache. I’m dealing with the rest of the group, inclement weather, difficult terrain to accomplish a safe evacuation, spotty or non-existent communication with the “outside” world, and limited resources. Questions that WFR course instructors have drilled into my head are 1) Can this person stay on the trip, or do they need to be evacuated? 2) If they need to be evacuated, how and how quickly? I can’t just dial 911 (on my cell that has no service) and wait ten minutes for an ambulance with a team of medical professionals to whisk away my client who is complaining of abdominal pain. I am taught to become a detective to try to solve a medical mystery. However, more importantly, I know that it’s not necessarily essential that I figure out precisely what the cause of the mystery abdominal pain is, but I do need to make a decision and act on it. KC needs to go asap! I need to wrap her in a sleeping bag so she stays warm, keep talking to her to provide comfort and to monitor her, and use my satellite device to contact the office to get a helicopter here right now, as well as make sure that the rest of my group is warm, safe, and not freaking out. (This scenario is a true story, by the way. My co-guide, KC, got evacuated via helicopter from Columbia Bay on the last day of a 5-day sea kayaking trip in Prince William Sound, Alaska. From the moment she first approached me complaining of severe abdominal pain, to the moment that she landed at the hospital in Valdez, about 1.5 hours had passed. Not bad. Plus she got a heli ride over the largest tidewater glacier in the Sound out of it. She was fine, by the way.)

Here is a link to a DeLorme Satellite Communication device, similar to the one that I take on every trip. This is what saved us after it became clear that my VHF radio communication wasn’t going to do the trick. I highly recommend one of these communication devices. It could save your life, or the life of someone who you care about.

 

Now that I’ve been guiding professionally since 2010, and have dealt with medical situations, as well as evacuations, I see the value in fostering these decision-making skills. I know that it’s negligent of me to walk away after giving someone a cup of water whose breathing is labored and who is the color of a lobster, sitting directly underneath a bunch of coconuts on a tropical island. I’m a WFR! And along with that comes the responsibility to treat this person to the best of my ability. You never know who (and in what condition) you are going to come across out there.

 

To keep up with my skills and to continue honing them, as well as to keep my WFR certification current, I take a NOLS Wilderness Medicine Recertification course (3-day, 24-hour) every two years. These courses are scenario-based, which is the best way to get as much practice as possible responding to medical situations. This past October I completed my 4th course in Salt Lake City, Utah. These courses, often in beautiful locations, are challenging, fun, and a great way to meet others working as outdoor professionals. I highly recommend them. In fact, being a WFR is a requirement for a lot of jobs in the outdoor industry. Even if you don’t work in the outdoor industry, but you spend time in the outdoors (or not even), I still recommend taking a Wilderness Medicine course, or First Aid. There are varying levels of courses, depending on how far you want to take your training.

So get out there and get educated. Visit NOLS and NOLS Wilderness Medicine to learn more and to find courses, as well as for resources to assemble your own adventure medical kit (very important!). NOLS has a lot of other great activities and environmental initiatives going on as well, so check ’em out!

To all of you Ileneinakayak prospective clients, rest (and paddle) assured that I, your guide, will be up-to-date with my wilderness medical training.

 

Here are some photos from the NOLS Wilderness Medicine website to give you more of an idea of the fun that awaits you on these courses.

Oh yea, I almost forgot! The one photo at the beginning of this blog where something actually did go awry is the one with. . . . actually, you have to write in the blog comments which photo you think it is and what you think happened. I’ll mail the winner something cool! Good luck:)