I remember seeing one of these in Phoenix at a place run by Mistress Tina.
She was very popular.
Perhaps you know her.
<img src="images/graemlins/blush.gif" alt="" />

Worked for me.
Brought back old memories.
Ah, to be young and foolish again.

<img src="images/graemlins/wink.gif" alt="" />

]JAKE[

Are you living in the urban or rural part of England ?

Give us the type of situation that you will face so that we are able to give you some idea of what to put in your FAK.

Just FYI, this list is more the basic "urban" list. There are other courses that sort of give you a "wilderness" endorsement ('Wilderness First Aid", "Wilderness EMT" or "Wilderness Paramedic"). Basically what they do is give you more training to deal with injuries when you are more than like 1 hour away from medical care (not sure of exact time limit, or even if there is one). From what I've read and been told, there are many things that are taught in Wilderness courses that you cannot do in an urban setting. These things usually increase the chance of survival, but in an urban setting that is best left to doctors.

Do you have example in mind of what "wilderness EMT" would do that regular EMT couldn't? I'm just curious. I just thought that such courses put big emphasis on improvising supplies and carry out methods (which we learn anyway) since not everything that I have in the ambulance can be packed into the woods.

On the other note.
I looked thru a wilderness medicine handbook that comes with most of the "Adventure Medical" First Aid Kits and they showed a weird way of keeping tongue out of your way in order to keep airway clear. They basically took safety pins and punctured your tongue and lower lip which held them together therefore out of harms way. I showed it to a doc in the ER since I was wondering if you could just puncture flesh like that. He vowed to write to the guy who wrote a book (also a doctor) to take it out of there due to possible complications (infection, tears, muscle/tissue damage).

Matt

One example that comes to mind is the reduction of shoulder dislocations, an injury that is not uncommon in rough terrain (climbing, avalanche, etc). IIRC that's something an urban EMT would leave to the hospital staff, but in a truly remote situation the PT is better off getting the shoulder reduced in the field.

Some wilderness medicine links:

http://www.pitt.edu/~kconover/ems.htm#top (great resource!)
http://www.soloschools.com/wemtmod.html
http://www.nols.edu/wmi/index.shtml
http://www.umm.edu/outdoor/index.html

Depending upon the Wilderness 1st aid/EMT/EMT-ALS program you take, there may be a different emphasis on both the improvising of equipment/supplies as well as performing various skills that would not normally be practiced in an urban setting. Some examples of equipment improvisation might include using a SAM splint for a C-collar, not only the idea of using it for that purpose, but also learning how to bend and configure it to provide the correct support and fit. For ALS the use of a self-contained finger pulse ox, which might not be FDA approved. The use of a digital outdoor thermometer (the kind with a metal probe on a wire, where the meter portion is normally kept indoors), which can be used for taking continuous rectal temperatures for hypothermic patients. The probe is pre-coated and cured with silicone sealer to prevent soft-tissue injury. In-the-field reductions of dislocations. Splinting/taping methods that will allow the patient to continue to use the affected limb, so they can continue to travel. The use of I.V. antibiotics and other medications for long term management of trauma patients in areas such as caves, where removal of the patient can take days/weeks. Many states have Wilderness protocols in place, which the individual jurisdictions can implement at the discretion of the Medical Director. Generally, individuals who have only Wilderness EMT/EMT-ALS training without state level EMT/EMT-P certification/licensing cannot implement those skills and still be protected by law. Exceptions to this may occur on federal lands, such as National Parks, where the rangers may have WEMT and can implement those skills to which they have been instructed. Pete

Wow that looks like something I want to get involved with.

I use my own pulsox (bci digit) that I bought out of my own pocket so I can get constant reading on the patient so I can work on other stuff but keep eye on vitals. I never knew there was a restriction on use or special trainign for that. I know about pulsox limitations but not restrictions.

Matt

There are certain pluse-ox devices that are often sold for use by the general public in helping them with their excersie programs, but they are not FDA approved. Here is an example:
http://www.rei.com/online/store/ProductD...p;amp;langId=-1

Here are some web sites for the self-contained finger model:

http://www.coralmed.com/index.cgi?page=pulse_ox.html&cart_id=4497140_24272
http://www.scantechmedical.com/onyx.htm
http://sales.reddingmedical.com/merchant.cfm?id=1147&step=4


They work the same and may even be the same model, but the ones for the general public are marked/listed as "not a medical device". Pete