Willie<br>I think that there is a significant issues in question. First, what is a reasonable level of training to undergo to feel comfortable to provide emergency care. What equipment is it reasonable for a prepared layman to carry with him on an outing, and what are likely injuries to expect in a remote setting.<br><br>You mentioned the wilderness EMT program. The wilderness EMT program is an advanced medical program that advocates reduction of dislocations, advanced wound care, and use of medications that fall outside of the realm of the "usual" paramedic. There are many states that would not allow these treatments to be applied by a non-licensed practitioner.<br><br>I think for the average weekend "explorer" a basic red cross course in first aid is adequate. I would think that the majority of injuries can be handled with basic first aid and possibly external assistance in evacuation.<br><br>For a scout leader or someone with comperable responsibility for others, an EMT course might be appropriate. However, EMT courses focus on motor vehicle trauma with an emphasis on spinal immobilization and cardiac emergencies which are the "bread and butter" of an EMS system. Much of the equipment used in EMT programs is not available down in the boondocks.<br><br>As you and I have discussed previously, if I were approached by a layman planning a trip to the Boundary Waters Canoe Area, I would consider the inclusion of antibiotics; stuff for nausea, vomitting, and diarrhea; something for little pain and big pain; injectable corticosteroids; something for eye injuries and infections; and so on. I do the same for cruising sailors now in my practice.<br><br>How much of this stuff do you (1) want to carry and (2) are you REALLY gonna need on a weekend trip? What is the risk to the patient if they don't receive "advanced" treatment? <br><br>Responding to the question that you raised regarding wound care, there is no emergency in the treatment of a major soft-tissue wound. When a doctor is confronted with a laceration that occurred longer than eight hours ago or is heavily contaminated, appropriate treatment is to pack the wound with sterile gauze (dry or soaked with sterile saline or a dilute solution of betadine or clorox). The packing is changed daily for three days. If there is no infection after three days, the wound can be sutured with no increase in scarring and a far lower risk of infection. In the situation that you describe, there is no rush for definitive treatment.