The History of Wilderness EMS
As put together by Keith Conover, MD, WCP
The Timeline of Wilderness EMS
June 1960
Mountaineering Freedom of the Hills includes a chapter on First Aid in the mountains
June 1967
Medicine for Mountaineering first published by The Mountaineers
Feb-83
1970's: NASAR Emergency Medicine Committee
First, I would like to recognize the early work of Stan G. Bush, who was chairman of the Emergency Medicine Committee of the National Association for Search and Rescue -- in the 1970's, he invested a big part of himself in propelling the idea of what originally was then called Wilderness Medical Technician.
Therefore, the first document is a letter he sent to us, the members of that committee, in order to push the idea and the process of developing a consensus-based, peer-reviewed curriculum for SAR team medical personnel.
- February, 1977: REPORT: OR -- The First Step in the "Second Mile"
Early 1980's: end of the Stan Bush/NASAR Emergency Medicine Committee Era
Next is a document I prepared for the NASAR Emergency Medicine Committee in 1980, which really didn't go anywhere, but is an interesting reflection of our thinking at the time. I haven't bothered to scan in the latter parts of this document, it's really just a listing of some of the topics of the national EMT-Paramedic curriculum as it existed at the time. Note also that this was before the 1986 survey by WEMSI that determined that SAR teams did NOT want SAR as part of any WMT or WEMT curriculum.
While I had been preparing the above document, Stan Bush had been putting together an outline from all the notes he'd been getting -- he recommended that I pilot my program in the central Appalachian area as planned, and he sent out a document with all the other information he'd put together. Some of the errors are no doubt from the scanning process, others from the original.
But more interesting are the topics -- from my viewpoint now as a physician with long involvement with WEMS, the medical topics sound, well, naive. (They didn't at the time, and spurred my to study hard in medical school.) To look at them now with more medical sophistication, it's like saying that "mountain rescue team members need to know how to accomplish the following types of rescue: 1) easy 2) hard 3) really hard." Nonetheless, this was one of the first curricula of any sort to be published. And it's of great value in showing the state of the art in those days and how we've progressed. (I don't know of any WEMT programs that teach how to do "extended" CPR, for example.)
Unfortunately, the NASAR Emergency Medicine Committee went defunct soon after this, and when resurrected under a new name, was no longer involved in curriculum development. I remember one meeting of this new committee, right after which I quit NASAR. The NASAR board and president wanted the new, much smaller and exclusive Medical Committee to rubber-stamp the (as-yet-incomplete) WEMT curriculum a private contractor was going to teach for NASAR to, among other things, raise money -- the founder of the Wilderness Medical Society walked out of the room saying something to the effect of "both I and the WMS have better things to do than act as a rubber stamp."
Nonetheless, the Wilderness EMT idea probably wouldn't have even have developed if it hadn't been for Stan Bush, Chairman of the NASAR Emergency Medicine Committee in the '70's and 'early '80's and his wide and inclusive committee membership.
Here is the document he produced
February 1983
Wilderness Medical Society incorporated (Drs. Paul Auerbach, Ed Geehr, Kan Kizer)
June 1983
Auerbach publishes The Book "Wilderness Medicine - Management of Wilderness and Environmental Emergencies"
Late 1980's: WEMSI Founded as the Wilderness Emergency Medicine Curriculum Development Project
Now, on to the seminal documents of the Wilderness EMS Institute (WEMSI). WEMSI was founded in 1985-1986, as a group of volunteers working toward a good SAR team member Wilderness EMT curriculum, which would, it was hoped, serve as an academic backbone for such training nationwide. Originally, WEMSI was called the "Wilderness Emergency Medicine Curriculum Development Project" and these three documents were issued under that name. A packet containing all three of these documents was mailed to every medically-involved SAR organization and SAR-oriented EMS organization we could find. The results from the questionnaire determined WEMSI's direction for the past fifteen years.
- WEMCDP Prospectus: this document compiled all the relevant background we could assemble that would help respondents in making their decisions about the direction of Wilderness EMT training.
- WEMCDP Prospectus Addendum: this was a set of last-minute additions to the Prospectus, sort of a one-issue newsletter.
- WEMCDP Questionnaire: this was the list of important questions for the future of WEMT training, still quite valid.
June 1985
Stonehearth Open Learning Opportunities (SOLO) runs first Wilderness First Responder Class
June 1986
SOLO WEMT Class approved by New Hampshire
July 1990
Wilderness Medicine Institute incorporated in Colorado by Buck Tilton
1995: ASTM Wilderness First Responder standards
In 1995, after several years of work, the EMS Committee (F-30) of ASTM produced standards for the scope of performance of, and the training of, the Wilderness First Responder. ASTM doesn't offer its standards for free, so I can't put them up on the web page or link to them here. However, you can buy a copy from the ASTM web page. The details are here:
ASTM Committee F-30 on Emergency Medical Services. F 1616-95: Standard
guide for scope of performance of First Responders who practice in the
wilderness, delayed or prolonged transport settings. West Conshohocken, PA:
ASTM, 1995.
ASTM Committee F-30 on Emergency Medical Services. F 1655-95:
Standard guide for training First Responders who practice in the wilderness,
delayed or prolonged transport settings. West Conshohocken, PA: ASTM, 1995.
June 1995
WMS publishes Practice Guidelines for Wilderness Emergency Care
June 1996
The American Red Cross publishes "When Help is Delayed"
Winter
1998
Maryland certifies WEMTs using the WEMSI curriculum
More later.
WEMT Training
If you're looking for Wilderness EMT training, but not a SAR team member, or you need EMT training along with the WEMT module, there are many providers of such courses. (Note that WEMSI WEMT classes are offered much less often, and are specifically aimed at SAR team members.) There are many WEMT providers, but the three largest providers of WEMT courses, all with excellent reputations, are:
- Stonehearth Open Learning Opportunities (SOLO) is the oldest and one of the largest of the WEMT schools, with a reputation for very high-quality teaching. SOLO is based in North Conway, NH, in the White Mountain National Forest in New Hampshire. They also offer courses throughout the world.
- The Wilderness Medicine Institute (WMI) is sometimes known as "SOLO West" -- started by some instructors who parted from SOLO on friendly terms, and continues with SOLO's tradition of high-quality instruction.
- Wilderness Medical Associates has been around almost as long as SOLO, and despite a somewhat checkered past (especially in regards its now-lapsed relationship with the National Association for Search and Rescue), still has a reputation as a very high-quality WEMT course provider.
- CDS Outdoor, Inc. is relatively new to the Wilderness Medicine education field. They offer WEMT based upon the WEMSI Curriculum and WFR and WFA Courses.
The curricula offered by all WEMT providers varies -- there is no national standard curriculum for WEMT -- but WEMSI courses, and those offered by the above three providers, are generally similar and of high quality.