Risk Management & First Aid

The Risk Management and First Aid Group focuses on managing safety in outdoor programming.

Wilderness Medicine

Observations, questions and dialogue on wilderness medicine topics.
  • Wilderness Medicine

    WFA Scope of Practice Document Update

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    The Wilderness First Aid (WFA) course, widely taught by numerous providers, can be burdened with unrealistic expectations of the topics and skills that can be taught in a basic layperson first aid program. In 2010 , sensing a need to clarify what first...
  • Wilderness Medicine

    Hantavirus in Yosemite National Park

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    by Paul Auerbach Our National Parks are a treasured heritage, and one of the ways in which we appreciate the outdoors. Millions of visitors flock to the parks in order to camp, hike, climb, swim and most of all, appreciate the wonder and natural beauty...
  • Wilderness Medicine

    Wilderness First Aid Retention Study

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    Wilderness First Aid (WFA) courses are taught by multiple individuals and programs. They have become a standard for people working and recreating in the outdoors. Are they effective? Can the participants remember the information? Can they perform the...
  • Wilderness Medicine

    Building a Wilderness First Aid Kit

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    Re-posted with permission from Wilderness Medical Associates International. Walking through the first aid aisle at your local outfitter store can be overwhelming. While there are many excellent prepared kits on the market, often enthusiasts choose to...
  • Wilderness Medicine

    When to Use Tourniquets

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    Improper application is an important cause of failure.  They can also fail when they breakdown from environmental exposure or from poor construction (e.g., older version knockoff).  Always check your equipment before heading out and replace anything questionable.  Practice with any tool before you need it for a real emergency.

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  • Wilderness Medicine

    Treating Severe Heatstroke with an External Cooling System

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    by Paul Auerbach Heatstroke is a life-threatening emergency. Therapeutic cooling measures need to be undertaken rapidly in order to prevent the catastrophic organ failure associated with markedly elevated body temperature. The general dictum is to cool...
  • Wilderness Medicine

    Treating Rattlesnake Bites in the Field

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    by Paul Auerbach There are two excellent photographs of a rattlesnake bite victim that appear in the June 10, 2010 issue of the New England Journal of Medicine (362;23:2212). Entitled “Rattlesnake Envenomation” in the IMAGES IN CLINICAL MEDICINE...
  • Wilderness Medicine

    Hand Injuries Not to Miss

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    by Paul Auerbach Hand injuries are common in outdoor enthusiasts. Some of these injuries are easy to diagnose, and others are more difficult, usually because the signs and symptoms are subtle or because the examiner is inexperienced. Emergency physicians...
  • Wilderness Medicine

    Support for Ankle Sprains

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    by Paul Auerbach Sprained ankles are the bane of existence for hikers, trekker, and joggers—indeed for most athletes or anyone who has the opportunity to twist a foot on an uneven service, stepping over a rock, or falling into a hole. The classic...
  • Wilderness Medicine

    Probiotics and Acute Infectious Diarrhea

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    by Paul Auerbach Probiotics are live microorganisms that are purposefully ingested by humans to improve their health—the thought is that probiotics improve “digestive health.” The specific microorganisms are commonly of the genera Lactobacillus...
  • Wilderness Medicine

    Classroom Medicine

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    I recently sat through a wilderness medicine class by a well-meaning instructor who, despite decent credentials, had never cared for anyone in the wilderness. This is just after reading a poorly crafted wilderness medicine text. Instead of listening to...
  • Wilderness Medicine

    Ibuprofen and Altitude Illness

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    I've been receiving emails about the recent online publication of a study in the Annals of Emergency Medicine titled “Ibuprofen Prevents Altitude Illness: A Randomized Controlled Trial for Prevention of Altitude Illness With Nonsteroidal Anti...
  • Wilderness Medicine

    Risk-taking Behavior and Helmet Use in Skiers

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    by Paul Auerbach, M.D. The general consensus in the medical community regarding helmet use and skiing (also snowboarding) is that helmets should be worn to prevent or lessen head injuries related to falls and collisions. While a helmet may not significantly...
  • Wilderness Medicine

    Lightning Safety Awareness

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    by Paul Auerbach This post relates information learned in a recent issue (Volume 22, Number 3, 2011) of the journal Wilderness & Environmental Medicine , published by the Wilderness Medical Society. In an article entitled “Lightning Safety Awareness...
  • Wilderness Medicine

    Wilderness Medicine - 6th Edition released

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    I want to let everyone know about the release of the 6th Edition of Wilderness Medicine, the premiere textbook on the subject, edited by our frequent contributor Dr. Paul Auerbach. There are not too many books out there that I personally consider as "classics"...
  • Wilderness Medicine

    Epinephrine for Out-of-Hospital Treatment of Anaphylaxis

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    by Paul Auerbach, M.D. For management of a serious (even life-threatening) allergic reaction, I have been teaching adults to administer epinephrine (adrenaline) by injection for years. This can be a lifesaving intervention. The Emergency Medical Services...
  • Wilderness Medicine

    Ski Helmets and Reaction Time

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    by Paul Auerbach, M.D. Ski season is upon us. Many experts (including myself) are of the opinion that helmets should be worn by all downhill skiers and snowboarders to help prevent head injuries. One of the “con” arguments proposed by some...
  • Wilderness Medicine

    Wilderness Medical Society Practice Guidelines for Frostbite

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    by Paul Auerbach, M.D. Led by Scott McIntosh, MD and his colleagues, the Wilderness Medical Society has published "Practice Guidelines for the Prevention and Treatment of Frostbite" ( Wild Environ Med 2011:22;156-166). These guidelines are intended...
  • Wilderness Medicine

    Stinging Nettles

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    by Paul Auerbach, M.D. Hikers often brush up against injurious plants, such as poison oak or thorny shrubs. One particularly vexing plant is the “ubiquitous weed, Urtica dioica ,” commonly known as stinging nettles. As described in an article...
  • Wilderness Medicine

    Sawyer Squeeze Water Filtration System

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    by Paul Auerbach, M.D. As most of you know, I am sometimes sent outdoor health equipment and supplies to evaluate. I’ve recently received a few items worthy of mention. Sawyer Squeeze Water Filtration System First, there is the Sawyer Products ‘Squeeze’...
  • Wilderness Medicine

    Comparing New Agents Used to Control Bleeding

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    by Paul Auerbach, M.D. Once of the major recent advances in trauma care has been the evolution of topical substances that can be applied to wounds in order to limit or stop hemorrhage (bleeding). This is very important in wilderness medicine, because...
  • Wilderness Medicine

    The Concept of Risk

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    by Paul Auerbach, M.D. Dr. Robert “Brownie” Schoene, an enormously talented, accomplished, and insightful physician who resides within the bedrock of wilderness medicine, gave a wonderful presentation about the concept of risk at the 2010...
  • Wilderness Medicine

    In the Wake of Hurricane Irene – Methods of Water Disinfection

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    by Paul Auerbach, M.D. In the wake of Hurricane Irene, many people will be without electrical power for days. If they need to disinfect water to obtain drinking water, the following are some techniques that may be used: Water disinfection is the treatment...
  • Wilderness Medicine

    The Role of the Routine Physical Examination in Young People

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    by Paul Auerbach, M.D. Increasing numbers of young people participate in outdoor activities, including strenuous competitive athletics. In so doing, they subject their bodies to stresses that are more intense and prolonged than those presented by a largely...
  • Wilderness Medicine

    Fatal Bear Attack

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    by Paul Auerbach, M.D. By now, most everyone is familiar with the tragic circumstances in which a visitor on a trail in Yellowstone National Park on July 6, 2011 surprised a brown (grizzly) bear with cubs, provoking a fatal attack. Fortunately, events...
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