FolksThis is an update on the wilderness first aid scope of practice process and documents.
Our group of colleagues have been working steadily on these documents.We have circulated several drafts of the Wilderness First Aid (WFA) Scope of Practice document, considered the feedback we have received and are close to a final draft. We’ve also been working on a Wilderness First Responder Scope (WFR) of Practice document and have a solid working draft which the providers are reviewing.We hope to post this for review later this spring.
One of the challenges we face is balancing the needs of a large spectrum of students, from outdoor trip leaders to camp staff and non-institutional outdoor recreationists, with the length of the course and our ability to deliver the material effectively. A WFA is a basic and introductory course in wilderness medicine, yet we’ve been asked to teach GPS and survival skills, detailed emergency plans, improvised litters, and a wide variety of medical topics. The elder hostel argues for cardiac curriculum, the therapeutic program for mental health curriculum, the ocean-based program for marine toxins, the high latitude program for more on cold injury. Folks up north don’t want to hear about heat illness and folks down south don’t want to hear about frostbite.
Choices must be made. As we develop each SOP document, we consider the available medical evidence, input from a variety of sources including practitioners, educators, and consumers, and our collective experience as guides, trip leaders, medical providers and professional medical educators.
We have had many collegial and interesting discussions on what should or should not be included in the scope of practice of a WFA .It is easy to reach consensus on the majority of the content. We spend most of our time on the question of what should be core and what can be an elective skill or topic. There is a need to balance a clear minimum standard for this credential while providing some flexibility to meet individual program needs.
I’m excited that the Wilderness Medical Society (WMS) will consider publishing the scope of practice documents in a consensus position statement on wilderness medicine courses for laypeople. The WMS is writing a series of position statements on important issues in wilderness medicine.  The first consensus statement, on altitude illness, will be published in the next edition of the Wilderness and Environmental Medicine Journal. A statement on frostbite treatment is also being developed. Tony Islas MD, incoming WMS President, has offered the WMS as a place to support periodic, perhaps annual or biannual, gatherings of wilderness medicine providers to discuss common issues and revise these documents as needed.  I think this is an excellent forum for us to publish our work and continue our conversations. The consensus position statement brings the weight of the society to bear on this question, and it’s very appropriate.
A copy of the most current WFA SOP is attached (see the attachment link below). We are still open to comments.
Take Care,
Tod Schimelpfenig
Curriculum Director
Wilderness Medicine Institute of NOLS