Wilderness First Aid vs EMT

[Eagle732]

So I see that high adventure camps are now requiring at least one crew member to have Wilderness First Aid certification. A friend with no previous first aid training took the16 hour long, $90 course and is now good to go to Philmont this summer. Now Im all for training, in fact Im on our districts training team, and I believe that you can never have enough training to prepare for an emergency. Ive been a firefighter/EMT for over 30 years, the last 25 with a major metropolitan fire department. So what Im wondering is why doesnt BSA accept EMT as sufficient training in place of Wilderness First Aid? Maryland EMT (my cert.) is currently up to 130 hours of initial training. Now the obvious answer is that EMT certification is not the same as WFA certification but I just read the Red Cross Wilderness First Aid Basics manual my friend used and I dont see anything in there that isnt covered under my EMT protocols, in fact it is very basic. I went to a Red Cross chapter website and looked at what one needs to have to be a WFA instructor. It seems that you just need to be a Red Cross Advanced First Aid Instructor, request a copy of the WFA material and verify that you have reviewed it on the form provided. No special instructors class needed. Considering that we Scouters are spending a substantial amount of time and money so that our Scouts can attend a High Adventure camp you would think that BSA would be a little more flexible.

[Gold Winger]

I know a fellow who is a PA and an EMT who went through Wilderness First Aid a couple years back. I wondered if they had taught him anything new. He explained that the course wasn't so much how to deal with injuries but how to deal with them in the wilderness. It's one thing to deal with a broken ankle when you have a well stocked ER or big truck filled with gear but another when you're four hours from the nearest help.

 

That's what he told me. Maybe it varies from course to course.

 

 

[SctDad]

I know what you mean by 'what's the difference?'

 

Well this is so that they can have one standard and that everyone meets one standard.

 

YES. For those of us who are already certified in EMS, or have 10 years as a Combat Medic in the military, we should be able to challange.

 

Let us take a test, if we fail then we just need to take the course, if we pass then we meet the standard and let us get our card.

 

I can agree but I can also see where the BSA is coming from.

 

That is my two cents worth

[CalicoPenn]

Here is what National BSA's Philmont Website has to say about the first aid certification requirements for Philmont crews.

 

First Aid and CPR Certification

 

Philmont requires that at least one person (preferably two) in each crew be currently certified in American Red Cross Standard First Aid or the equivalent and CPR from the American Heart Association, the American Red Cross, or the equivalent. Several hours may be required for Philmont staff to reach a remote backcountry location after a message is delivered to the nearest staffed camp. First aid and CPR training will result in proper and prompt attention being given to injuries and/or illnesses. You must present current certification cards upon check-in to verify this requirement.

 

Equivalent training may include instruction by ambulance or fire department personnel, community colleges, or other organizations. You must have a letter indicating length of training, topics covered, and participant roster.

 

You can find this at:

 

http://www.scouting.org/HighAdventure/Philmont/Hikers/crew.aspx

 

This comes direct from National - not from any council sites. It requires Standard First Aid certification, not Wilderness First Aid (as some Council sites are stating - the one I saw used it as a selling tool for a Wilderness First Aid session).

 

Note also the use of the word Equivalent. EMT is more than sufficient training for equivalency purposes. Philmont, and I suspect the other National High Adventure Bases as well, will accept EMT as equivalent certtification - and your EMT will cover both the first aid and CPR portions. Its unlikely they will ask for a letter outlining the course topics and length if you present a copy of your certification. The flexibility you're wondering about is built right in to their statements.

 

BSA's risk management department is also smart enough to know that an EMT on site trumps anyone with Red Cross standard or wilderness first aid certs, just as a Paramedic would trump an EMT-B and an MD trumps all.

 

Calico

 

 

 

 

[GernBlansten]

I took WFA two years ago. Its focused on what to do when help is not on the way. Identify the problem, stabilize the situation, work with what you got and evacuate the victim if possible. It certainly isn't a substitute for EMT training, it isn't meant to. I would think an EMT should be able to challenge the course, but then again, there were things I'm not sure an EMT might have covered. Lots of McGyver style brainstorming on what to do with what you got. We joked that we could make an AED out of two rocks, boot laces, a Nalgene and wool sweater. Practical examples too like recovering an unconscious diabetic with a honey bear enema. There also seemed to be an sense that some things just cannot be "fixed" in the wilderness and when to just quit and save yourself. Makes no sense to bring yourself to exhaustion when CPR doesn't recover the victim in 10 minutes when nobody is coming to help.

[Gold Winger]

" Practical examples too like recovering an unconscious diabetic with a honey bear enema."

 

I don't like the sound of this. How's that work and will I be glad that I'm out when it happens?

 

" and an MD trumps all."

 

Maybe by rule but . . .

 

Years ago, I was chatting with my endocrinologist and somehow the conversation turned around to this. He said that if he was around an accident and someone needed help, he'd step up but if there was an EMT available, he'd step aside because they have more relevant training and more experience dealing with things like head injuries and severe bleeding. Then again, maybe he was just being modest.

 

[RememberSchiff]

As I understand as of 2008, Red Cross First Aid and CPR is no longer sufficient. At least one Philmont crew member must have completed WFA from a nationally recognized organization as stated in this link (found by Searching from the new scouting.org)

 

http://old.scouting.org/philmont/2008firstaidrequirements.pdf

 

I was an EMT and as mentioned, there is a the big difference in handling wilderness situations and resources. You won't have the big truck ( no backboard) and will likely have to direct others to handle patient care including clearing the spine and patient transport over miles of rugged terrain. Back in civilization, you may be able to get your patient to the ER within the "golden hour" but not in the wilderness, you will be providing patient care for hours maybe days.

 

Just don't take any (the cheapest) course, make it worth your while. I would recommend that you take WFA through a Wilderness organization like SOLO, NOLS, or WMA, as the quality (instructor and course material) that I have seen is far better than those through the standard safety course providers (as you discovered thumbing through the Red Cross course book)! My WFA (SOLO) course was very hands-on outside, with four different accident scenarios.

 

Also WFA is just 16 hours (an intense weekend), but you can go further with the longer and more intense WFR and WEMT courses. Note, CPR might not be included in all WFA courses, so you might have to take that separately. Shop around. Ask about the instructor's background, be bold and ask if any course instructors are EMT's or Paramedics? Try to get into their course. In my course, my instructor was a retired big city EMT and AMC group leader; three students were former EMTs or EMT/fireman - all felt they had learned much. I am not aware of a challenge course, there was a written test at the end of my WFA (SOLO) course.

 

I too have been disappointed with the instructor quality from the group you mentioned. My scout troop takes CPR certification through the training resources of our local fire department and WFA through SOLO.

 

Most MD's do not have Emergency Medical training, so if we are "playing medical cards", I think a RN trumps all. On one memorable EMT call, the attending ER doctor was a podiatrist, just picking up some extra dough by working a shift; he was not much help. Best ER personnel are the Army medics from the local base that sign on for a hospital shift.

 

Rambled a bit, hope this helps.

[Ohio_Scouter]

CalicoPenn,

 

FYI...Regardless of what is posted on Philmont's website, here are the instructions that Philmont sends in the mail to crew advisors in their Council and Unit Planning Guides:

 

FIRST AID AND CPR CERTIFICATION REQUIRED (Note NEW REQUIREMENT 2007)

 

Philmont requires that at least one person, preferably two, (either an advisor or a youth participant) in each crew be currently certified in American Red Cross Wilderness First Aid or the equivalent* and CPR from the American Heart Association, the American Red Cross, or the equivalent. The American Red Cross Wilderness First Aid is a sixteen hour course designed to help in situations when help is not readily available. Several hours may be required for Philmont staff to reach a remote backcountry location after a message is delivered to the nearest staffed camp. First aid and CPR training will insure proper and prompt attention is being given to injuries and/or illnesses. You must present current certification cards upon check in to verify this requirement.

 

* Equivalent training can include instruction by ambulance or fire department personnel, community colleges or other organizations. You must have a letter indicating length of training, topics covered, and participant roster.

 

[dzierzak]

The BSA National website has apparently NOT been updated with new requirements.

 

The 2008 Council & Unit Planning Guide sent to all lead advisors included the following on page 3:

 

"Philmont requires that at least one person, preferably two, (either an advisor or a youth participant) in each crew be currently certified in American Red Cross Wilderness First Aid or the equivalent* and CPR from the American Heart Association, the American Red Cross or the equivalent."

 

* is a list of the equivalent nationally-recognized organizations.

 

Parts of the above statement were bolded and underlined.

 

The 2008 Planning Guide is available at:

 

http://philmontdocs.watchu.org/Docs/Planning_guides/Council_guide_2008.pdf

 

ed

[dzierzak]

Note, in previous years equivalent training included (quote from website):

 

"Equivalent training may include instruction by ambulance or fire department personnel, community colleges, or other organizations. You must have a letter indicating length of training, topics covered, and participant roster."

 

This is no longer listed as an option in the Planning Guide.

 

ed

 

 

 

[Eagle732]

Im at the station working today and it just so happens that we had 4 hours of EMT refresher. After the class I asked the instructor to review the Wilderness First Aid book and asked if our EMT certification meets the WFA standard. The opinion was that EMT far exceeds the WFA material cover in the WFA Basic book which is the minimum standard required by Philmont. Also I posed this hypothetical situation to the instructor; Im with a crew in Philmont (or anywhere else) along with a certified WFA individual and there is an accident with serious injuries. Who is legally responsible for the patient? Answer: the highest trained medical person, in this case the EMT.

Calico: www.philmontscoutranch.org has the new standards for 2008 which states Philmont requires that a least one person, preferably two, (either an advisor or a youth participant) in each crew

be currently certified in American Red Cross Wilderness First Aid or the equivalent* and CPR from the

American Heart Association, the American Red Cross or the equivalent. They then list several sources for the course other than Red Cross. Course prices that I have seen are $60 to $140.

GernBlansten: Honey bear enemas are not covered in either the WFA material or my EMT protocols.

 

[John-in-KC]

To me, if you have a question, call Philmont, NT, or SeaBase. Over the years, I've found Philmont to be very open to answering a Crew's questions, especially during the deep off-season.

 

This especially applies to the difference between the two sets of 2008 season guidance!

[Gold Winger]

Eagle732, why are you so resistant to the additional training? As others have stated, the course covers more than "don't use a tournequet for a head wound," it covers how to make do with what you have when you're miles from anywhere.

 

[hops_scout]

"Eagle732, why are you so resistant to the additional training?"

 

I'm not Eagle732, but let's think about this. He's already spending a significant amount of money to go to Philmont. You want him to drop another $100-200 on something that he *might* learn something he's not already qualified and certified to do?

 

 

[Gold Winger]

I'm not asking him to do anything. Maybe instead of asking his EMT instructor or us, he should call philmont and chat with their health officer guy, a W-EMT named Gavin Falkner.

 

I exchanged emails with him and had a few telephone chats before I went. Very approachable fellow. I'm sure that he's fielded my questions a thousand times before but he took the time to answer my questions.

 

Philmont (575) 376-2281

 

camping@philmontscoutranch.org