Lectures

The Elusive Work Life Balance: Non Traditional Approaches to Wilderness Medicine and Clinical Practice

Recording

Survival Principles for the Wilderness Medicine Provider

Medicine Beyond the Boundaries

Recording

Rescue Medicine Risk and Consequences: 15 Lessons from Two Decades of Mountain Rescue

Recording

Q&A

How have you seen physicians without an emergency medicine background engage in wilderness or rescue medicine?

The most important is to get involved and get patient care experiences. I have friends like pulmonologists become altitude medicine experts for example.

How does Oregon/the crag rats manage multiagency medical scope of practice? Our team has had some difficulty figuring out our medical roles as most of our searches are out of county. for example, the county we are based in doesn’t recognize wilderness first responders but counties we respond in do, but our medical director doesn’t seem to know what to do with a SAR team.

This is a very difficult problem. First, in Oregon, the sheriff is in charge of search and rescue, so default is to the sheriff personnel on scene (SAR team). The best situation is to have a nationally recognize credential. In the US this would be doctor, nurse, PA, Paramedic, EMT, EMR or CPR/FirstAid. A Wilderness First Responder really cannot provide medial care unless they have another credential. I’m trying to advocate for my teams getting EMR instead of WFR for this reason

When assessing risk, are you typically only assessing risk to self and others? Is risk to environment necessary to consider also?

We do consider risk to environment. We try not to destroy the environment and try not to leave textiles or hardware. Sometimes we do have to leave a sling on a tree or tape on a tree to mark a route. It’s not great, but sometimes necessary.

Has the increased number of people in the backcountry put an increased stress on programs sponsoring expensive rescues (i.e., requiring helicopters).

It has mostly put an increase stress on personnel: more searches and more people required to help search/rescue. We are very busy. Some teams are actively recruiting in my area and my team has started regular patrols on Mount Hood to have a team available on busy weekends. That said, we don’t use expensive programs any more than normal because we have so few resources. We have no dedicated SAR helicopters except for coast guard (200 miles away) and military (not always available quickly). We had more helicopters 2 decades ago, but many were sent to Afghanistan and Iraq