National Outdoor Leadership School - Index

National Outdoor Leadership School - brochure - Index

4
THE
Leader
WILD SIDE OF MEDICINE
Kids are at greater risk of exposure from environmental heat and cold because their bodies’ thermoregulation is inherently
less efficient than an adult’s.
Playing Nice with
Mother Nature
Keeping Kids Comfortable
Come Rain or Shine
BY TOD SCHIMELPFENIG, WMI CURRICULUM DIRECTOR
If you want to know what a NOLS instructor does
when they lead courses, take your children wilderness
camping. The same skills and techniques I’ll use
when leading a wilderness course are directly applicable
to backpacking or paddling with children. In
1987, when our two older sons, Sam and Dave, were
8 and 4 respectfully, we hiked into the Wind Rivers
just in time for a wet late-August snowstorm. I was
looking forward to a relaxed fishing trip, but seamlessly
switched into instructor mode in order to adapt
to the unexpected weather.
There were four of us in a small A-frame mountain
tent. We needed to keep the boys warm and dry,
not to mention all of us from going stir crazy. The ugly
rubber galoshes with the Mickey Mouse logo proved
very helpful, as did the extra layers I carried into the
mountains, yet I still focused, as we do with our students,
on constantly drying clothing, especially socks
and mittens. A campfire served the dual purpose of
entertainment and drying.
WILDERNESS MEDICINE
PRACTICES & PROTOCOLS
Wilderness medicine for the
urban medical professional
• 3-day intensive module
• 18 hrs. of category I CME
• 24 hrs. of EMT CEUs
• Field-based scenarios
• Interactive role playing
Register now:
Wilderness Medicine
Institute of NOLS
(866) 831-9001
wmi@nols.edu
www.nols.edu/wmi
Remembering to keep children warm and dry in
the wet and cold is especially important because smaller
people have more body surface area to mass than larger
folks. In addition, the head, a source of heat loss, is
proportionally larger. Thus, children experience greater
exposure to environmental heat, cold and sun.
Thermoregulation is less efficient in children than
adults. Children generate more metabolic heat per
kilogram of weight than adults during exercise. They
can gain more heat from the environment in hot environments,
and can lose it faster in cold weather.
They sweat less efficiently than adults, start sweating
at higher body temperatures, and acclimate slower
than adults. Children have less subcutaneous fat than
adults and may not recognize and respond to overheating
or chilling.
It’s the parent’s role to be responsible for making
sure the children are warm, yet not overheating. Rest
children often in the shade on hot sunny days, and
watch them carefully in the cold for that sudden transition
from happy and active to whiney and shivering.
As do many adults, and NOLS students, children
don’t think about the effects of UV radiation on the
skin and the eyes. Make sure they protect their skin
with hats, clothing, sunscreens and sunglasses.
As for my family’s trip, we were warm, dry and
cozy as we waited out the storm. As it most often happens
in August in the Winds, bluebird skies quickly turned
snow to slop and cold temperatures to warm. Those galoshes
came in handy as we hiked up to Cathedral Lakes,
and Dave caught his first of many Wind River trout.
ACCIDENTS HAPPEN.
Tod Schimelpfenig
GET READY.
Real Life Drama:
WEMT Grad in Action
BY ANDY BLAIR, WMI PROGRAM DIRECTOR
At the Wilderness Medicine Institute, courses are
designed to give you the confidence and decisionmaking
abilities to handle medical emergencies in remote
settings when they happen for real. Here is a story
from Chris Nielsen, a WMI grad from our Wilderness
Emergency Medical Technician (WEMT) course. In
this letter, he relates a personal experience that required
the use of his wilderness medicine training.
“Last summer, I was fighting fire for the Bureau of Land
Management in eastern Idaho. I had the opportunity to
spend 16 days with the Snake River Hotshots and also
had the opportunity to use my wilderness medical skills.
One of our sawyers had a snag strike him on the
helmet. When I arrived on scene, he was responsive,
alert, and well-oriented (AOx4). I determined there was
a definite mechanism of injury for spinal injury, so I
had another EMT control the patient’s spine. We were
many hiking hours away from an extraction point where
a vehicle could reach us and at least a half hour hike
from a helicopter landing zone. I determined we were
at least one hour from definitive care, so I decided to perform
a focused spinal assessment. This assessment would
allow me to make a reasoned decision on whether my
patient needed spine immobilization and, if not, we
could have him walk out rather than us carry him. This
approach would also save resources that were needed elsewhere
on the fire.
The focused spinal assessment was successful: the patient
remained A0x4; he was sober and reliable; he had
normal circulation, sensation, and motion in all four extremeties
with no distracting injuries; and he denied spine
pain or tenderness. We released our control of the spine
and slowly hiked to the helispot for extraction. My knowledge
and actions permitted us to safely evacuate the patient
without requiring a very complicated, dangerous,
and expensive medevac.
That’s the first time I’ve ever been in a situation
where I was the most medically qualified and everyone
looked to me to make the final decision on patient
care. There was another EMT, but because of our location,
he deferred to my wilderness training.”
If you spend any time in remote locations, you need wilderness medicine training.
For 17 years, the Wilderness Medicine Institute of NOLS (WMI) has defined the standards
in wilderness medicine training. With a wide range of course and certification opportunities,
our graduates head into the backcountry prepared to act with confidence, make complex
decisions and manage emergencies. To find a course near you, contact:
THE WILDERNESS MEDICINE INSTITUTE OF NOLS
www.nols.edu/wmi • (866) 831-9001