If a physician treats a patient in the woods, and nobody’s around to see it…

It’s not quite how the adage goes, but it’s not too far from the truth: According to a recent Outdoor Industry Association report, more than 142 million Americans — 48.4% of the US population — participated in at least 1 outdoor activity in 2016.1 As the number of active Americans increases, the scope of opportunities for physicians trained in wilderness medicine has also increased.

Wilderness medicine includes everything from treating regular medical conditions in hostile environments to treating emergencies such as hypothermia or hyponatremia. Some specific areas of interest within the field include high-altitude medicine, dive medicine, envenomation, trauma, search and rescue, and disaster medicine.2 For the wilderness medicine novice, a wilderness first responder course can go a long way to covering the basics.

Stewart Decker, MD, a family physician in southern Oregon, shared his experience with wilderness medicine in a Fresh Perspectives blog post3 for the American Academy of Family Physicians, calling his own wilderness first responder course “the single best CME experience I’ve had.”

Dr Decker shared a number of basic tips — the tenets of wilderness medicine — that are essential to keep in mind. One simple but essential tip is to “get them stable to go home/go home to get them stable.” In the case of a medical emergency in the wilderness, knowing when and how to evacuate safely can go a long way toward resolving a patient’s situation.

Dr Decker also pointed out that much of what falls under the umbrella of wilderness medicine is facing ordinary ailments in a different or difficult environment. Medical skills for dealing with medical conditions such as heart attacks or headaches are still very much necessary in these cases. Among the more specific of Dr Decker’s tips are carrying honey (for use by diabetics as well as for antibiotic purposes), closing scalp wounds by tying hair from either side across the wound, and to always — he emphasized — carry a headlamp.

For physicians looking to become specialized in wilderness medicine, a variety of options exist. Wilderness first responder courses may be an option for individuals currently undertaking medical studies. Additionally, the Wilderness Medical Society offers education, certification, research, and more.4 There are also wilderness medicine conferences, including the annual Wilderness Medical Society meeting and a Masters of Wilderness Medicine Conference,4 that occur throughout the year.

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Wilderness medicine is important preparation for venturing out into the elements, but the practical skills and improvisation practice are applicable to a variety of situations, such as in-flight emergencies or natural disasters. Although preparation for anything is a transferrable skill across all areas of medicine, specializing in wilderness training offers a fun and interesting way to learn new skills.

References

  1. Outdoor participation report 2016. Outdoor Industry Association. https://outdoorindustry.org/resource/outdoor-participation-report-2016/. Published September 21, 2016. Accessed July 12, 2018.
  2. Sward DG, Bennett BL. Wilderness medicine. World J Emerg Med. 2014;5(1):5-15.
  3. Decker S. Into the woods: top tips for wilderness medicine. Fresh Perspectives. American Academy of Family Physicians website. June 5, 2018. https://www.aafp.org/news/blogs/freshperspectives/entry/20180605fp-wilderness.html. Accessed July 12, 2018.
  4. Wilderness Medical Society https://wms.org/. Accessed July 12, 2018.