- Guatemala - January 2015
- Canyons Resort, UT - Feb. 2015
- Steamboat, CO - Feb 2015
- Dallas/Ft Worth, TX - Mar. 2015
- The Netherlands - April 2015
- Fall Creek Falls, TN - May 2015
- Moab, UT - May 2015
- Columbus, OH - June 2015
- Cape Town/Safari - June 2015
- Cascades, WA - June 2015
- Jackson, WY - June 2015
- Mt. Hood, OR - June 2015
- Chamonix, France - July 2015
- Boulder, CO - Sept. 2015
- Grand Canyon, AZ - Sept. 2015
Why Certify in Wilderness Medicine?
AWLS® COMBINES PRACTICAL WILDERNESS MEDICINE WITH MEDICAL THEORY
*see the About Us tab for further information on continuing education credits.
WILDERNESS MEDICINE IMPROVISATION TIPS
WILDERNESS WOUND MANAGMENT: Geoff Clover, MD
Although numbers vary by study, skin and soft tissue injuries may comprise up to a third of outdoor injuries. Wound management consists of controlling bleeding, minimize infection risk and promoting healing/minimizing loss of function. Direct pressure is the most effective method for hemostasis in the majority of wounds, tourniquets being reserved for major arterial bleeds in extremities or uncontrolled bleeding using pressure methods. Underlying immune compromise and immunization history (i.e. tetanus) may influence evacuation decisions. Only those with 3+ tetanus immunizations, the most recent in the last 5 years, do not require tetanus prophylaxis in non-clean wounds (most wilderness wounds). Consider the nature of the wound: clean, dirty, contaminated, presence of foreign bodies, special characteristics such as animal/human bites or stings and possible underlying nerve, tendon, or bone injury. Rabies prophylaxis should always be given in suspect animal bites and is near 100% effective. Testing and reassessing function, perfusion and sensation in the affected area is basic management. Proper wound exploration and debridement is difficult in the wilderness. If attempted, subcutaneous anesthesia is recommended, with addition of epinephrine to prolong effect and reduce bleeding, even in digital blocks. Potable water is preferred as an irrigant, at least one liter delivered via a syringe/needle/angiocath. Higher volume may be beneficial if only low pressure irrigation is available (such as a drink bottle or water bladder). Removal of contaminating material is ideal.
Wilderness Medical Society Practice Guidelines for Basic Wound Management in the Austere Environment Robert H. Quinn, MD, Ian Wedmore, MD et al. Wilderness & Environmental Medicine, Volume 25, Issue 3, Pages 295–310, September 2014
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