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Fresh from Wilderness First Responder course

Published: 6/16/2011
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By Maddy Butcher Gray

Six days into my Wilderness First Responder course, after yet another 10 hours of lectures and rescue simulations, I got a little giddy.

Up to then, the course, offered by Wilderness Medical Associates at the Chewonki Foundation in Wiscasset, Maine, was a jumbled mass of acronyms and protocols.

Sure, the instructors were fabulous and my classmates were inspiring. But I was quietly gagging on the sheer mass of information we needed to ingest.


-- When do you really worry about a head injury?

-- When do you stop CPR?

-- You have two critical patients. Only one can be evacuated. Who do you choose and why?

My peers were saying things like:

“That patient is slipping on AVPU. And he has an MOI spine.”


I was in a foreign land and giving that international gesture for choke.
But on that blessed sixth day, I was finally able to clear my head of minutiae and take a long view of wilderness medicine.

I breathed and considered triangles.

In WMA terms, three triangles make up the Patient Assessment System. It helps rescuers assess a situation in a logical, methodical manner.
Each triangle has three major points to address as one arrives on a scene and begins to help patients. These triangles give us a tiller to steer through rescue scenarios:
First, you make sure the scene is safe, determine the number of injured, and how they may have been injured.
Second, you do a preliminary check of the patient’s circulatory, respiratory and nervous systems to make sure nothing life-threatening is going on.
Third, you get to know the patient a bit better by taking vitals, doing a physical exam, and recording a history.
We learned the Patient Assessment System on Day One. But it took six days to truly absorb it and put it to proper use.  With or without the litany of abbreviations, I could finally approach a patient with confidence.

“Hi, my name is Maddy and I’m here to help you. Can you tell me what’s wrong?”

I helped a patient with heat stroke.
I helped another who’d fallen from a tree, gouged up his leg and knocked his head.
I helped one poor fellow with a dislocated shoulder.
The pushy, drunken loudmouth? I helped him away from the scene so my fellow rescuers could help his friends.

For years, I've worked with horses and have developed my own wellness checklist. It's become an intuitive process. Usually, it's just me and a quiet, cooperative, four-legged patient. If It's bad, I call more knowledgeable friends or the vet.

But human patients?
They talk back.
They moan and scream.
They question.
They faint.
They give me stress.

Granted these were scenarios with made-up victims and simulated wounds, but before the course, I’m pretty sure I would have been a dubious rescuer. I might have panicked. I might have done harm.

My head instructor, Eric Duffy, would say I drank the WMA Kool Aid.
But drinking Kool Aid suggests you’re buying into something without critical examination. It also suggests the drink might be bad for you.

I’d rather think of myself as another WMA fish.
The bait?
A course to give me skills and training for critical thinking when something bad happens in the woods.
The hook?
The confidence acquired by knowing I have these skills and training so I can help folks when something bad happens in the woods.

Now I feel I can help the horse AND the rider.

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6/17/2011 Craig
Like anything else in life dealing with people; At most times I would given the chance deal with Animals over people. That being said, I retired 2 years ago fro 42 years of EMS to the paramedic level for 24 years, on thh streets and WMEMT and National Ski Patrol for 15 years of that. It was a great career, much different than dealing with animals that calm down with a caring word or touch.
6/23/2011 Julie Kenney
Great job Maddy!!!! I'll make sure to call you the next time I'm injured :) In all seriousness, though, you should be very proud to have put all this time and energy into something that could potentially save someone's life, let alone help them when they need some assistance, especially out in the wilderness.

"No horseman or horsewoman has ever finished learning" - Mary Gordon-Watson