WILDERNESS MEDICINE INSTITUTE ? 866-831-9001 WWW.NOLS.EDU/WMI

WMI IN ACTION

Chris Nielsen, WMI Wilderness Emergency Medical Technician "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 (A&Ox4). 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. If not, we could have him walk out rather than carrying him. This approach would also save resources that were needed elsewhere on the fire. The patient passed the focused spinal assessment and remained A&0x4; 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.? WEMT grad Chris Nielsen (right) fights fires with the Bureau of Land Management.

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