If outdoor life is in your interest – first aid should also be that!

This quote is from the education programI’ve recently finished and is an excellent saying of how outdoor people should think. The course I’ve taken is called Wilderness Advanced First Aid, WAFA. The school, which goes under the name NOLS and stands for National Outdoor Leadership School, is located in USA and was founded 50 years ago. Me and my class were very lucky to get this opportunity to study this course – and also to have two inspiring teachers learning us how to take care of injured people. The course lasted for five days with hours in school from 8 am to 5 pm, and also night shifts on wednesday and thursday. On thursday we got to have scenarios with highschool students acting injured patients.

You never know what will happen in the wilderness

When you’re out in the ”wilderness” you never know what will happen. Many things you need to figure out by your self and how to act in the best way considering what access to help you have and materials. But there are some rules you always need to follow and the most important is to look after you self. If you get injured you won’t be able to help the other person.
If you get to a person in need you should always have this in mind;
L = Location: Is it safe for me to enter the area and the injured person? What could have happened – risk of back injury? Are there any blood and do I have glows to protect my hands? Are there any more people? Is this a situation where it’s a question about life or death?

There are some indicators to have in mind if the persons neck needs to be immobilized and if you suspect there could be a neck- or back injury you need to immobilize the head immediately.

A = Airways: You have to make sure the airways are clear.
B = Breathing: Is the patient breathing?
C = Circulation: Are the patient bleeding? Check the whole body. Does the patient have pulse?
D = Decision: Should you continue immobilize the patients neck or have you gotten enough information to release the head?
E = Evaluation: Here you start to have a look at the patients most important complaint and do a full body examination. Palpation, strenght/movement in feet and hands, looking for liquid from ears and so on. You also need to check vital parameters such as pulse, awareness, the skin temperature/color and breathing. Also questions about the situation, medical history, allergies, medication, how the patient has been eating/drinking and so on.
A few example from what we learned about in the course
  • Burning injury

    The skin can be injured on different levels. Outdoor people usually burn their hands and feet because of sitting down when cooking their food in the outdoor kitchens. If the skin is injured you need to cool it down with lukewarm water at least 15 min to get deep down in the tissue. Remove rings and watches. All full-skin-injuries (all the way down to muscle tissue, skeleton and fat tissue) should be evacuated. Also if you’ve injured your face, neck, hands, feet, armpits and growings.

  • Blisters

    You can get blisters from friction, burning injuries and frostbites. One rule is to not puncture a blister because of the infection risk, but if you need to continue walking in your boots you’ll probably need to drain, wash and put tape (for example blistoban) on the blister. When you drain the blister the needle needs to be sterilized! The best way to avoid blisters is to check your feet regularly and if you get the smallest sense that your skin is getting warmer on a certain spot – take off your boots and cover with tape or something that takes away the friction.

  • Hypothermia

    This condition can be very serious and can go very fast. Hypothermia means that your body decreases in temperature and below 35 degrees you are in a mild stage of hypothermia. You’re shivering, your pulse increases to give more blood to your body, you can get frustrated and angry. Here you need to get your self activated/in movement, dry and more clothes, water and food.

    Moderate hypothermia means you’ve reach another state of temperature drop in your body. Your body is now shivering without control and your state of mind is on a low level. You’re pale and passive. You’ll need the same treatment as on the ”mild stage” and also get in a ”warm package” – for example wrapped in warm clothes in a sled.

    Serious hypothermia means you’re unconscious, no shivering, your heart is weak and you’ll probably need help with your breathing. This person have to be wrapped in warm clothes and in a ”warm-package” and evacuated immediately.

Other medical conditions, injuries and treatment
Some other conditions/injuries/treatments we’ve learned about are:
CPR, altitude sickness, infections, muscle/skeleton injuries, amputations, medical chock, head injuries, back injuries, how to build a litter, pneumothorax, how to take care of wounds and also wounds caused by external material (for example a stick), how to act in thunderstorms, drowning accidents and much more.
This week with the WAFA-course feels like a perfect complement to my physiotherapist education. With all my knowledges I hope to act in the right and best way I can to help people in need. But remember always to be a step ahead and prepare yourself for the activity you’re about to tackle.

A perfect saying for outdoor people!


Immobilizing the head. Here we’ve rescued a person laying in cold water.


Wrapping a wound with a stick in the back.


Organizing our selfs before we start to carry the patient.


My amazing class mates, two teachers and Benjamin after graduating from the course.


Proud to have completed the course and get the diploma!