Post: #1

I'm currently out at work in the middle of the Canadian north, and got a pretty decent infection that required a 2.5 hr trip to the hospital for a doc to look at it. Was basically sent in because after a doc looked at a pic from the medic here, said it looked like I was at the cross roads of it being able to be handled with oral antibiotics, or it getting real bad so wanted a hands on look.

Anyways it got me thinking, since I go out on my own or in small groups sometimes on long hikes. Or in the past I sailed across the Atlantic with a small group, and sometimes in instances like that, you're literally days from help, and beyond the reach of choppers.

Basically, does there exist some sort of intensive next level first aid training? I'm not talking about a 2 day course you do for work that covers CPR/Choking/burns, but something not as intensive as a 2 year paramedic course.

Maybe something that covers more advanced hands on stuff like stitching wounds, running IVs, giving injections, setting broken bones, crash course on drugs etc. Obviously not at a doctor's level, more a 'it's better than nothing' level. Or are you likely to do more harm than good?

Also if there are any doctors or pharmacists here, on remote trips such as these, are there ever exemptions given for prescription level drugs? Like for instance in this case antibiotics? Next level pain killers? Had I been forced to go another 3-7 days without these drugs due to being stuck in a small sailboat 2000km from land, it probably could have gotten much worse.

Post: #2

EMT courses are 2-3 months and go over a lot of information, though it only covers prehospital care. There are also some 1-2 week wilderness EMT courses out there but ymmv.

Stitches, dropping IV lines, etc... Are things you actually want done by a pro. They can get ugly real quick if they get messed up. There's no real crash course from pharma, as it gets super complicated super fast - some things should not be mixed, contraindications are not to be trifled with.

Post: #3

(07-04-2014 01:02 PM)Seadog Wrote:  Basically, does there exist some sort of intensive next level first aid training? I'm not talking about a 2 day course you do for work that covers CPR/Choking/burns, but something not as intensive as a 2 year paramedic course.

Maybe something that covers more advanced hands on stuff like stitching wounds, running IVs, giving injections, setting broken bones, crash course on drugs etc. Obviously not at a doctor's level, more a 'it's better than nothing' level. Or are you likely to do more harm than good?

Remote Medical International in Washington state has a very respected Remote EMT (REMT) program. You can also try the National Outdoor Leadership School's (NOLS) Wilderness medicine courses. RMI's REMT goes a bit further than the Wilderness EMT as it covers things like tropical medicine, travel medicine, IVs, catheterization, and suturing.

I'm attending the REMT course in October.

http://www.remotemedical.com/RMI-Trainin...e-EMT-REMT

Post: #4

Seadog: I was wondering why you were in Canada and not Indonesia, seeing the Indo flag next to your name was a natural thing.

Post: #5

I would recommend looking at NOLS courses: http://www.nols.edu/wmi/courses/course_matrix.shtml

They offer 20, 40, 80, and 200-hour courses on wilderness first aid. Classes typically in varying locations around the American west and some international locations as well.

Post: #6

(07-05-2014 03:51 PM)Cattle Rustler Wrote:  Seadog: I was wondering why you were in Canada and not Indonesia, seeing the Indo flag next to your name was a natural thing.

Hey Everyone, thanks for the links. They provided some good insight.

And yes, usually with my job, they do about 2 yr international rotations. Work was slowing down in Indo and my time was more than up, so they loaned me to Canada for the busy winter while they looked for something, and didn't really find anything, so basically said hold tight in Edmonton. Just officially got back here about 6 weeks ago. In process of getting a place setup since all my belongings basically amounted to a few bags.

Post: #7

Anything marketed to the military that advertises "Live Tissue" based training, not sure which companies are still in that game, but it's the best there is.

For the most part, there are some really specific, relatively simple things that can be done that can take a patient from 'gonna die' to 'gonna be ok if he gets to a doctor in the next hour' and 'gonna be ok if he gets to a doctor in the next 48 hours', stuff like administering IV fluids, antibiotics, etc, to stretch that 48 hours out gets complicated fast, and requires you to have the necessary equipment on hand.

Giving medical attention is all about the supplies you have on hand and the game in your hands. For trauma (falls, GSW, burns, blast, etc), the stuff that needs to be done to stabilize the patient in the first few minutes after the injury, and prior to packaging and transport, plus the packaging, is stuff that anyone can be trained to do, but the equipment is specialized, bulky, and expensive, and the skills are perishable--it's not quite like riding a bike, you don't forget it, but you'll be slow if you've been 'out of the game' for more than a month or so, and "slow" is not something you want to be in an incident like that. Basic preventative medicine (take your anti-malarial, watch out for the bad plants, don't dehydrate or eat food that will make you sick) doesn't require specialized training, just a minimum of preparation.

For non-professionals, the best thing to do with any medical problem is escalate it to a higher level of care. On the basis of my own limited knowledge, in the case listed in the thread OP, there isn't really any information or equipment that could be taken into the field, that would have changed the advised course of action.