David Johnson, MD

David Johnson, MD

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In addition to his writing, teaching, and business responsibilities with Wilderness Medical Associates, David (DJ) also works as an Emergency Physician at Central Maine Medical Center in Lewiston, Maine His outdoor pursuits have included wilderness canoeing in Canada, climbing and hiking in North and South America, coastal kayaking in the Georgia and Maine and blue water sailing around and across the Atlantic Ocean. DJ is passionate about curriculum development and teaching. His biggest challenge is to try and make apparently complicated concepts accessible and usable for people regardless of where they have to deliver care. DJ states that it is “…often more important to have clarity about the urgency and severity of a problem than it is to have a precise diagnosis. We need to understand what a patient does or does not have and whether or not it is a big deal.” His reward is the light bulb going on in students minds. When one can say “I’ve got it; I didn’t realize it would be so simple!”

Posts By: David Johnson, MD

Q: The new medical advisor of our guiding company has advised us not to distribute over-the-counter medication to our clients. What is your opinion? Technically, one could argue that giving medication under these circumstances (paid guide giving to a client, non-family member) could be considered practicing medicine without a license.  Many school nurses are prohibited from dispensing…




A medical advisor can and should be an integral part of your risk management team, not just the person who writes prescriptions for epinephrine. Functions could include review and advice on policies that have to do with safety, medical management and treatment protocols. If you do any screening, an adviser can also give some guidance…




Femur fractures are serious injuries that usually occur as the result of significant forces. A full assessment, focusing on critical system problems and their stabilization is the crucial first step.

Effective stabilization of femur injuries will help alleviate pain and decrease the possibility of complications. I believe that either a vacuum splint or good padding in a stable carrying device does a good job of providing both.

Although there is no literature supporting their efficacy in the prehospital setting, a commercial traction splint can be a useful tool when applied by a skilled practitioner who receives periodic training on a particular device and/or uses it during rescues or EMS calls. They should not be left on for a prolonged period of time (e.g., greater than 2 hours) unless limb neurovascular integrity and splint tension can be monitored properly and regularly.

Regardless, these are painful injuries. All require the administration of analgesics.




Q: Can a group of field researchers, certified in basic first aid, be allowed to have an epipen in a first aid kit at the location. There are no individuals with known allergies or prescription for epipen, but they will be in a remote location (2-6 hrs from emergency medical services.