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…



Tags: , , , , , , , ,

Tourniquets have a checkered history past and current combat in the SW Asian theaters has drawn new attention to them.

Tags: , , , , , , , , ,

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.

Tags: , , ,

Dr. Johnson discusses the benefits of antihistamines and the proper administration considering a swollen airway.

Tags: , , , , ,

Creating protocols for administering epinephrine in vials and things to consider.

Tags: , , , ,

Dr. Johnson’s thoughts on using pulse oximeters to diagnose High Altitude Pulmonary Edema (HAPE).

Tags: , , , ,

If you heard about the man who survived a cardiac arrest by receiving 96 minutes of cardiopulmonary resuscitation (CPR), you might be wondering how I feel now about our position on when to discontinue CPR.

In the wilderness or remote setting, stop resuscitation if there is no pulse after performing 30 minutes of continuous CPR.

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.

Could/should Wilderness First Responders be certified to use the King Airway? Could be, yes; should be, no. The limited time available in a WFR course are better spent on more relevant and practical topics and skills.