Wilderness First Responder with NOLS
Recently, I finished a Wilderness First Responder course taught through NOLS. The class was hosted by Adventure Outings, the student outdoor club at Cal State Chico. The classroom portion of the course was on campus at the Wildcat Recreation Center.
Before the Class
The ARTA Pro Guide Course ended just before Memorial Day weekend, while the WFR courses didn’t start until the following Tuesday, so I had a few days between the two classes. On Saturday, I picked up my parents from a backpack along the Pacific Crest Trail south of Mount Shasta. While they were doing a day hike on Sunday, I worked on my blog post on the Pro Guide Course.
On Memorial Day, I dropped my parents off for another PCT backpack, then continued south to Chico. I got there around 1:30. The check-in time for my AirBnB wasn’t until three, so I spent some time walking around the Cal State Chico campus and Chico’s very walkable downtown. I stopped in a nice used bookstore and found a book on early Grand Canyon river guides.
After getting set up in my Airbnb (a lovely little bungalow less than a mile from campus), I stocked up on groceries and settled in.
The course was taught by a pair of NOLS instructors, Clemencia and Muggy. We had 24 students, at least half of which were either river guides or in the process of becoming guides. Most were college age, many of them students at Cal State Chico.
The class was about two-thirds lecture and one-third hands-on scenarios. In the scenarios, some of the students in the class would play someone injured or ill while the rest of the students had to work through the patient assessment and potentially treat them.
There was a big emphasis on the patient assessment system. Systematically going through a series of steps to gather information that informs decisions on evacuation and treatment. You start with sizing up the scene: safety, number of patients, etc. Approach the patient and get consent to treat, then check their airway, breathing, and circulation, and make an initial decision about a potential spinal injury. After that, it’s a head-to-toe examination, take the patient’s vitals, and ask them about relevant medical history.
We did 3-4 scenarios working through the patient assessment process every day. They started it out fairly simple, gradually incorporating more elements over the course of the first few days until we were doing the whole system. Most of these were done in the recreation center, but for some of them, we got out to some recreation fields or a little creek that runs through the center of campus.
Once you’ve worked your way through the whole assessment system, then it’s time to start treating (other than immediate threats to someone’s life discovered during the airway, breathing, and circulation check) and making decisions on evacuation. These treatment and evacuation decisions for different injuries and illnesses were the main emphasis of the lecture portions of the course. We mainly talked about injuries (wounds, sprains and broken bones, burns, etc.) during the first half of the class, with an emphasis on illness during the second half.
For the most part, the class ran from 8-5 every day, with an hour break for lunch. We had Day Six off (I spent it working on the pre-course “homework” for the swiftwater rescue course I’d be doing the following week and writing up my notes from the Pro Guide Course). On two days, we also had an evening session. Day Three, our evening session was in the classroom, working on splints. On Day Seven, it was out at Big Chico Creek Ecological Reserve.
That evening was pretty interesting. Not only were we out in more of a wilderness environment, but it was also by far the longest scenario, keeping us with our patient for a couple of hours. A longer duration is one of the things that distinguishes wilderness medicine from its urban counterpart, where the time to higher-level care is much shorter. Muggy does some mountaineering and joked that sometimes in that context, “A regular evacuation takes a week. A rapid evac takes seven days.”
The last day of the class is the final exam. There’s a 100-question multiple-choice test and a practical exam where you and a partner have to do the patient assessment on an instructor playing the part of an injured patient. Everyone in our class passed.
After the class
We finished up in the early afternoon on day 10. I spent the rest of the afternoon working some more on the notes from the Pro Guide course and getting everything packed up. The next day it was back on the road for the drive to Cañon City, Colorado, for my swiftwater rescue course.
During the Pro Guide Course, Noa really emphasized how important and valuable Wilderness First Responder training was so I came into this class with pretty high expectations. I have to say the experience exceeded them. Clemencia and Muggy were great instructors: highly knowledgeable in the subject matter and great at teaching it. We also had an excellent group of students. I was always happy to be partnered with any of them during the scenarios.
This class is a firehose. I took even more notes than I usually do, filling a pair of 150-page Rite in the Rain notebooks. Most of my studying came in the form of typing up and reorganizing my notes on the computer every night (though I got behind on the days when we had the evening sessions).
On Day 9, I also worked through a 300 question online practice test. This particular practice test does come with the caveat that it’s not an official NOLS product and some of the questions are not up to date with the latest changes in the curriculum, but I found it very helpful. It played a key role in my only missing three questions on the written test.
Between nine or more classroom hours and out-of-class studying, this is a class that’s going to suck up all of your time for ten days. Don’t plan on getting much else done during the course. I’d recommend copious note-taking, whatever study methods work best for you, and the online practice test.