ARC Wilderness First Aid vs. Others

[rdclements]

I doubt that I will ever go through the training and certification to be a professional medic. I got my first real first aid training in '81 and have had the opportunity to continue learning and to occasionally be helpful. I have never represented myself as anything other than a volunteer lay person, or exaggerated my training/skills/expertise.

 

I have responded to and have multiple saves in an interesting range of situations from basic whittlin chip trouble to multi-day technical rescues. In each situation, I have never received anything but respect and appreciation from the pros when I handed off the patient to their care. I'm convinced that lay training has a valuable place in the chain. I'm sorry if you don't agree, but many others do.

 

BSA has a requirement and expectation for a certain level of training in the volunteer corps. They are partnered with ARC to get people 'certified' to that standard. As long as I have the means, I will continue to serve as a volunteer instructor for them.

 

If someone gets confused and mistakes "certification" from a Red Cross course as a more professional rating, they are responsible for their own ignorance and present us with another opportunity.

[dScouter15]

rdclements - nothing that I posted conflicts with what you posted. At no time have I disparaged anyone for seeking first aid training. And, should you look at the history of my posts, you will see several occasions when I encourage more advanced first aid training for Scouts and Scouters.

 

While I still stand by my position on some of training programs, and of some people who intentionally misrepresent their role, I do apologize that my tone in that original post seems to have clouded the point I was trying to make.

 

Despite this, I have not made any personal attacks on any participant in this forum, or towards and specific person at all. Would it be possible, rdclements, for you to answer the question I asked of you in the previous post?

[BrentAllen]

dScouter15,

The main reason most businesses went with AHA was their card was good for 2 years while ARC was good for one. ARC is now good for two years. There is a Statement of Understanding between the ARC and AHA which says they recognize each other's training. You can read it here:

 

http://www.heart.org/idc/groups/ahaecc-public/@wcm/@ecc/documents/downloadable/ucm_315746.pdf

[rdclements]

dscouter, I stand corrected. Your problem was with the enthusiastic bystander. My police and firefighter colleagues have training in managing folks like that while maintaining professionalism and effectiveness. I'm sure it's a challenge.

 

There's not often a pro around when you need one. That enthusiastic bystander with his questionable training conducted with dubious oversight is the kind of guy who will most likely be the first to reach you when you go down.

[STCDirector]

I have the priviledge teaching The American Red Cross and the Emergency Care and Safety Institute Wilderness First Aid.

 

I feel the best program between the two is currenlty through the Emergency Care and Safety Institute.

 

If you would like more information please feel free to get in touch with me at info@somersettc.com

[Beavah]

Contrast these titles with "Wilderness EMT", "EMT-W", or "Wilderness First Responder." Persons holding these titles may also have official legal certification or license as an EMT or FR, and have completed additional training on performing their duties in the back country. But, these courses and "certifications" typically do not provide any additional legal authority to practice emergency medicine with an expanded scope of practice.

 

Yah, I understand where both dScouter and rdclements are comin' from, and I agree with both of 'em.

 

First Aid courses, including Wilderness First Aid, are layperson courses. Conventionally, they do not have performance standards in the same way that professional courses do. While they might have "tests" or "certifications" those aren't real in that sense. Kinda like Lifesaving MB or ARC Community CPR. WFA is a reasonable basic field first aid course for laymen, but it's not anything more than that. From a weak provider, it could be less than that.

 

First Responder and EMT courses lead to professional licenses. So by definition they do have performance standards, and the certifications offered are "real." Of course providers do still vary in quality, and state licensing tests can be passed even by folks I'd consider pretty weak.

 

Wilderness endorsements are typically an add-on to the respective professional course. So an EMT-W program typically meets the EMT licensing requirement plus an additional 30-50 hour training on wilderness protocols. Some providers offer "upgrade" courses to urban EMT-B's for the -W certification. Similarly, WFR uses the state's base MFR course with additional wilderness components.

 

What gets tricky is that not all states offer an EMT-W license class. Some do, others do not. So if yeh live in a state that doesn't offer a -W licensure, takin' the wilderness stuff doesn't add to your license or protocols in an official way. Same with states that don't offer a WFR license class. As a WFR in such a state, you are considered a civilian first responder. Yeh might even be considered a civilian first responder with an EMT-W certification, if yeh did it with a provider in another state that wasn't recognized by your state of residence and never did National Registry.

 

The outdoor industry, however, has by and large accepted the WFR as the base professional certification for professional guiding. So if yeh want to get employed in a guide service they will expect WFR (or EMT-W) even if they're located in a state that doesn't offer a WFR license class. So in some states, da Wilderness certifications are treated as professional licenses, in others not, but they are still recognized by da industry as professional certifications.

 

For all of that, I think it's just grand for people to get as much training as they can, particularly in non-urban environments. It's a funny thing, eh? My experience is that many professional EMTs are not da sharpest knives in the drawer, as da pay is pretty low and da burnout in the profession is pretty high. Often da civilians with higher levels of training are better at some stuff - just because they got into it out of real passion and stuck with it because of that (and because they had other forms of income). Lots of the wilderness cert. folks are that way, eh? They're bright people who are doin' it because they love wilderness and feel this is how best to be prepared.

 

So quality-wise it's all over da place, and hard to make definitive statements. Who do yeh want takin' care of you on a mountain side, the urban officially licensed EMT-B or the AMGA mountain guide with EMT-W certification who might not be licensed in the state? Probably the latter until yeh make it to the trailhead.

 

Beavah

 

[KC9DDI]

Beavah - I think that sums it up pretty accurately. Like I said before, I think dScouter is referring to some issues internal to the EMS profession, and while I don't necessarily disagree with him/her, I don't think this forum is really an appropriate place to fight that battle.

 

I do have one question though - I didn't know that any state offered an EMT-W certification with a scope of practice beyond that of a Basic EMT (or that states equivalent if it doesn't call them EMT-Bs). Could you tell me what state/s have this legal certification level, as I'd like to learn more about their program. Thanks!

[Eagle92]

My understanding is that WEMT is a EMT-B upgrade.

[wayne@gctel.net]

I attended the WEMT upgrade course offered by Wilderness Medical Associates last year in Hill City, SD. I attended the course with a number of individuals from diverse backgrounds, US Secret Service Agents, Firefighter/EMT's, and even a woman who spends summers at the South Pole.

 

The skills I learned in this course did not take me out of legally authorized scope of practice. But did challenge me to look differently at how I would operate in a remote environment with limited personnel, equipment and supplies. Living and working in a rural community, I have incorporated a lot of this into my practice. As an EMS educator, I found the course to be interesting in how it forced the participants to get out of the "this is the protocol" mentality and begin to think and problem solve.

 

Most EMT's will only be with their patients for a few minutes to an hour at most. If you find yourself in the woods, on a canoe trip or something like that, you may be needing to care for that patient for a much longer period of time.....several hours to maybe a day or too. This adds a whole other dimension to patient care for some EMS providers. This course helps to provide some basic training in this.

 

Did I learn any new basic skills in this course...No. In fact I was expected to be knowledgeable and proficient when I arrived on day one. But I did have a wonderful experience delving into problem solving of what if scenarios in less than ideal conditions out in the middle of nowhere and you and your team are the only ones to care for the injured or ill.

 

It was an awesome experience.

 

Wayne

[KC9DDI]

Wayne - I've never heard anything but good things about WEMT programs. As a paramedic myself, I frequently find myself frustrated with "cookbook providers" who treat the protocol as kind of a check list, and don't or can't think critically about what's actually going on with the patient, and how to treat the patient most effectively. I'm glad to hear that the WEMT program works on changing that line of thinking - now if only initial EMT and paramedic training programs would adopt that same mentality! But I'm still unclear on which, if any, states offer a legal EMT-W certification with an expanded scope of practice. I had thought that the course was like AMLS, for example, that offered valuable in-depth training, but wasn't credentialled at a legal level.

 

Getting back to the larger theme of this thread, I don't think that any nebulous-ness about the alleged legal standing (or lack thereof) of those trained as WFR or EMT-W should dissuade Scouters from taking advantage of these training programs where they are available.

[wayne@gctel.net]

KC9DDI de KD0AAA....I agree 100% with what you are saying. I instruct EMT and First Responders and while we teach to National Curriculum, we do a lot of scenario based training with situations that are more complicated to make the students problem solve and get out of the cookbook mentality.

 

As for an expanded scope of practice...I am not sure of any states that do, and at the current level of training within the WEMT, in fact a quick search on the internet shown Maine as being the only state (I could find) that officially recognizes the designation.

 

And as you mentioned about not being dissuaded from getting the training, I can not agree more...if nothing else it is a great way to get those CE hours for NREMT in a fun, different, and challenging situation.

 

73's......KC9DDI de KD0AAA

[Tampa Turtle]

I have had the ARC CPR course and the AHA CPR course (through work) and found the AHA version more comprehensive and realistic.

[JMHawkins]

I went through the ARC WRFA 16-hour course, and thought it was great. Packed with information and practical, I think it was a worthwhile course and would recommend it. I don't know how anything could be shorter and still be effective though. There was very little fluff in the 16 hours, and we had a 4 or 5 to one student to teacher ratio. The only way to shorten it would be to cut out the scenarios or just leave off some material. As it is, I think it's just the start of being competent. More practical examples, more practice, maybe some reflections aftwerward to help retain the key skills, but of course all that would make it longer and more expensive.

 

I thought the cost was very reasonable, but these days even reasonable isn't always easy to come up with. Considering the amount and nature of the material, I don't see how it could ever be "cheap" without a big subsidy from somewhere. This is probably one of those things that's important and expensive (both time and money) and everyone just needs to figure out where it goes on their own personal priority list.

 

As far as input from other WFA types, this course had lots of MOFA and SAR influence, and at least one EMT-W (or whatever they call them in WA state) instructor on the staff, as well as a professional moulage artist (and let me tell you, pulling up the shirt of an "avalance victim" in one of our scenarios and seeing a rib sticking out of his chest spurting blood definitely added to the experience). Of course that could fit into Beavah's point about "course quality is hit or miss depending on the instructor" as this was a pretty outstanding set of instructors who have been doing this type of course for several years already.

 

 

[SOLO]

Beav (I find that hard to writethat because it's my nickname). When I was first sent a link to this forum, I hesitated to respond. However, after giving it much thought, I figured I'd throw my hat into the ring. As the co-founder of SOLO in 1976, we created the Wilderness First Aid program, which I can assure you has become the template or skeleton of all WFAs now out there. Being the oldest fulltime wilderness medicine school in the world doesn't necessarily immediately qualify us for being the best; however, the fact that we are still around and still growing is some sort of testament to our doing something right. There's some really interesting wilderness medicine history that has been "forgotten." Without going into a dissertation of its evolution, I'd like to point out some facts. WMA and WMI, along with SOLO are mentioned as the "big three." Together we all have an interesting connection. Buck Tilton who is mentioned in a number of posts as being eminently qualified to write the BSA curriculum was a student, along with his then partner Melissa Gray, in the first ever WFR course taught in the US. Frank Hubbell, co-founder along with Peter Goth, founder of WMA, had joined forces in the early '80's and created the WFR curriculum. Frank was a longtime pre-hospital person who went on to become a physician and Peter was a physician at the time. Frank had been teaching and designing pre-hospital courses throughout college in the early 70's and decided to return to NH and start teaching a two-day program to college outing clubs. By 1976. he and I built the SOLO campus and gave SOLO a formal legal structure. Peter had connections with Outward Bound and an interest in wilderness medicine. Ironically, he lived within 50 miles from us. So, we got together and decided to take the same approach Frank had used in creating the WEMT and add wilderness training to the newly minted DOT First Responder course. A course was set up in Florida and Buck and Melissa were students. Not long after, they came north to SOLO and worked with us for a number of years becoming EMTs and eventually instructors. Buck and Frank co-wrote two books. Eventually the two asked if they could relocate in the West and start a SOLO West in Pitkin, Colorado, using SOLO materials, certs, etc. In recognition of the role they played in helping SOLO grow, we gave them our Western contracts and our blessings. Eventually, they said they wanted to change their name to WMI, to which we agreed, although they were still using SOLO materials and certifications. Then we got the call that they were selling to NOLS, and the rest is history. Our relationship with WMA evaporated after a couple years although some of their instructors also had been teaching for us. So, we have the same basic foundation when it comes to these programs. Many other groups are spin-offs. Competition is healthy-- it keeps us on our toes. When the ARC, Boy Scouts, ASHI, and several other organizations decided to jump into an already crowded pool, things became really complicated. Now it is definitely a "buyer beware" market. Cheaper does guarantee better, and there's no question that the experience of the "big three" and several other groups along with their instructor oversight is overall better than these other organizations. I am only speaking from a secondhand perspective; I have never taken a BSA or ARC course, but we've certainly benefitted by gaining more sponsors who have not been happy with their experience. Just an interesting note: the curriculum that was created by the BSA was almost word-for-word the curriculum that SOLO used until 2000 when we realized it was far too intensive and no longer allowed for the experiential segment we deemed essential to the learning process. As a result of the BSA development of a curriculum, the rest of the providers, who were expressly excluded in the initial BSA document as not being recognized, began a lengthy consensus process through which a new WFA curriculum was created and has been implemented by most of the non-BSA groups. Rules have changed, and we still teach dozens of programs to scouting groups. We love the scouts and our instructors enjoy the enthusiasm of the participants. I think the motives of the BSA to have their own curriculum were good; I can't say the same about some of these other newcomers. Let the buyer beware. We just want you to get the best training possible so you can be safe and can help others in need.