About the Wilderness EMS Institute

A project of
The Center for Emergency Medicine of Western Pennsylvania
and
The Appalachian Search and Rescue Conference



Our Mission

WEMSI's mission is to improve medical care for people remote from the Emergency Medical Services system. We work for improved Wilderness EMS in three ways: teaching; research; and directly providing Wilderness EMS services.

Our teaching activities include offering and sponsoring classes for field personnel and the physicians who provide medical oversight for them. We offer Wilderness EMT and Wilderness Command Physician classes in western Pennsylvania and nearby areas. Organizations offering Wilderness EMT or Wilderness Command Physician classes that follow our entire curriculum, and meet a few quality-control requirements, may register their classes with WEMSI. Participants in WEMSI or WEMSI-registered classes receive recognition (cards and patches) from WEMSI. WEMSI does not become involved in the finances of such registered classes.

We also make our Wilderness EMT and Wilderness Command Physician curricula available to those who wish to follow it without registration, or adapt it for their own use. Please request an order form from the Center for Emergency Medicine.

WEMSI also sponsors Topics in Wilderness Emergency Medicine, quarterly lectures on wilderness EMS, in the Pittsburgh area.

WEMSI promotes research into topics relevant to the needs of wilderness EMS providers. We also serve as an information resource for physicians and members of search and rescue teams and EMS agencies interested in applying the medical literature to wilderness EMS.

WEMSI is working toward a model Wilderness EMS system in Pennsylvania. We are working with state organizations such as the Pennsylvania Emergency Health Services Council, the Pennsylvania Division of Emergency Medical Services Systems, the Pennsylvania Search and Rescue Council, and Pennsylvania Emergency Management Agency. While working toward such an ideal system, we provide medical oversight to selected Pennsylvania search and rescue teams as an interim model. While our interim Wilderness EMS system is parallel and separate from the existing EMS system, we support the idea of tightly integrating wilderness EMS with the existing "street" EMS system. (WEMSI currently operates under the broad delegated practice provisions of the Pennsylvania Medical Practice Act until such time as Wilderness EMS can become part of the state EMS system.)

WEMSI Wilderness Command Physicians are also available for immediate on-line consultation by local medical control physicians dealing with wilderness medical problems; call the Mercy Hospital Communications Center at 1-800-232-5921.



The Organizations

The Appalachian Search and Rescue Conference (ASRC)

is a volunteer search and rescue organization devoted to wilderness search for lost persons and the rescue of injured persons from hiking, hunting, or other accidents. The ASRC conducts special technical operations including mountain and cliff rescue.

There are currently ASRC Groups in Pittsburgh, PA; Columbia and College Park, MD; in Washington, D.C.; and at Charlottesville, Chesapeake, Richmond, Blacksburg, and Norfolk, VA.

ASRC Groups also are part of the Appalachian Region of the Mountain Rescue Association. The ASRC is affiliated with the Eastern Region of the National Cave Rescue Commission and the National Association for Search and Rescue.




TheCenter for Emergency Medicine of Western Pennsylvania (CEM),

founded in 1978 and incorporated in 1983, is a consortium of Pittsburgh-area hospitals and the University Health Center of Pittsburgh, the largest single medical campus in the U.S. Through its large residency program (the University of Pittsburgh Affiliated Residency in Emergency Medicine), the Center trains emergency physicians, and it also conducts a highly-respected paramedic training program.

The Center provides medical command for the city of Pittsburgh, and provides emergency ground and aeromedical transportation services (STAT: Special Treatment And Transport). The Center for Emergency Medicine is well-known for its research in emergency medicine and prehospital care (the use of lighted stylets for intubation is a recent CEM innovation). The Center publishes many papers in the Annals of Emergency Medicine and other medical journals. It is the center for Pennsylvania's Basic Trauma Life Support training, and it is the headquarters of the National Association of Emergency Medical Services Physicians.



The Wilderness EMT Curriculum

A primary WEMSI goal is to produce a comprehensive, realistic, peer-reviewed Wilderness EMT Curriculum, including Lesson Plans, a Course Guide, and a textbook. We are developing a Wilderness Command Physician course, and provide medical oversight to local SAR teams as a demonstration project.

The purpose of our Wilderness EMT Curriculum is to fill in the gaps between search and rescue and EMT/EMT-P training. And, we want to extend both the SAR (search and rescue) and the EMS system so they can meet "in the middle" in the person of the WEMT. Our ultimate goal is to provide better care of those in the wilderness who are injured or ill.

The target population for the curriculum includes members of mountain, cave, and other wilderness search and rescue teams, and members of rural rescue squads with wilderness search and rescue responsibilities. The curriculum is not designed for outdoor recreation trip leaders or guides, unless they are part of a wilderness EMS system with a physician medical director.

The prerequisites for the curriculum (and a "post-requisite") and the reasons for them, are as follows:

Virginia Ground Search and Rescue Field Team Member certification or similar training is required, so that we don't have to repeat basic search and rescue training in the WEMT course. Adequate SAR training is readily available in our area (i.e., the Virginia GSAR training program, and training and certification offered by organizations such as the ASRC).

Programs such as the National Association for Search and Rescue's Fundamentals of SAR and the National Cave Rescue Commission's Orientation to Cave Rescue are also available across the continent.

EMT or EMT-P training is required. It is readily available throughout the U.S, and is the basis for all recognized U.S. prehospital continuing education courses (e.g., Prehospital Trauma Life Support and Basic Trauma Life Support courses). We are developing EMT equivalency guidelines for Canada.

Clinical training in the Emergency Department is considered a "post-requisite" of the class; although we believe that specific clinical training is essential to the education of the WEMT, we cannot integrate this into the curriculum itself. Therefore, we will provide clinical training recommendations to each student, and to each student's Wilderness EMS medical director. We will urge that this clinical training be arranged by the medical director, and that this clinical training should continue on a regular basis. See the Clinical Rotations: Outline and Checklist for specifics of clinical training.

After much discussion, we decided in 1987 to develop a single WEMT curriculum for EMTs and for Paramedics. The same course curriculum would be used for EMTs, EMT-Ps, and anything in between. Why?

First, we felt we must teach something about advanced techniques even to Basic EMTs. Compared to street EMS, wilderness EMS is very much a team effort (often with a large team!). Basic WEMTs will often need to assist their WEMT-Paramedic team members with advanced skills (e.g., helping prepare IV bags and lines under the WEMT-Ps supervision).

Basic WEMTs must know much of the same pharmacology, anatomy, and physiology that the wilderness paramedics mush know. Basic WEMTs must know about the proper use of medications commonly carried in outdoors enthusiasts' medical kits, must understand the principles of oral fluid replacement, and must be able to deal with common primary care problems, as must wilderness EMT-Ps.

No advanced skills beyond EMT-P skills are needed for routine wilderness ALS. Central lines, Foley catheters, chest decompression, and NG tubes are all legitimate parts of the standard EMT-P training curriculum. Therefore, the WEMT module need not teach any new invasive skills. Escharotomy and fasciotomy are surgical skills that are occasionally needed, but require surgical training far beyond that given to EMT-Ps, and should be reserved for physicians or others already specifically trained in these procedures.

We offer a course completion certificate at local classes based on our Curriculum. We rely on state EMS agencies to coordinate with state search and rescue agencies to establish state WEMT licensure or certification, and rely on local or regional medical command physicians to establish appropriate protocols.

For WEMSI's interim medical oversight program, Wilderness Command Physicians and WEMT members of search and rescue teams must meet WEMSI credentialing requirements before being permitted to operate under WEMSI medical direction.

More information on the Curriculum appears in the Course Guide; version 2.0 of the Course Guide should be available during July or August 1997 and will be available by mail for the cost of copying, shipping and handling from the Center for Emergency Medicine, and will also be available on this Web site in Adobe Acrobat format.



The following free one-sheet pamphlets are available here in Adobe Acrobat format - although they duplicate the material found elsewhere in HTML format on this site. You may download and print them out for your own use. If you find the page layouts a bit strange, it's because some are designed to be folded.

Printed copies of these pamphlets are also available from the Center for Emergency Medicine of Western Pennsylvania, 230 McKee Place, Suite 500, Pittsburgh, PA 15213-4904, 412-578-3203. NOTE: This number is NOT for information about specific classes; please see the schedule of courses for the contact persons for specific classes.

If you don't have the Adobe Acrobat reader, you may download it here.

Get Acrobat Reader (gif)

July 23, 1997: Keith adds: All our pdf files are in Acrobat 3.0, and if you have problems reading them with version 1.0 or 2.0, please follow the above link to upgrade to the latest version (free).

Small Adobe PDF icon "Wilderness Emergency Medical Services Institute" (pamphlet)

Small Adobe PDF icon "Wilderness EMT and Wilderness Command Physician Classes" (pamphlet)

Small Adobe PDF icon " Wilderness EMT Curriculum" (pamphlet)

Small Adobe PDF icon "Wilderness EMT Documents" (order form)




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