[WEMSI Letterhead]

Reply To:
Keith Conover, M.D.
36 Robinhood Road
Pittsburgh, PA 15220-3014
412-561-3413

December 10, 1993

To: All interested persons

From: Keith Conover, M.D., Medical Director

SUBJECT: Personal Wilderness Medical Kit

As part of the Wilderness EMS Institute's move toward a physician controlled Wilderness EMS system in this region, we have already established protocols for care by personnel operating under WEMSI medical direction. At present, this includes all medical personnel who are conducting a search or rescue operation under the training guidelines of the Eastern Region, National Cave Rescue Commission, and all members of the Appalachian Search and Rescue Conference conducting search or rescue operations in Pennsylvania. (Copies are available from WEMSI: contact George Pry at 412-578-3171 if you need a copy.)

We are now going beyond these general protocols to establish standing orders for Wilderness EMTs and more advanced providers. Wilderness EMTs and more advanced providers will perform procedures and administer medications under direct on-line medical direction or by using these standing orders when unable to reach a WEMSI Wilderness Command Physician. There are several parts to this process: credentialing both prehospital providers and Wilderness Command Physicians (our Wilderness EMT and Wilderness Command Physician classes will of course play a large part in this), establishing protocols and communications procedures for direct medical direction, and establishing specific standing orders.

The enclosure is concerned with another question: what drugs will WEMSI prehospital providers be able to give? We are assuming that what we are doing is outside the scope of "normal" EMS, and that our providers are not functioning as EMTs or paramedics, but as special wilderness providers, and that therefore "normal" EMS protocols, standing orders, and policies may be inappropriate.

We will be establishing two kinds of medical kits. First are the team medical kits. These will be discussed in a future memo.

Second is the topic of this memo: personal wilderness medical kits to be carried by individual providers. Providers often respond individually to wilderness operations, and may be on scene before team kits are available. And, providers must often go into the field on search tasks with only personal gear. Therefore, each provider will be expected to carry a personal wilderness medical kit. Basic EMTs will carry oral medications, and those who are trained to administer injections will also carry a few injectable medications. (Basic EMTs can use an Epi-Pen without any special training, so it is included in the basic medical kit.)

Though we'd like to issue these kits, at present we have neither the financial or administrative resources to do this. Therefore, we will expect all providers to purchase the contents of their own medical kits. WEMSI will provide prescriptions for members to do this locally. For some schedule II drugs such as morphine, we may have to set up a centralized distribution service, but we're still thinking about this. We may be able to get donations of some drugs from drug companies and distribute them.

First, we must establish the contents of the personal, and in a month or two, team wilderness medical kits. From there, we can set up formal policies and standing orders for their use. Please review the personal medical kit list, and get your comments to me by the January 15 WEMSI Staff/Instructor Workshop, to be held concurrently with the winter meeting for Eastern Region, NCRC near Elkins, WV. (Those who wish to instruct at future Wilderness EMT classes should attend this Workshop.) For information about the Workshop, contact Jack Grandey:

Jack Grandey, EMT-P
862 N. Beechwood St.
Philadelphia, PA 19130
1-215-232-8105 (H)
1-215-471-7170 (W)
1-215-871-9880 (Pager)

Thank you very much.

[signed]

encl: WMEDKIT.DOC, first draft

Designed by a member of