Practice in Context
Given the inherent risk for a variety of injuries, as well as the remote locations in which wildland firefighters work, it seems beneficial to have more people on the fireline with training in wilderness medicine. They'll be able to handle the routine problems, work without medical resources, manage the patient if transportation is delayed, and make decisions on the urgency of transport.
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This fragmented EMS delivery and occupational health care on wildland-fire incidents haven't gone unnoticed. The National Association of State Emergency Medical Services Officials continues to support the development of an organized approach for granting legal recognition for out-of-state personnel for fighting wildland fires.
Recently the Safety and Health Working Team formed the Incident Emergency Medical Task Group to address these challenges. The IEMTG will coordinate with the appropriate local, state, tribal, federal and national organizations to develop and recommend standards for the delivery of EMS and occupational health services on incidents that are managed by National Wildland Coordinating Group member agencies.
The appropriate care of the sick and injured on incidents continues to be of great concern. Lack of clarity has led to heightened costs for incident emergency medical services operations, greater exposure to liability for all agencies and employees involved, and concerns about quality of care.
Tod Schimelpfenig has been a National Outdoor Leadership School instructor since 1973, has more than 30 years of field experience as an EMT, is a fellow of the Academy of Wilderness Medicine, and is a two-time winner of the Wilderness Medical Society's Warren Bowman award for contributions to the field of wilderness medicine by a non-physician. Schimelpfenig has served as the NOLS risk-management director and Rocky Mountain School director, and on the board of the Wilderness Medical Society. He is a founder of the Wilderness Risk Manager's Committee, has taught wilderness medicine since the late 1970s and has written numerous articles on educational program, risk management and wilderness medicine topics. He is the author of NOLS Wilderness Medicine and co-author of Risk Management for Outdoor Leaders. Schimelpfenig is currently the curriculum director of the Wilderness Medicine Institute of NOLS.
Bequi Livingston contributed to this article.
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