Quite a few years ago (back in 2012!), I started guiding on occasion with Andrew Skurka. At the time, I had done volunteer leading of trips with a local Boulder, CO outdoor group but not paid to guide. As part of guiding for Andrew, I needed to get (at minimum) my Wilderness First Aid certification (WFA) and a CPR cert.
Though I had a long-since-expired basic EMT course under my hiking shoes, wilderness medicine ended up being a little different. Meaning rather than the urban medicine focus of my long-ago EMT training, I learned to apply medical concepts with less communication, more latitude with specific protocols, and making do with fewer items vs. what I would have in an urban setting.
The weekend-long course served as a useful introduction to wilderness medicine that, coupled with some common sense, allowed me to feel comfortable performing basic first aid in a wilderness setting.
I sandwiched the occasional guiding stint along with writing for this website and some freelance work and maintaining an increasingly busy IT career over the years. And re-upping the certs every two years during a weekend. And during these re-cert weekends, I’d invariably be taking the class with a good chunk of people retesting for their Wilderness First Responder (WFR) certification.
Almost eight years later, I finally blocked out the time to take the National Outdoor Leadership School /Wilderness Medicine Institute (NOLS) WFR course.
Here are some thoughts on the class and what I think of the experience overall.
TL;DR – For an outdoor professional, a Wilderness First Responder (WFR) course would be something to consider and well worth your time. If you need some basic wilderness first aid knowledge for yourself or close family and friends, the weekend-long Wilderness First Aid (WFA) class might be a better fit both for time and money spent and the focus of the course itself.
What is a WFR?
A Wilderness First Responder or WFR (pronounced woofer), cert is traditionally the primary medical certification for those working full time in an outdoor-related field such as guiding, trail work, SAR, working in remote areas with limited communication such as field geologist or archeologist, etc.
Typically done over 80 hours of class time plus a mock rescue at night, this 10-day class covers much of the same material as the WFA class that people also use to re-cert their WFR, but at a much deeper dive with much more hands-on training.
Note: I did not take many photos during class. I have a fair amount of stock photos in this article.
What topics does the WFR class cover?
To quote the NOLS course description:
Upon completion [of a WFR course] you will be able to conduct a thorough physical exam, obtain a patient history, assess vital signs, provide emergency care in the wilderness, and make crucial evacuation decisions.
What this sentence means in practical terms is you’ll learn to treat wounds, splint, pull traction, administer some very basic meds appropriately, some various other treatments, and (perhaps most importantly) assess, treat, stabilize, monitor, and evacuate patients until people with more medical knowledge, training, and equipment can take over care of the patient(s). You’ll also be CPR/AED and EpiPen certified.
Who should take a WFR course?
If you work full time in the outdoors (search and rescue, guiding, full-time trail crew, etc.), the WFR course is a useful cert.
Now that guiding is a significant part of my income stream, the WFR cert makes more sense. I have the time, and I have to recertify every two years anyway, be it for WFR or WFA. An initial expense of ten days and ~$800+ is understandably a substantial commitment for many, however.
If you want some basic first aid knowledge for yourself or perhaps when out with friends and family, the weekend-long Wilderness First Aid (WFA) course at less than a third of the price of the typical WFR class makes more sense. I delayed taking the WFR class for so long because, in my corporate life, I never had the two-week chunk of time to dedicate to taking this course. NOLS also offers an in-between cert called Wilderness Advanced First Aid (WAFA), but this five-day course appears to be less common.
If you are an existing medical professional such as a nurse, paramedic, or doctor with an already extensive medical skill set, the two-day Wilderness Medicine for the Professional Practitioner (essentially a WFA cert) or the five-day Wilderness Upgrade of Medical Professionals (WUMP) course might be classes that will help you take your existing base of medical experience, skill, and knowledge and apply it to a wilderness setting.
Initial impressions of my WFR class
I’ll say right up front – I ended being one of the old men in the class! At 45 years old, I skewed older than the mainly mid-20s to early 30s crew who took this course. Perhaps four or five us were in the 40+, or maybe even the 35+, crowd. Being in Moab, with many people planning a working vacation of sorts here mixed in with their travels (and, yes, a fair amount did rock Melly fleeces and traveled in a van. 😀), may explain the younger nature of the students overall. Or perhaps not. About an equal amount of men and women took the course.
I’ll say when I took my WFA class; which can function as a WFR re-cert, the age distribution ended up being more spread out. People in the outdoor field naturally want to keep up their cert over the years. I’ll also say that at no point did any of the students make me feel like a middle-aged guy who wandered in from their kid’s soccer practice by mistake. 🙂 An excellent class full of people sincerely dedicated to learning the material and all trying to help each other pass the course.
Surprisingly at first, perhaps half to two-thirds of the class did not have any previous medical training other than CPR/AED. It seems taking a WFA class first, and then a WFR might be atypical. Most students took a deep dive first.
Everyone had some type of outdoor activity they enjoyed, of course. Again, being Moab perhaps, climbing, and mountain biking seemed to be the primary activities people enjoyed overall.
What can make or break a class ends up being the instructors. Fortuitously, I had two excellent instructors who ended up being informative, experienced, helpful, both serious and funny as appropriate, and more interested in making sure we understood the concepts than any “GOTCHYA”-type activities. Not to say that they did not throw curve-balls, but the curveballs always instructed as opposed to setting us up to fail.
The class itself
The setup of the course is such that there is a mix of classroom instruction and then applying the information in hands-on scenario training. As mentioned, the overall focus of the introductory medical classes such as this is assessment, stabilization, monitoring, and possible evac for patient care purposes. The cornerstone of this class is the Patient Assesment System. All treatment, monitoring, care, and evacs come out of this critical part of the curriculum. A portion of the curriculum that will be stressed over and over again even when learning such topics as mental health, wound care, splints, etc.. Additionally, a full day is given to CPR/AED training but still within a PAS triangle framework.
A pleasant surprise to me, versus other classes at times, is how the instructors emphasized knowledge, experience, proper planning before the trip, and skill over gear. In the outdoors, our community tends to emphasize the tools rather than how to apply the tools. I found it refreshing how two experienced outdoor education professionals wanted us to know what to do and how to perform our care rather than discussing too much about the equipment. And how to prevent a medical incident in the first place!
Of course, the instructors discussed types of meds and types of equipment to carry to a certain extent. But, again, the emphasis ended up being more on what to do with the tools rather than the tools themselves. An excellent example of this thought process is when the instructor challenged us to put together a search and rescue kit that could only fit in a standard Nalgene bottle. One memorable line from the primary instructor? Something along the lines that the students tend to buy a lot of medical gear after this class and how you don’t need to do that. Very refreshing! How many discussions have I seen or heard that drones on and on about packs, water filters, shoes, etc. vs. more essential topics?
Another unexpected, but welcome, discussion ended up being a quick rundown of technology needed to communicate in an emergency or even monitoring situation. The quick review on cellular vs. sat phone vs. radio vs. commercial options (e.g., SPOT or an InReach) is not a topic I heard during my previous wilderness medicine classes. When our primary role as WFRs is to stabilize and care for a patient until more in-depth treatment can be performed, carrying some form of a communication tool is mandatory. In 2019, any person responsible for lives on some level needs to know these options. I am glad the instructors, and the local Search and Rescue guest speaker (more on that below), both mentioned these options in enough detail so a student can perform their research and find the best communication tool for their specific role and needs.
As mentioned, the class is very hands-on. You will be outside in the grass, on the ground, or even in the local creek on one occasion, etc. for at least a quarter, if not a third, of the class. Many of the scenarios use make-up that will stain clothing to some extent (fake blood and bruises primarily). Wear comfortable clothing; clothing you don’t mind getting a bit dirty. A beater pair of shoes I wear for various things and the same pants I use for trail-work (or shed building! ;) ) worked well for me. One evening we even did a mock rescue at the local recreation area. Our instructors gave us a scenario, threw in some curveballs (and some humor), and had us performing patient care in the dark by headlamp. Very instructive..and even fun.
Finally, we covered the heavy (and necessary) topic of the mental state of patients. One of our instructors has a wilderness therapy background, and it shows in many positive ways. On both a personal level and on a professional level (be it in my past IT career or my current outdoor one), I could have benefited from this portion of the class. Both a strength and a weakness of mine are that I have an analytical nature, and I tend to want to solve problems; not every issue needs to be addressed. Sometimes, (frequently?) listening and acknowledging the problem is more important than the problem solving itself. A simple realization for many. It only took me 45+ years…
And unique for areas like Moab, we went to the local SAR center and saw the equipment up close (ooh! choppers!), and spoke to the SAR personnel directly. Being a small town with varied terrain (desert, mountains over 12k ft, rivers), a lot of visitors, but a small population, talking to the SAR folks proved to be an interesting field trip.
What about the test?
You will be assessed with a practical test and a written exam. The tests aren’t hard, but you need to prepare. The instructors do want you to succeed, but since you are dealing with patient care, they want you to know the material, too.
Though most of what you need to know can be gleaned from the class itself, I suggest looking over the NOLS textbook for studying at night. If you can, practice your patient assessment skills at night too. Joan’s a certified WFR, and she graciously volunteered (well, drafted, actually. Ha!) to be a patient the night before my exam.
Finally, WMI has an online test with a 300+ question database with many of the questions directly on the written test I took. Be aware though most of the items are at current standards, I’d say a few questions are slightly outdated vs. what we learned in the class (e.g., the few about RICE). Overall, though, I found this online quiz to be an invaluable study aid for the multiple-choice written test.
How does the NOLS WFR course compare to other WFR courses?
A quick Google search will reveal many other organizations that teach the WFR course. Both large ones such as the East Coast-based SOLO, smaller regional schools such as the Wilderness Medicine of Utah (affiliated with the University of Utah School of Medicine), and quite a few smaller programs, too.
A quick perusing of all these programs indicates they all follow similar guidelines. I recertified my WFA last year through the Wilderness Medicine of Utah program, which also functioned as a WFR recert class, and I do not recall any significant differences in the curriculum. A quick search of Da Google shows that different organizations collaborate on these standards.
I think (from my example of one) it comes down to the instructors as to the overall quality of the class. When in doubt, do research, ask, and inquire about referrals. Any reputable program would be happy to put you in touch with former students. I found the instructors at both NOLS and the Wilderness Medicine of Utah program to be excellent, for example.
As for other organizations recognizing each other’s cert? Different organizations may or may not have different answers or stipulations. When in doubt, call and ask. In my case, two years from now, I am going to double-check if NOLS will recognize the locally offered re-cert class as eligible for keeping up my WFR cert per their standards. Or if the local org even recognizes a WFR cert, they did not issue. The fact that multiple organizations collaborate for standards strongly indicates the apparent answer, but that is speculation. Again, verify with each org before committing time and money.
Where to take the WFR classes
The WFR classes are offered throughout the country and not just in areas we associate with outdoor meccas.
How to find these classes? First, Google is your friend! If you specifically want to take a NOLS/WMI course, the NOLS website has a very detailed schedule, too. REI is a partner with NOLS and conveniently offers quite a few classes at their stores.
I found the WFR class to be an excellent investment of both my money and time. Not only did I earn a certification that will allow my outdoor career to deepen and possibly expand a bit (I’ll be attending my first SAR meeting next month), I learned some skills that will help me both personally and professionally. An excellent experience that will only enhance my time in the outdoors in the years to come.