Medical Oversight, Educational Core Content, and Proposed Scopes of Practice of Wilderness EMS Providers: A Joint Project Developed by Wilderness EMS Educators, Medical Directors, and Regulators Using a Delphi Approach

Millin, Michael G.; Johnson, David; Schimelpfenig, Tod; Conover, Keith; Sholl, Matthew; Busko, Jonnathan; Alter, Rachael; Smith, W.L.; Symonds, Jennifer; Taillac, Peter; Hawkins, Seth C.

doi:10.1080/10903127.2017.1335815

Cited by 7 publications

(5 citation statements)

References 3 publications

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“…Protocol development from a qualified source, such as a medical director, can assist a ski patrol in providing the medical care that is most specific and beneficial for their individual situation. 7 Of the 15 medical directors surveyed, all but 1 have expanded their ski patrol's protocols and 13 perform quality improvement tasks, demonstrating how medical directors can play an active role in furthering and monitoring the quality care provided by ski patrols. While only one half of the surveyed ski patrols had a medical director, 19 of the 22 surveyed ski patrols stated that they expanded their medical protocols.…”

Section: Discussionmentioning

confidence: 99%

“…As ski patrollers don uniforms and are compensated for their medical work, many argue that ski patrollers are acting within the official healthcare system as prehospital medical providers 6 and that their training, protocols, and oversight should be evaluated in line with other emergency medical service providers. Furthermore, because ski patrols provide prehospital medical care that exceeds the scope of Good Samaritan or Basic First Aid practice, 7 many experts argue that ski patrols, by definition, practice emergency medical services, and should, therefore, become formally affiliated with emergency medical services agencies. 8,9 While there has been 1 study that investigated the basic medical care provided by ski patrols in 9 ski areas in Utah, 10 there have been no studies that investigated ski patrols, their medical direction, and their protocols throughout the entire US region.…”

Section: Introductionmentioning

confidence: 99%

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A Survey of Ski Patrols in the United States Comparing Medical Direction, Patroller Training, and Patient Care

Fell,

Linney,

DeLoughery

et al. 2023

Wilderness & Environmental Medicine

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Introduction-Ski patrols are tasked with substantial challenges: distance from definitive care, complex extrications, and winter environments. Rules for US ski patrols stipulate that ≥1 persons be trained in basic first aid, but no further regulations regarding the specifics of provided medical care exist. This project investigated patroller training, patient care, and medical direction of US ski patrols through a survey of ski patrol directors and medical directors.Methods-Participants were contacted via email, phone, and personal contacts. After consultation with known ski patrol directors and medical directors for question guidance, 2 separate institutional review board-approved surveys were designed: 1 for ski patrol directors and 1 for ski patrol medical directors, containing 28 and 15 qualitative questions, respectively. The surveys were distributed with a link to the encrypted Qualtrics survey platform. After 2 reminders and 4 mo, results were downloaded from Qualtrics into an Excel spreadsheet.Results-Twenty-two responses from patrol directors and 15 from medical directors were received. The response rate is unknown. Outdoor emergency care certification was the minimum medical training required by 77% of the study participants. Twenty-seven percent of surveyed patrols belonged to an emergency medical service agency. Fifty percent of 11 surveyed ski patrols had a medical director, 6 of whom were board certified in emergency medicine. All surveyed medical directors stated that they assisted with patroller education, and 93% assisted with protocol development.Conclusions-The surveys demonstrated variability in patroller training, protocols, and medical directorship. The authors questioned whether ski patrols would benefit from increased standardization of care and training, quality improvement programs, and medical directorship.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Survey of Ski Patrols in the United States Comparing Medical Direction, Patroller Training, and Patient Care

Fell,

Linney,

DeLoughery

et al. 2023

Wilderness & Environmental Medicine

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“…In another perhaps more legalistic perspective, the scope-of-practice issue speaks to the benefit of having medical oversight for programming if interventions beyond first aid are planned. Medical oversight and advice from a board-certified and state-licensed physician for all medical programming is a best practice (Millin et al 2017; Warden et al 2012).…”

Section: Myth 7: Dislocation Reduction Misunderstandingsmentioning

confidence: 99%

Ten Myths about Medical Emergencies and Medical Kits

Hawkins

Simon²

2021

Adv. archaeol. pract.

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Wilderness medicine is plagued by myths and dogmatic teachings not supported by evidence. This article focuses particularly on those teachings and tools that would be most likely used in archaeological fieldwork. It lays out 10 of the most common and concerning myths taught in wilderness medicine and wilderness emergency medical services, both in terms of first aid and preparation of medical kits. The myths described are provide a structure for the main purpose of the article: to explain interventions and medical kit contents that are more evidence based and supported by modern understandings of wilderness medicine and fieldwork risk management. The list of top 10 myths includes (1) the use of medications other than epinephrine for anaphylaxis and (2) the availability and proper use of epinephrine auto-injectors, (3) the use of suction devices and tourniquets for snakebites, (4) the use of spinal immobilization for neck injuries, (5) the identification and treatment of heat illnesses, (6) the use of CPR in remote areas, (7) the appropriateness of dislocation reduction in remote areas, (8) the use and choice of tourniquets for arterial bleeding, (9) the initial definition and management of drowning patients, and (10) wound management myths.

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“…All programs anticipating medical training and medical operations should consider having a formal medical advisor or medical director. This could be a physician, or a PA or APRN working in collaboration with a physician (Millin et al 2017; Warden et al 2012).…”

Section: Medical Oversightmentioning

confidence: 99%

“…Consensus-generated recommendations now exist for some categories of WM training , such as specific WFR curricula (Weil and Schimelpfenig 2016; Wilderness Medical Society Curriculum Committee 1999). Other organizations have developed consensus guidelines for performing WM, such as the Wilderness Medical Society (WMS) evidence-based clinical practice guidelines and a collaborative Delphi methodology proposal for scopes of practice of various certification levels (Hawkins 2020; Millin et al 2017).…”

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confidence: 99%

Wilderness Medicine Education

Hawkins

Winstead

2021

Adv. archaeol. pract.

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Wilderness medicine classes are widely available to archaeologists and field scientists, but because wilderness medicine is an unregulated field, knowing what the various courses and products mean can be difficult. Based on the education chapter in the recently published textbook Wilderness EMS, this article—written by same two authors as the book—explores a number of topics relevant for the field scientist, program director, or administrator seeking to obtain wilderness medicine training for archaeologists. The article first explores the history of wilderness medicine products and certificates available to interested parties. It then differentiates between the various products available today along with their benefits and limitations for the end user. Products and trainings described include certifications (including Wilderness First Aid [WFA], Wilderness Advanced First Aid [WAFA], Advanced Wilderness First Aid [AWFA], and Wilderness First Responder [WFR]), as well as single use or continuing education trainings (including Stop the Bleed, CPR, conference courses, and field schools). Particular attention is paid to the specific and actionable needs of a field scientist in remote areas.

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Medical Oversight, Educational Core Content, and Proposed Scopes of Practice of Wilderness EMS Providers: A Joint Project Developed by Wilderness EMS Educators, Medical Directors, and Regulators Using a Delphi Approach

Cited by 7 publications

References 3 publications

A Survey of Ski Patrols in the United States Comparing Medical Direction, Patroller Training, and Patient Care

A Survey of Ski Patrols in the United States Comparing Medical Direction, Patroller Training, and Patient Care

Ten Myths about Medical Emergencies and Medical Kits

Wilderness Medicine Education

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