Hesperian health guides

[NewBlood]

I went on a bit of a rabbit hole after reading the "investing for collapse" thread, especially the account of the Balkan war posted by Hristo.

I've been thinking about getting some advanced first aid or EMT training for a while, but from what I can read about those I'm not sure they would provide very actionable knowledge in a situation without much high tech resources available.

Jacob had mentioned "Where there is no doctor" and "Where there is no dentist" before, and I found the Hesperian website which publishes those plain language health guides and many useful others. A lot of those resources are available for free as PDF (you can also buy the books or donate to support their work), in multiple languages.

https://hesperian.org/books-and-resources/

I haven't read much of those guides yet, but would be interested to hear if anybody with medical experience has an opinion.

[Ego]

I've been thinking about getting some advanced first aid or EMT training for a while, but from what I can read about those I'm not sure they would provide very actionable knowledge in a situation without much high tech resources available.

Consider reserving an EMT and or WFR coursebook from the library and page through it to see if the info you want to learn is covered. Much of the EMT program involves stabilization and transport to a higher level of care. WFR is much less detailed but does provide some more info on what to do if you are unable to get to the ER right away.

Sign up for the The NOLS Scenario emails. https://www.nols.edu/en/about/resources/newsletters/

Every time I get one I try to imagine that it is actually happening and ask myself what I would do. It often leads to areas where my knowledge/skills are weak or rusty. Here are some of the older scenarios https://blog.nols.edu/topic/case-studies

If you have someone with a particular condition, make a flow chart of what to do if the common things happen. For instance, if your spouse is diabetic, read what you can about managing diabetic emergencies. Once you have that down, move on to what you would do if you were away from care and a disaster happens like their glucose monitor/auto injector failed and you have to figure out the correct amount of insulin to administer. They may have it under control today but when things go wrong they may be delirious and unable to help. Create a physical flow chart. Send yourself calendar reminders with personal scenarios.

Once you work through the conditions of your loved-ones move on to the common conditions of the community. Viral and bacterial infections. Dehydration. Hypothermia. Choking. Injuries and wound management. Heart attack. Stroke. Anaphylaxis....

I wish someone would make a Duolingo for emergency medicine.

ETA, we carried physical copies of both Hesperian guides on our long trip and the pdf versions on our computers now.

[NewBlood]

Ego, thank for all this, very helpful.

Those NOLS scenarios are great, will add those to my regular readings.

[theanimal]

If you have no prior medical training, I think taking the WFR is far more useful than pursuing the EMT. The WFR will deal with having constraints and working to find solutions with limited options whereas in the EMT class it'll be more like, "There's nothing we can really do, let's hope the ambulance arrives and we get to the hospital fast." Furthermore, WFR covers almost all of the same material as covered in the EMT class, the only exceptions being childbirth and administering certain injections like Naloxone (Narcan). I do wonder if the wilderness EMT would be any different, but considering that WEMT is just a WFR plus EMT training I am doubtful. I do think the extended training of a WEMT would lead to more scenarios and practice in different circumstances than a traditional WFR.

I'd also recommend seeing if you can find any reviews on the instructors for any course you are willing to take. Some are very, very good and worth every penny and beyond. Others are so, so and will kill you to death by powerpoint. To illustrate, I compare all my instructors to my first WFR. My instructor was a physicians assistant in a hospital who had served as a medic in Iraq and climbed the White Mountains in winter frequently with his friends. His experience brought a TON to the classroom.

[zbigi]

I'm going through "Where there is no dentist" and find it very interesting.
There's even an ERE twist to the book, as they show how to make a toothbrush out of a piece of bamboo

[sky]

I referred to "Where There Is No Doctor" last year when I had an ear infection. There was no useful information on earache and ear infection.

[Ego]

I referred to "Where There Is No Doctor" last year when I had an ear infection. There was no useful information on earache and ear infection.

Their website does not have a link to the chapter on ear infections but it is in the book. One of the things I like about it is that they tell you which antibiotics to use. This is useful when in a place where you can buy antibiotics over the counter.

[sky]

Yes, that page is in the section: Health Problems of Children Not Discussed in Other Chapters.

To be fair, when I went to the doctor I was prescribed antibiotics, as recommended in this section, so it is correct. But it seems like there should be better coverage for a common ailment such as ear infection. I would carry another reference book, or use the internet.

[NewBlood]

Thanks all for chiming in!

@animal, thanks for the insights, I'm looking at WFR courses near me now Your comments on EMT training reflect exactly what was putting me off.

[mathiverse]

I've been thinking about getting some advanced first aid or EMT training for a while, but from what I can read about those I'm not sure they would provide very actionable knowledge in a situation without much high tech resources available.

Did you end up getting first aid, EMT, or WFR training? How did it go?

[AxelHeyst]

I can't remember if I posted my WFR experience on the forum somewhere or only in my MMG. I took the WFR in Bishop in 2018. I'd taken basic first aid a couple times but otherwise no other medical training.

We spent a fair amount of time covering circumstances where any help might be many hours or days away, and you might have to move the person over rough terrain to even get to a place where you can get rescued.

We spent a fair amount of time on DIY makeshift 'splints'... we didn't learn about setting bones so much as using stuff people in the backcountry probably have with them to e.g. immobilize a broken leg so the person can be moved over rough ground without causing more injury.

A lot of it was "okay, sitting around waiting for help isn't an option. What's the simplest, least-bad thing you can do to help get this person out?" a big emphasis on how to not make things worse. If you see someone with an obviously broken leg and they're bleeding slowly from it, what's the first thing you do? (tldr is make sure there isn't something else more major going on that might kill them quick, like a blow to the heat, spinal injury, etc, before even paying any attention to their leg).

We also discussed things like sanitation and wound care, because it's feasible you're in a situation where someone has enough time to die from an infected laceration.

Also a fair amount of time spent on psychological issues... mostly revolving around people freaking out. My 'exam' scenario, for example, was a hiker who'd sprained her ankle falling near a cliff, and she was freaking out and hyperventilating. The 'correct' answer, after making sure she didn't have a spinal injury/etc, was to move her away from the cliff because she was scared of it and then help her calm down by going through some controlled breathing exercises with her.

Also, like 50% of the course was going out and doing scenarios. All those hours spent practicing thinking critically while someone is (acting at) being in pain or unconcsious or maybe dead were SO SUPER VALUABLE imo. Even if I don't really remember much of the specifics from the course, just the time spent getting used to thinking usefully while people are hurt has made me less of a liability in the woods. Also, thinking about all the different ways you can get hurt or die in the mountains has made me a more risk-aware outdoorsman.

+1 what animal said about the instructors. One of mine was a woman whose main thing in life was speedclimbing El Cap (NIAD) and had spent time on YOSAR iirc. I don't know how much location will make a difference, but I feel like the fact that I took mine in Bishop meant that almost every single participant was cool, too.

[NewBlood]

Hi mathiverse, thanks for reviving this thread! This had dropped down in my "list of things".

And thanks so much AH for sharing your experience here!

At the time of the earlier messages, I looked into the WFR options available near me but got boggled in the logistics of making it happen (I don't even own a car). It still sounds very valuable and I will try to find an equivalent in my home country when I move back this summer, there are a couple of things that seem similarish.

[Western Red Cedar]

Just chiming in to say that I did the 40 hour Advanced Wilderness First Aid class in 2006. It was great and I'm much more confident in the backcountry as a result of that experience. I'm pretty meticulous in building my own first aid kit as a result of the class, and I've helped a number of friends or stranger on camping trips or outdoor expeditions because I'm well-prepared and confident about treating minor injuries.