Covid-19 has put a strong pause on many things in 2020, with the hopes that we can just pick up where we left off when it is safer to do so.  While we may just be able to postpone a haircut or vacation, that pause has also wreaked havoc within the wilderness medicine industry since so much of the certification process relies on in-person coursework and practice.
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Blanket, long-term extensions are not the permanent answer as skills continue to decline unless they are refreshed and practiced.  For many people, in-person courses are not available or not a realistic option, yet they still need to keep their WFR certification valid.  Longleaf Wilderness Medicine has designed and implemented a one year certification extension that is fully online and self-paced and includes interactive elements.  With a focus on three key learning foundations, participants walk away from the course with refreshed knowledge and skills - and a valid WFR certificate.

Review
We typically hope that people do not have to use the wilderness medicine skills that they learn, at least beyond the caring for minor wounds, gastrointestinal distress, musculoskeletal injuries, and general aches and pains that commonly arise when recreating.  A WFR Recert course is designed to include extensive review of less commonly used assessment and treatment guidelines. 

​Knowledge review is present in a few forms in the WFR Remote Extension.  Including short text readings, whiteboard lectures, and practice quizzes, participants are able to review up-to-date medical information and best practices and refresh information from previous courses.  The review component also includes scenario review where participants can watch LWM instructors work through the response and assessment process.

Practice
It is not enough to review information; the muscle memory required for in-depth response, assessment, and treatment also needs to be stretched.  The WFR Remote Extension course includes interactive scenarios filmed to provide a first person perspective where participants direct the response and choose your own adventure style case studies.  

In addition to guiding response as part of a set scenario, the WFR Remote Extension course includes outlines for at-home skills and scenario practice.  Our guides allow the quick set up of a friend or family member as a patient to support response review and practice.  ​

Demonstrate
The last piece of the WFR Extension course is the demonstration of a full patient assessment.  Participants film themselves responding to a pre-determined scenario and skills checklist that is then submitted to LWM for review.  LWM instructors provide specific feedback based on the demonstration of skills, with the result being either a full pass or allowing for a resubmission with feedback applied.  

Previous course participants have rated the patient assessment demonstration as a key component to their learning; with the submission review requirement, participants have stated that they knew they had to hold themselves to a high standard and ensure that they were completing the whole patient assessment process without shortcuts.  To ensure that participants are still receiving key feedback on their response skills even without in-person meeting, LWM instructors provide specific, in-depth feedback to the response videos and are available through discussion boards and email throughout the duration of the course.

Moving Forward
We are looking forward to returning to in-person instruction and continuing to support the development of confident, skilled backcountry medical response.  In the meantime, there are options for keeping a Wilderness First Responder certification valid.  Whether you are an LWM alum or hold a WFR from another organization, we hope that you will join us for the course. 

Resources:
WFR Extension FAQs
More information about the WFR Extension

Understanding how our bodies create, maintain and lose heat is key to preventing hypothermia. By taking a few proactive measures to make sure that the body is able to optimize heat generation and maintenance, outdoor ventures in cool and cold climates can be safer and more comfortable.

The body produces heat by metabolizing the energy in the food we eat, making it important to remain well fed and hydrated before, during and after participating in activities in cold environments. Ensuring regular consumption of calories throughout activity as well as eating meals with a balance of carbohydrates, fats and proteins will provide adequate energy to keep the internal furnace burning. Proper hydration supports consistent blood volume and regular circulation of blood throughout the body and ensures that this warmth travels to the extremities and skin.

In order to retain the heat generated by the body, it is important to wear proper clothing for the environment. Using a layering system that includes nonrestrictive, dry materials will allow for a clothing system that can be adjusted throughout the activity depending on the conditions and level of exertion. The goal is to stay warm without sweating in order to avoid the resulting chill of evaporative cooling. Individuals should add and remove layers consistently to achieve warmth without sweating.

Recognizing the symptoms
Mild hypothermia occurs when the core body temperature decreases. Individuals experiencing mild hypothermia can present with signs that include violent shivering, pale, cool skin and a series of changes often referred to as the “umbles”: stumbles, grumbles, mumbles, and fumbles. Early recognition of these symptoms in ourselves and our group members is key to treating hypothermia in its mild phase. 

A patient with mild hypothermia can be treated as follows:

1. Protect from the cold: Exchange wet or damp clothes for dry layers and provide additional protection to the patient by placing them in a warmer environment (car, tent, house, sleeping bag).
2. Refuel the furnace: Provide food with simple sugars and carbohydrates. Warm, sugary drinks are a good option for fast acting calories.
3. Gentle exercise to further enhance heat production: 

• For patients who are already up and moving: If the person is already up and moving around, allow them to continue that light movement
• For patients who are sitting/sedentary: After providing additional calories, have the patient stay in their current position for 30 minutes prior to supporting them to get up and move around.

Additional Information
All LWM courses provide detailed information on the body’s response to cold and cold injuries.