Wilderness medicine is a rapidly evolving field and is of increasing importance as more people engage in hiking, climbing, kayaking, and other potentially hazardous activities in the backcountry. The modern definition of wilderness medicine is "medical care delivered in those areas where fixed or transient geographic challenges reduce availability of, or alter requirements for, medical or patient movement resources". A primary focus of the field is the evaluation, prioritization (triage), preliminary treatment of acute injuries or illnesses which occur in those environments and the emergency evacuation of victims. However, back country rescue and wilderness first aid is not the sole activity of wilderness medical professionals, who are also concerned with many additional topics. These include but are not limited to:
Secondary care follow up to first aid in remote settings, such as expeditions
Evaluation of experience and issuance of updated protocols for first response and secondary care
The prevention of wilderness medical emergencies
Public policy advisement to wilderness planning agencies, and issuance of guidelines to disaster planning agencies, professional guides and amateur back country enthusiast organizations
Point of care Ultrasound
Wilderness medicine is a varied sub-specialty, encompassing skills and knowledge from many other specialties. The specific curricula will vary but an example can be seen in the curriculum for Fellowship in the Academy of Wilderness Medicine (FAWM).
The Center for Disease Control in the U.S., and its corresponding agencies in other nations, also monitor leading health threats, pathogen vectors in conjunction with local departments of health, such as Lyme disease, plague and typhus which may be carried by small mammals in a back country or wilderness context.
Insights from the field of Military Combat Tactical Care (TCCC) interact with wilderness medical practice and protocol development. Moreover, new products and technologies tested in combat are adopted by wilderness medical personnel and vice versa.
Applications to Covid-19Edit
As of April 2020[update], studies and trials are underway that examine the possible benefits of nitric oxide in the treatment of Covid-19. This research is related to the role of nasal breathing in the creation of nitric oxide, which increases oxygen absorption in the lungs. Nitric oxide was also investigated as an experimental therapy for SARS.
Brian Strickland, MD, a fellow in Wilderness Medicine at Massachusetts General Hospital who studies “acute respiratory distress” in high altitudes, is applying this research towards Covid-19. He is currently involved in clinical trials which apply the use of inhaled nitric oxide as a treatment for Covid-19. This approach was inspired by the work of Associate Professor of Emergency Medicine at the Harvard Medical School N. Stuart Harris, who has been studying the effects of altitude sickness on mountain climbers, such as those who climb Mount Everest. Harris noticed that the consequences of high level altitude sickness on the human body mirrored Covid-19’s dysfunctional impact on the lungs. His focus on nitric oxide comes from its role in being able to breathe in high altitudes.
Internationally there is huge variety in the medical training for wilderness medicine.