Medical jobs that work in the wilderness

Some general rules about Wilderness Medicine as a field:

1. There is no money in it.

2. When there is money, it isn't much.

3. The more money there is, the less wilderness medicine is involved.

4. The most reliable pay is in teaching.

5. It is fun and flashy... until you are 6 hours into the litter carry.

6. KISS. A lot of neat tricks are only neat in the setting of a course, but then you can't remember at 0200 on the side of a mountain.

7. Real wilderness medicine is a lot of basic nursing (paraphrase of Drs. Wilkerson and Moore).

8. Except for antibiotics and narcs, Wilderness Med is 99% BLS. (AKA I wish all my partners were WFRs.)

9. Flavors are many including rescue medicine, expedition medicine, austere medicine, and uncommon environmental medicine.

10. I forgot 10... I just made these up just now. You do that a lot in Wilderness Medicine.
 
11: When you have to pack it all in you realize how much junk you carry every day.

12: Real wilderness environments typically don’t have cell signal/radio reception. 12.5: Your sat phone will die when you need it most.

13: The wilderness sucks when you are stuck in the middle of nowhere with inadequate supplies.

14: ATVs and dirt bikes break down on the trail even when cared for properly. 14.5: Horses don’t always behave.
 
Peak said:
11: When you have to pack it all in you realize how much junk you carry every day.

12: Real wilderness environments typically don’t have cell signal/radio reception. 12.5: Your sat phone will die when you need it most.

13: The wilderness sucks when you are stuck in the middle of nowhere with inadequate supplies.

14: ATVs and dirt bikes break down on the trail even when cared for properly. 14.5: Horses don’t always behave.
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All that is definitely true. But Im ok with it and definitely drawn towards it. I'm single and definitely can get away with this sort of work. Lol
 
#13 should rarely present itself, if you're doing the job correctly. Although, life happens and I can imagine that being pretty awful.
 
WyoRecast said:
#13 should rarely present itself, if you're doing the job correctly. Although, life happens and I can imagine that being pretty awful.
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I strenuously disagree. Only in rescue medicine, specifically your model of reach and treat from the ambulance, do you stand a good chance of having most of the things you need in adequate supply and timeframe. Wilderness medicine has a much broader set of practice environments (#9). There is a reason for such a focus on improvised care. I'd say most of the time you don't have everything you need when you want it. Depending on your environment, you may be able to usually get what you need eventually.
 
Summit said:
I strenuously disagree. Only in rescue medicine, specifically your model of reach and treat from the ambulance, do you stand a good chance of having most of the things you need in adequate supply and timeframe. Wilderness medicine has a much broader set of practice environments (#9). There is a reason for such a focus on improvised care. I'd say most of the time you don't have everything you need when you want it. Depending on your environment, you may be able to usually get what you need eventually.
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I agree with that, because wilderness medicine, as a practice, includes so much. I will admit that in my bubble of the RAT environment we generally had great equipment and had plenty of it. Our pre-callout inspections were brief, but if we didn't have something that we potentially needed, we wouldn't typically deploy. We were required to have all of our avy gear, including extra batteries, extra probes, and even an extra transmitter (albeit the extra was a pretty cheap model, but it would work in a pinch). All of our meds were inspected monthly, and any meds used during a call were replaced at the end of the call or end of shift, depending on the circumstances. The RAT team had a callout for an anaphylaxis pt in the Mount Hood National Forest. I was not on this call but I have heard about it many times. The two crew members, an experienced paramedic and a skilled intermediate were the only members to respond. There was no fire response into that area. The call turned into a code, and they used so much equipment (as one would expect on a code), including needle cric. The equipment that we had (and that I'm sure the RAT crews still have) was enough to handle any type of call, including this code. Small defibrillator was also available. The total pack weight was pretty heavy, as I'm sure you could imagine, but if it was needed it was ALWAYS available. So yes, I agree that #13 is a reality of "real" wilderness medicine, but I assure you that everything I did was very real, very remote, and we were always prepared for every circumstance. This was compensated by carrying the ambulance on our backs, though, but it could occasionally pay off. The 10 essentials were the 25 essentials for us, because we didn't want #13 to present itself. It's the difference between success and failure when it comes to patient care.
 
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