This document discusses wilderness first aid. It defines wilderness as a remote geographic location more than an hour from definitive medical care. The goals of first aid are preserving life, alleviating suffering, preventing further illness or injury, and promoting recovery. First aid providers must recognize their limitations and seek additional care when needed. Legal aspects of first aid include good Samaritan laws, confidentiality requirements, and obtaining consent from patients. Providers should take precautions to prevent the transmission of infectious diseases.

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Background
CHAPTER 1

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Learning Objectives (1 of 2)
 Define wilderness.
 Define first aid.
 Explain why first aid is important.
 Explain the legal aspects of first
aid, including confidentiality,
good Samaritan laws, and
consent.
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Denali National Park and Preserve, Alaska

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Learning Objectives (2 of 2)
 Explain the potential psychological and emotional impacts of
first aid.
 Describe several bloodborne and airborne diseases of
concern.
 Describe infection disease precautions and the importance of
preventing disease transmission.

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Wilderness First Aid
 Wilderness
• Remote geographic location
• More than 1 hour from definitive
care
 Examples
• Recreation
• Occupations in remote areas
• Urban areas with overwhelmed
EMS
• Residences in remote
communities
• Developing countries

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What Is First Aid? (1 of 4)
 The helping behaviors and initial
care provided for an acute
illness or injury
© Jerry Horbert/Shutterstock.
FIGURE 1-1 Wilderness is defined as any remote geographic location more than 1 hour from
definitive medical care.

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What Is First Aid? (2 of 4)
 Goals of the first aid provider:
• Preserving life
• Alleviating suffering
• Preventing further illness or
injury
• Promoting recovery
© Jeanne Provost/Shutterstock.
FIGURE 1-2 Many outdoor occupations occur in remote locations.

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What Is First Aid? (3 of 4)
 First aid competencies:
• Recognizing, assessing, and prioritizing the need for first aid
• Providing care by using appropriate knowledge, skills, and behaviors
• Recognizing limitations and seeking additional care when needed

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What Is First Aid? (4 of 4)
 First aid does not take the place
of proper medical care.
 Recognizing a serious medical
emergency and knowing how to
get help could be crucial in
saving a life.
© Howard Backer, M.D.
FIGURE 1-5 You can never have too much knowledge about what to do for injured or
suddenly ill people.

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Legal Aspects of First Aid (1 of 2)
 You are not expected to place your own life and safety in
jeopardy.
 You are under no moral obligation to aid an injured or ill
person, except in two situations:
• Your employment requires it
• A preexisting relationship exists

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Legal Aspects of First Aid (2 of 2)
 Confidentiality
• Be extremely cautious about revealing information.
• Law recognizes people have the right to privacy.
• Do not discuss what you know outside of medical need-to-know.
• Exceptions: rape, abuse, and gunshot wounds

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Good Samaritan Laws (1 of 3)
 Encourage people to assist others
 Protect the rescuer when the rescuer is:
• acting with good intentions;
• acting during an emergency;
• acting without compensation;
• acting within the scope of their training; and
• not guilty of acting in a grossly negligent (reckless) manner toward
the person.

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Good Samaritan Laws (2 of 3)
 Negligent actions include:
• Giving substandard care
• Withholding care when duty to act
• Providing care while under the influence
• Causing injury or harm
• Exceeding your level of training

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Good Samaritan Laws (3 of 3)
 Once you have started treatment, you are legally obligated to
remain with the person until care is turned over to an equally
or better-trained person or group unless your own safety is
threatened.

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Utah Law
Utah Good Samaritan Law:
– “A person who renders emergency care at or near the scene of, or
during, an emergency, gratuitously and in good faith, is not liable for
any civil damages or penalties as a result of any act or omission by
the person rendering the emergency care, unless the person is
grossly negligent or caused the emergency.”
• Utah Judicial Code 78B-4-501 Effective 5/8/2018

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Consent (1 of 4)
 Permission that the injured or ill person must give before first
aid can be given
• Informed
• Implied
• Children

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Consent (2 of 4)
 Informed consent
• Tell the person you are trained and what you will be doing.
• Ask if you can help.

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Consent (3 of 4)
 Implied consent
• It is assumed or implied that an unresponsive person would consent
to life-saving interventions.
• An alert person who does not resist the administrations of a first aid
provider is also assumed to have given implied consent.

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Consent (4 of 4)
 Consent for children
• Consent must be obtained from the parent or legal guardian of a child
or mentally incompetent adult.
• First aid should be given based on implied consent when a life-
threatening situation exists and a parent or guardian is not present.

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Psychological and Emotional Issues (1 of 3)
 First aid is stressful for the rescuer and the injured or ill
person.
 Stress, anxiety, and panic can compromise safety and
interfere with rescue and first aid.
 Rescuers should provide comfort and reassurance to injured
and ill people.

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Psychological and Emotional Issues (2 of 3)
 Be calm and honest.
 Encourage the person to
express their feelings.
 Give realistic answers.
 Explain what you are doing and
why.
 Implement stress management
techniques.
 Let the person take part in the
physical care.

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Psychological and Emotional Issues (3 of 3)
 Rescuers may feel overwhelmed, angry, frustrated, or
depressed.
 Discuss your feelings with:
• a trusted friend;
• a mental health professional; or
• a clergy member.

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Some Diseases of Special Concern (1 of 2)
 Bloodborne diseases are carried by an infected person’s blood
• Human immunodeficiency virus (HIV), which causes acquired
immunodeficiency syndrome (AIDS)
• Hepatitis B virus (HBV)
• Hepatitis C virus (HCV)

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Some Diseases of Special Concern (2 of 2)
 Airborne diseases are transmitted through the air by coughing
or sneezing
• SARS-CoV-2, which causes COVID-19
• Tuberculosis

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Infectious Disease Precautions (1 of 2)
 First aid providers should treat
blood and body fluids as if they
are infectious.
 Use personal protective
equipment whenever possible.
• Nonlatex gloves (preferably
nitrile)
• Mouth-to-barrier devices
• Eye and face protection
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FIGURE 1-7 Infectious disease barriers for first aid.

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Infectious Disease Precautions (2 of 2)
 Vigorously wash hands and
exposed skin before and after
giving first aid.
• Use soap and water if possible.
• Rub hands together for 15 to 20
seconds.
• Rinse.
• Dry with a clean towel.
 Use an alcohol-based hand
sanitizer if soap and water are
not available.
© Yurakrasil/Shutterstock.
FIGURE 1-8 Use a waterless handwashing solution if there is no running water available.

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Immunizations (1 of 2)
 No special immunizations are needed for wilderness activities
in North America and other developed areas.
• Keep routine immunizations up to date.
• Special vaccinations recommended for remote travel

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Immunizations (2 of 2)
 Routine
• Diphtheria, pertussis, tetanus
(DPT)
• Measles, mumps, rubella
(MMR)
• Polio
 May be required at international
boarder
• Yellow fever
• Coronavirus
 Commonly recommended for
international travel
• Typhoid
• Hepatitis
 Special needs
• Hepatitis
• Rabies
• Japanese encephalitis
• Meningococcal meningitis

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Travel Medical Insurance
 Check your insurance before travelling internationally:
• Travel
• Medical
• Evacuation