I skid down the side of the mountain the moment I see the crash. My trail runners burn rubber as I launch myself over a boulder to get to the victim, a 44-year-old hang glider who caught a gnarly gust of wind coming over Big Bear Lake. He is moaning and clutching his side as I ask his name to discern a level of responsiveness. He mumbles something about the fall, and I check his airway, noticing a large amount of blood in his mouth and a pale film of skin across his forehead. I bark directions at my partner to help me move him into a spine stable position, and she holds his head to ensure that we don’t further damage what could be a severed spinal cord. We check his vitals before performing a head-to-toe patient assessment in which we discover a sorely broken rib. As I frantically scribble the details into my notebook, we formulate a plan to get help before we move him into a recovery position so that he doesn’t choke on any of the blood he is coughing up. Then, we wait.
A week ago, if you had asked me what to do if I saw a rock climber plummet 40 feet off a granite wall or a mountain biker flip headfirst over her handlebars, I would have frozen in discomfort with nothing to say. Injuries are about as common in the great outdoors as trees or rocks, yet it’s startling to realize precisely how few wilderness enthusiasts have any sort of training for what to do when things inevitably go tits-up. That’s where the NOLS (National Outdoor Leadership School) Wilderness First Aid course comes in and how I found myself simulating a high-elevation hang gliding accident in the back of a wooden cabin in Monrovia, CA.
NOLS is based out of Lander, Wyoming, but thanks to a partnership with REI, these classes are available far and wide, taking up 8 hours of course-study a day over the span of a full weekend. During that time, my classmates and I were immersed in diagrams, pamphlets, and acronyms for everything from RICE therapy (rest, ice, compression, elevation) to CSM (circulation, sensation, and motion). This was coupled with six real world scenarios in which we got thrust into the woods just outside the cabin to descend upon a group of wounded “patients,” not knowing what would get tossed at us next.
I probably killed my first two casualties. I failed to identify the primary symptoms of shock when a woman was babbling a mile a minute with cold, clammy skin, elevated breathing, and a heart rate well over 150 bpm. Her ankle was sore, but I stumbled over my words, wondering if perhaps she had fallen and hit her head, momentarily losing consciousness and making the ankle the least of our concerns. In another scene, I forgot to complete a top to bottom spinal assessment of a climber who had been nailed in the head by a rock. Thank god my class buddy was already securing the victim’s neck with his hands in case of possible spinal injury.
The back and forth between indoor instruction and hands-on activities like how to create a lower leg splint (out of gauze, a mat, a sleeping bag, and a piece of rope) made sure that the class moved at a swift and engaging pace for the entirety of its 16 hours. We did an in-depth patient assessment of a runner with severe heat stroke, learned the proper way to reset a dislocated shoulder, and saw how to dress a wound that needs to be evacuated for stitches. I thought that the class might terrify me after revealing the multitude of things that can go wrong in the wild that I hadn’t even considered, but it did exactly the opposite.
The point of the NOLS Wilderness First Aid class isn’t to magically turn you into a doctor or an EMT in a single weekend; rather, it’s to empower you to feel more confident going out into the backcountry alone, with your kids, or with a group of friends. When cell service is scarce and potential rescuers are often a few days’ hike away, it is crucial to know what to do when your mountaineering companion twists an ankle while glissading a slope in crampons (tape it properly using the NOLS technique and then slowly hike her out) or is vomiting and experiencing the worst headache of her life at 14K feet (immediately descend to a lower elevation and wait to see if symptoms improve).
I’m probably the only one of my climbing friends who has never broken a bone, and I know that this luck will run out one day if I keep going hard in the mountains. Thankfully, the Wilderness First Aid course and certification have given me some much needed tools for how to slow down in a panicked situation and go through a step-by-step process to give injured bodies the best chance of survival when shit hits the fan.
Let’s face it; things are going to go wrong in the wild. How you react doesn’t have to.