Matt Foruria shivered and moaned beside the lake, blood dripping down his face, but nobody ran to call 911. In the wilderness, calling an ambulance isn't an option, which is why Foruria and the other students "rescuing" him were taking the Wilderness First Responder course.
Anyone who goes more than a few miles into the wilderness should be prepared to take care of medical emergencies, said Matt Stauffer, one of the two Wilderness Medicine Institute instructors who came to Juneau to teach the 10-day course. The course teaches students to improvise in the wild based on standard medical practices.
"If they're going to be spending time away from the traditional 911 area, then it's important," Stauffer said.
While the American Red Cross teaches people to prolong lives for a few minutes until an ambulance crew arrives to take over, anyone in the woods or on the water has to be ready to take care of the patient for a day or more, Stauffer said.
"Bad things never happen when it's sunny and warm and bunnies are hopping across the field," Stauffer said. "Bad things happen when they're tired and cold and the honeymoon's over."
Some of the students were in the class because they knew from personal experience how easily accidents can happen in the backcountry. Student Sean Hill was hiking with friends on Pike's Peak, Colo., four years ago when he slipped on some icy rock and fell 30 feet down the mountain.
Nobody he was with knew what to do. Hill had to hobble half a mile through waist-deep snow to a campsite on his broken ankle, compounding the injury and the pain. From there it took search and rescue 10 hours to evacuate Hill. He promised himself then that he'd learn what to do in a similar situation in the future.
A few days into the Wilderness First Responder course, Hill faced a similar scenario. One of his classmates lay at the bottom of a hill, having supposedly tumbled down and hurt her knee. Hill turned a Crazy Creek camping chair and several cloth bandages into a makeshift splint, then helped her back up the trail.
"It's definitely getting smoother, the whole process of patient assessment," Hill said. "You get used to being calm and it's so useful to a patient."
The most common backcountry ailments are sprains, strains, blisters and upset stomachs, Stauffer said. The course covers treatment for those common problems. For blisters, Stauffer teaches students how to drain the fluid, clean the wound and then treat it so it won't rub any longer. Then the blister sufferer should get better fitting shoes and start wearing liner socks.
The course dedicates more time to rarer, but more serious, medical emergencies. The students learned how to assess whether a patient has a spinal injury and needs to be carried out of the woods, or whether they can walk out. They covered broken bones, bleeding wounds, head injuries, burns, hypothermia, frostbite, strokes and more.
Along the way they got lectures in prevention.
"Are there still people who spend a lot of time in the back country wearing nothing but death cloth, cotton?" Stauffer asked the class rhetorically during a lesson on hypothermia. "They'd be better off with nothing on."
Cotton gets wet easily and stays wet for a long time, leaving wearers cold and more prone to hypothermia. The other course instructor, Mike Moxness, said that over the last year he has rescued a dozen military guys. They tended to go for hikes in their cotton fatigues, and end up wet, cold and finally hypothermic. The worst case he saw was a soldier crouched in a stream, not moving from the frigid water because he didn't realize where he was. The soldier barely knew his own name.
"Emergency medicine really is a series of stacked priorities. You take care of what's most important and next important," Moxness said.
But unlike first aid on the road system, there's less on hand to treat a patient. The Wilderness Medicine Institute provides a list of 26 bandages, medicines and equipment it recommends people put in their first aid kit: safety pins, gloves, emergency blanket, irrigation syringe, triangular bandages, cloth tape, trauma shears, tweezers, scalpel, thermometer, blood pressure cuff and stethoscope....
What people carry in their first aid kit isn't nearly as important as what they know, Stauffer said.
"If somebody shows up with the greatest medical kit in the world and doesn't know how to use it, it doesn't do any good," Stauffer said. "The course is taught from the standpoint of someone who has to make do with what's in their pack."
The first few days of class students were given first aid and outdoor equipment to use during the practice scenarios.
"You can't expect people to right off the bat improvise a traction splint with bark and moss," Moxness said.
By the end of the class the students carried only what they normally pack into the woods. They knew how to cut foam sleeping pads into neck collars, rip the metal inserts from their packs to build splints and use Ziplock bags to cover wounds.
On the shore of Auke Lake last week, the students wrapped their shivering patient in sleeping bags and tarps. Soon Foruria's shivering subsided.
"Learning how to improvise is the whole point," Moxness said.
The Wilderness First Responder course has been offered once a year at University of Alaska Southeast for the past several years. For information on when and where else the course is offered, visit http://wmi.wmi.nols.edu
Kristan Hutchison can be reached at firstname.lastname@example.org.