Wilderness Medicine

In the context of wilderness medicine, soap and SOAP are both indispensable. An explanation is in order. We’re all familiar with lower-case soap. This noun refers to a substance that’s added to water to remove dirt, grease, grime, and germs from various surfaces, including skin, hair, clothing, pots and pans, and so on.

Soap In The Wilderness

Traditional soap works in two ways — as a surfactant to break water tension, improving water’s ability to penetrate surfaces, and as a molecule that has a love-hate relationship with water. Soap molecules have two ends, one that’s hydrophilic (loves water) and the other that’s hydrophobic (hates water). The hydrophilic end binds to water, while the hydrophobic end binds to anything other than water — dirt, grease, grime, germs. Imagine soap molecules as tiny carabiners that shackle dirt molecules to water molecules to enable the water molecules to usher them away.

In backcountry and wilderness settings, soap plays a vital role in preventing infection and transmission of disease. In fact, scrubbing vigorously with soap and water may be among the most important risk-management technique you practice during your time in the wilderness.

SOAP (Subjective, Objective, Assessment, Plan)

Now let’s move on to the other SOAP — all uppercase — which is an acronym for Subjective, Objective, Assessment, and Plan. As an outdoor educator, field instructor, or wilderness guide, this note-taking procedure is nearly as important as scrubbing your hands regularly with soap and water. This is especially true when you’re dealing with a client injury or illness in a remote setting. 

SOAP Notes, which I’ll be covering in this post, separate important information from the chaos and fog of emotion in order to provide clean, uncluttered details for making informed medical decisions and emergency response plans. 

With SOAP Notes in hand, field instructors and outdoor educators trained in wilderness medicine, as well as backcountry guides, are better prepared to respond to a medical emergency. They do this by:

• Following an organized, methodical process
• Tracking changes in a patient’s health status
• Keeping a record of assessments, anticipated problems, and any interventions already provided
• Communicating with emergency responders
• Ensuring a seamless transfer of patient care to next-level healthcare providers
• Documenting cases and care for improving organizational outcomes

Here at The National Center of Outdoor Adventure and Education (NCOAE), we developed the SOAP Note form shown below.

Our SOAP Note’s Form

Our SOAP Note form consists of the following seven sections (more…)

Having a first aid kit handy is always a good idea, but what should it contain? The answer to this question really depends on what you plan to be doing. There are different considerations for a kit that you carry in your car versus one that you grab up for a mountain bike ride or take with you on an overnight or multi-day backcountry expedition. 

Of course, you could purchase pre-stocked first-aid kits for a variety of purposes. Retailers and companies like REI, Adventure Medical Kits, and even Amazon and Target all sell first aid kits that may be right for your purposes. These can be convenient, and many are vacuum sealed to save space. However, they can be expensive and may contain less useful items for your purposes.

Putting together your own first aid kit lets you decide how many and what kinds of things you want. It also gets you thinking about what you’ll have on hand should a backcountry emergency occur. 

Pro Tip: Make sure your backcountry first aid kit is waterproofed and check it regularly to make sure things haven’t been damaged or have expired. 

Here are some things to consider when creating your own backcountry first aid kit:

What injuries/situations are likely to occur? (more…)