Todd Mullinex

Backcountry travel and wilderness recreation means traveling light while having everything we need to survive. A small problem like a deep cut or a sudden change in weather can quickly become an emergency when civilization is miles away.

That’s why wilderness medicine starts long before anything goes wrong. It starts with what you carry.

Everyday carry (EDC) is a popular topic of conversation among those in the self-defense and prepper communities, from which the term was born. In the world of wilderness medicine, EDC — or Echo Delta Charlie for those of you with phonetic alphabet experience — refers to the carefully selected tools and supplies you keep with you at all times to respond to injuries and illness that can occur in remote wilderness and backcountry settings.

In this NCOAE blog post, I explore the essential items you may want to include in your wilderness EDC and explains how a few well-chosen items can make a big difference when you’re far from help.

Think of EDC as a less formal wilderness first aid kit. Some EDC items are on “your person” meaning in clothes pockets and on a pants belt. Other items may be in a “go bag” that you always have with you. Your EDC’s contents, comprehension, and container will be personalized based on your expectations, risk tolerance, and how light you prefer to travel.

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Most healthcare professionals, including some pediatricians, would rather treat adults than children. That should come as no surprise. If you’ve ever had to draw blood from a young child, you know how heartbreaking it can be for everyone in the room. Maybe in the building. Those screams can be dramatic!

The emotional pain we feel as practitioners, let alone parents, can be as equivalent to the physical pain the child experiences. It adds new meaning to the expression, “This is going to hurt me more than you.”

Unfortunately, the desire to avoid such emotional pain, along with other challenges, often discourages even the most knowledgeable and skilled doctors, nurses, emergency medical technicians (EMTs), and other healthcare providers from assessing and treating children. In some ways, they’re just little adults. In other ways, they’re not. And what we don’t know about their similarities and differences compared to adult patients can hurt them. That is particularly true when it causes us to withhold medical care when that care is most needed.

To some degree, we often fear what we don’t fully understand, and in some ways, we have been conditioned to fear those differences. In a lot of medical education, this fear is often instilled by (more…)

For some readers, the headline of today’s blog might spark visions of Disney on Ice, complete with professional figure skaters dressed as emergency medical technicians, gliding, spinning, and soaring through the air as they provide emergency medical care in a winter wilderness setting. 

As they successfully evacuate the injured party from the ice, one skater performs a perfect triple axel in celebration. As for musical accompaniment, I’m thinking we should choreograph the entire scene to Vanilla Ice singing “Ice Ice Baby.”

I only bring this to mind because it was around this time (1990) that Vanilla Ice released his hit video recording, “Ice Ice Baby.” I climbed Mt. Shasta in Northern California’s Cascade Range that winter, and I recall the approach provided intermittent views of the frozen water that would make up the majority of the climb. I came to the realization that providing medical treatment and making potentially life-saving decisions would be much more difficult to achieve in icy conditions and bitter cold than in more temperate conditions. 

In the years since that icy climb, I have continued to enjoy ice and snow activities and have often participating in rescue operations, providing medical care in winter wilderness settings. In this post, I explore the unique challenges of providing wilderness medicine in cold, icy environments and lead you through the standard protocol for responding to injury or illness in these challenging conditions. 

And, for a little fun, I’m going to weave in a few lyrics from “Ice Ice Baby” to reinforce key lessons. So, strap on your crampons and “Let’s Kick It!” (more…)

You’ve no doubt seen the symbol below painted on the side of an ambulance, embroidered on the uniforms of emergency medical technicians (EMTs), or stuck to emergency medical equipment. Maybe you even wondered whether it had any meaning. What’s with the snake coiled around the staff? What’s the significance of the six-pointed star?

The Origin of the Star of Life

Emergency Medical Services (EMS) was formed in the United States in the late 1960s around the realization that survival rates were higher on overseas battlefields than on U.S. highways. The high mortality rate on our highways was due, in part, to the lack of an organized system for responding to accidents and treating injured parties. 

As emergency medical services were becoming standardized in the United States, the National Highway Traffic Safety Administration designed and later trademarked the blue, six-pointed Star of Life to serve as the official symbol identifying EMS personnel, vehicles, and equipment. The symbol was introduced largely because the Red Cross emblem is (more…)

When wilderness medicine practitioners gather ’round a campfire, one favorite topic of discussion involves which animals are the most dangerous. Barring the obvious winner, we humans, leading candidates typically include the gorilla, shark, lion, tiger, and bear. 

The unassuming mosquito and deadly microscopic organisms are often overlooked, but most likely lay absolute claim to the title.

In some parts of the world, the hippopotamus is considered the deadliest creature. Here at The National Center for Outdoor Adventure & Education (NCOAE), we’ve yet to conduct a course where hippos are involved but if we ever do, we will certainly take precautions to make these semi-aquatic animals are not on campus!

Where you are in the wilderness, of course, makes the determination of which animal presents the most peril to hikers, climbers and swimmers. For example, if you’re navigating the Boundary Waters that straddle the border between Ontario, Canada, and Minnesota here in the U.S., you’re more likely to encounter a bear than a gorilla. That’s why traveling to an unfamiliar remote location requires that you research the area to determine the biggest threats to your safety, including wild animals, and discover how best to avoid them and what to do if that doesn’t work.

The good news is that your odds of being injured or killed by wildlife are low, especially if you use common sense to avoid the biggest threats. Most wilderness injuries and fatalities come from falls, weather, and getting lost rather than from animal attacks. And don’t discount the stupidity factor, such as the man who was slapped with jaw-dropping $153,161.25 medical bill after trying to take selfie with rattlesnake.

In this post, we weigh in with our team’s take on the seven deadliest animals you might encounter when trekking through the wilderness in the U.S., along with some basic information to help you gauge your likelihood of encountering them and protect yourself and others in your group. First up, bears!

Bears

Bears are fast, powerful, and often unpredictable, especially when surprised or protecting their cubs, food, or territory. You’re most likely to encounter them in remote forested or alpine areas. Species include Grizzly bears in the northwest and Alaska, with black and brown bears being more widespread.

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When we venture into the backcountry, whether it’s a day hike in a nearby forest or a multi-day expedition into remote terrain, we knowingly trade comfort and convenience for solitude, challenge, and a deeper connection with nature. 

This is a trade-off that comes with a conscious decision to expose ourselves to a higher-than-normal level of risk. Backcountry travel increases our chances of experiencing injury and illness while decreasing our accessibility to nearby basic or emergency medical care.

Mitigating this heightened risk requires improving our wilderness medicine knowledge and skills, something we help people do here at The National Center for Outdoor Adventure & Education (NCOAE). Our Wilderness Medicine and Emergency Medical Technician (EMT) courses cover everything from scene size-up and patient assessment to providing cardiopulmonary resuscitation (CPR), treating wounds and fractures, and successfully evacuating patients from remote wilderness areas.

As experts in the field of wilderness medicine, we often find ourselves discussing what we believe to be the most essential wilderness medicine skills. Here, we present our top seven, in no particular order. These are skills that we think all of our students should possess before venturing into the backcountry.

1. Scene Size-Up and Patient Evaluation

Every wilderness medicine event should start with a scene size-up and patient evaluation, which consists of the following three components: (more…)