|Backcountry lessons could mean life or
BY: ERIC R. WRIGHT
Re-printed courtesy of the:
CASPER --- The thin beam of light from Tom Fink's headlamp
moved from side to side, bouncing slightly as he skied among
the dark shapes of spruce and fir trees in the quiet, winter
Then someone yelled, "Mark is down. Mark is down," and
the light flashed around as Fink turned toward the voice.
Minutes later, he joined two others skiers at the side
of a friend lying in the snow.
The injured skier, Mark Stierwalt, appeared to have sustained
an open fracture to his right leg and was losing blood.
The temperature was below freezing and falling. Dawn and
an ambulance or helicopter were more than 10 hours away.
The rescue scenario, created by instructors from the Wilderness
Medicine Institute (WMI) in Pitkin, Colo., was designed
to mirror a real-life backcountry medical emergency as closely
The four skiers were among 16 students who participated
in the WMI's Wilderness First Responder course in Yellowstone
National Park earlier this month.
Fink and the other two skiers worked together and quickly
splinted the leg, determined that Stierwalt had no other "injuries," and
went about building a makeshift shelter to keep him warm
Shortly after Stierwalt was attended to, another member
of the group, Julie Zelenakas, collapsed in the snow. Fink
and the remaining member of the party, Asa Hultman, puzzled
over Zelenakas' hypothetical condition and discovered she
was diabetic. She was treated and quickly recovered.
Almost three hours later, Lance Taysom, an instructor with
WMI, approached the group and informed them that the scenario
was over, and that they had done a great job.
The fracture that Stierwalt sustained and Zelenakas' diabetic
condition were not real, but all other aspects of the training
were, Taysom explained.
The difference between life and death for a patient many
miles from the nearest ranger station or hospital depends
on long-term medical aid, Taysom added.
The course, held Jan. 2 to Jan. 11 at the Lamar Buffalo
Ranch, was offered by the Yellowstone Institute, a non-profit,
educational organization based in Mammoth. It was taught
by Taysom and Jeff Holmes, also of WMI, whose combined experience
includes more than 15 years of Emergency Medical Technician
(EMT) and nursing work.
The class is a prerequisite for instructors at National
Outdoor Leadership School (NOLS) and is taken by park rangers,
backcountry guides and members of search and rescue squads.
The course began with an explanation of the difference
between urban and wilderness first-aid and initial patient
assessment followed by instruction in Cardio Pulmonary Resuscitation
(CPR) and treatment of shock.
In the six days that followed, the students split their
time between the classroom and practical, outdoor instruction
and covered topics including spinal injuries, fractures
and splinting, frostbite, altitude illness, cardiac and
respiratory emergencies, bites and stings and gender-specific
It's a lot of information to take in and retain in such
a short amount of time, and for Scott Karley, a participant
in the course who is attending Montana State University
in Bozeman, that was the hard part.
"The most challenging part of the course is keeping
it all straight in your head --- the signs and symptoms
of certain ailments --- and understanding how to take a
thorough patient history and exam is definitely key," he
Taysom and Holmes said the success of the course stems
from the continuous repetition of the basics, taught the
first two days of class and the constant practical applications
of classroom information in the form of realistic scenarios
"I've been teaching EMTs for (more than) 10 years," Taysom
said. "The (students) that come out of these classes
As realistic as the scenarios might be, Taysom and Holmes
said the enthusiasm and energy of the students also go a
long way toward making the course work.
For instance, on Friday after an eight-hour day of instruction
that included neurological, cardiac and respiratory emergencies,
the students were given the option of participating in a
large-scale, night rescue scenario.
All 16 students agreed to take part.
In below-freezing temperatures and darkness that cut visibility
to almost nothing, three student volunteers were split from
the group and led away by Holmes across a nearby creek,
through thigh-deep snow and out of sight.
Meanwhile, Taysom explained the scenario to those remaining:
There had been an avalanche, which had buried a number
of skiers. The rest of the students were asked by Taysom
to organize a search-and-rescue party, and he designated
one party leader.
The students took over from there. The leader designated
sub-leaders to handle equipment, personnel and a base position.
A small group, with only the minimum of first-aid equipment,
was dispatched immediately to locate victims and provide
The second group divided up shovels, blankets, backboards,
sleds and snowshoes and long-term care equipment and slogged
across the creek and toward the mock-avalanche site.
In one hour, three victims were located, assessed, treated
and transported to a base camp where two, with more severe
injuries, awaited dawn and a helicopter rescue.
At that point, Taysom and Holmes looked at their watches,
noted how efficiently and completely the students handled
the rescue, and complimented them on their success.
"Their greatest strength is their energy," Taysom
said later. "They don't slow down, and they take whatever
we throw at them."
Holmes said this class was slightly younger than what he
normally sees. They ranged in age from 20 to 48 and included
Hultman, who is an ocean kayaking guide from Ostersund,
Most of the students had some backcountry experience in
skiing, hiking or climbing, and some will use the skills
they learned in class on the job.
"Primarily, the reason I took (the course) is that
I work for the Forest Service on a fire crew out of Greybull,
(Wyo.)," explained Fink, who is from Worland, Wyo.
and attending MSU. "We do get some basic first aid
(training), but it's nice to have more skills to better
take care of your buddies out there."
But some, like Ardell Wells, who moved from Chicago to
attend MSU, are just beginning to discover and explore the
Rocky Mountain region's wilderness.
For her, the course provided the confidence she needed
to take extended trips into the backcountry, and she encouraged
anyone ---regardless of their experience level --- to take
"I put myself in the situation where if I was out
with my friends that maybe don't really know what they're
doing," she said, "I feel I would be completely
comfortable taking them or even dealing with a situation.
"You can never be prepared enough to go to the backcountry
and hike. Even if it's a day hike, you never know what is
going to happen. So you can never go wrong by taking something
like this," she said.
As long and difficult as the class may have been, it wasn't
all work and no play.
The students used their lunch hour one day to construct
a ski jump on a nearby hill, and Taysom, Karley and Hultman
managed to get in some air time.
Another day, the students built a large snow shelter, and
the next night, Deaby Gregoire and Lindsay McClintock, both
from Alaska, slept in it.
"I just did it for the heck of it," McClintock
said. "It wasn't cold at all. I had a pretty good night's
sleep, but I slept on a couple of rocks."
In addition to the final written exam, which all the students
passed, the final practical exam was a mock ice-climbing
accident 13 miles from a road.
The patient had fallen, striking his head and fracturing
his wrist. He also had an underlying asthma condition.
Although two test teams had to go through the practical
a second time because of incorrect prioritization of care
or overlooking a potential complication, Taysom said, "all
the teams (passed) and did an excellent job of assessing
for life-threatening injuries and functioning as a team."