• Prehospital guidance for medical provision for wilderness medicine

    by Alan Batt. Last modified: 22/12/15



    Mellor A1, Dodds N2, Joshi R3, Hall J4, Dhillon S5, Hollis S6, Davis P7, Hillebrandt D8, Howard E9, Wilkes M10, Langdana B11, Lee D12, Hinson N12, Williams TH12, Rowles J12, Pynn H13. Faculty of Prehospital Care, Royal College of Surgeons Edinburgh guidance for medical provision for wilderness medicine. Extrem Physiol Med. 2015 Dec 1;4:22. PMID: 26629337.



    To support leaders and those involved in providing prehospital medical care on expeditions in wilderness environments, the Faculty of Pre-Hospital Care (FPHC) of The Royal College of Surgeons of Edinburgh convened an expert panel of leading healthcare professionals and expedition providers.

    The aims of this panel were to:

    (1) provide guidance to ensure the best possible medical care for patients within the geographical, logistical and human factor constraints of an expedition environment.

    (2) Give aspiring and established expedition medics a ‘benchmark’ of skills they should meet.

    (3) Facilitate expedition organisers in selecting the most appropriate medical cover and provider for their planned activity.

    A system of medical planning is suggested to enable expedition leaders to identify the potential medical risks and their mitigation. It was recognised that the scope of practice for wilderness medicine covers elements of primary healthcare, pre-hospital emergency medicine and preventative medicine. Some unique competencies were also identified.

    Further to this, the panel recommends the use of a matrix and advisory expedition medic competencies relating to the remoteness and medical threat of the expedition. This advice is aimed at all levels of expedition medic, leader and organiser who may be responsible for delivering or managing the delivery of remote medical care for participants. The expedition medic should be someone equipped with the appropriate medical competencies, scope of practice and capabilities in the expedition environment and need not necessarily be a qualified doctor. In addition to providing guidance regarding the clinical competencies required of the expedition medic, the document provides generic guidance and signposting to the more pertinent aspects of the role of expedition medic.

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    Alan Batt

    Alan Batt

    Paramedic, educator, researcher
    Alan is a critical care paramedic, paramedic educator and prehospital researcher, currently working around the world as an educator and researcher. He has previously worked and studied across Europe, North America and the Middle East. He holds a Graduate Certificate in Intensive Care Paramedic Studies, and an MSc in Critical Care. His main interests are in care of the elderly, end-of-life care, patient safety, professionalism (including role and identity), and paramedic education.

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