Wilderness Medicine

Students practice a litter carry during a WFR course.

What is a Wilderness First Responder (WFR) Course?

The goal of a WFR is to make sure you have the knowledge to take helpful action, no matter what situation you find yourself in.


So, what is a WFR course?

Students practice CPR during woofer

Students practice CPR during woofer


A Wilderness First Responder course (WFR) is much more than just a course about first aid, CPR, or even emergencies. This course teaches you how to think critically, allowing you to apply your knowledge to unique situations that go far beyond typical backcountry-based trips.

What defines an emergency setting as “wilderness”?

Patient Evaluation practice


Students practice CPR during woofer

One of the core components of a Wilderness Medicine Course is learning how to problem solve in a ‘wilderness setting’. Wilderness is defined as delayed access to care (you call for help but they can’t get to you right away), you have limited resources (perhaps what is on your back or what is in your boat), and a hostile environment (limited protection from, heat, cold, wind, rain, etc.). While this obviously applies to backcountry objectives, it also applies to front-country emergencies such as mudslides, hurricanes, tornadoes, and fires – all of which can leave someone stranded in the wilderness even in their own home.


What do you learn in a WFR?

Students performing handson skills during a wfr


  • Wild Med’s Six Wilderness Protocols (see below)
  • A clear understanding of serious vs not serious issues
  • What situations can be managed on your own, and when to call for help
  • Identifying high-risk vs low-risk injuries, and what to do for each
  • Clear and simple steps for patient assessment
  • Prevention of the most common backcountry emergencies
  • Risk management and decision-making during outdoor trips
  • How to communicate clearly in an emergency to get the help you need


What can I do as a WFR?

WFR student performing abdominal exam


Wilderness Medical Associates (WMA) created six protocols for WFR’s in remote settings. They are designed to give WFR participants an enhanced set of tools that are practical in real-life situations. Many of them can aid in turning an emergency into a manageable situation while in remote areas.


These protocols include:

  • Reducing certain dislocations in the field.
  • Performing a thorough spine assessment
  • Properly cleaning and caring for wounds
  • Starting and stopping CPR in a wilderness context
  • Identifying anaphylaxis and delivering epinephrine
  • Delivering epinephrine for severe asthma attacks


What skills do I learn in a WFR course?

WFR students splinting a leg


These additional skills are useful anywhere – be it at home or offshore sailing. Learning more about these situations and problems will come in handy and could save a life.


  • Performing CPR for the Adult, Child, and infant at the professional rescuer level
  • Managing any type of airway compromise, such as choking
  • Controlling life-threatening bleeding
  • Identifying a concussion
  • Moving a patient who may have injured their spine
  • Determining if someone has a spine injury and how to proceed
  • Splinting basic for high-risk injuries
  • Responding to heat-based challenges
  • Thermoregulation and cold-based injuries
  • Considering altitude illness

How long does a WFR take?

WFR students demonstrate skills to instructor


A WFR course can range from 10-5 days. Courses shorter than 7 days are in a hybrid format, meaning there’s some portion of online learning prior to the in-person course start date. All in-person classes will be broken up into classroom lectures and hands-on practice. Hybrid courses provide lectures, books, and foundational learning all prior to the course so that the 5 days are focused on hands-on skills.


Both full-length and hybrid medical courses are great options. Often people with less medical knowledge or remote experience enjoy the longer courses. The 5-day courses work well for people who are coming in with some experience in the realm of emergencies and perhaps previous medical training.


How is a Wilderness First Responder course structured?

Round table of patient assessments


Of course, a WFR course teaches medical concepts, but where all wilderness medical courses really shine is the hands-on learning! Practicing hands-on skills in the most life-like situations is a core component of the course. This means that all participants will spend a portion of the course role-playing both as a patient and as the rescuer. While participants don’t have to be an expert actor, there is an element of role-playing, dressing up, and moulage (wounds from makeup) that make the experience vivid and often intense.


This is one of the most fun elements of a course, but even more importantly, it’s part of the course that puts knowledge into practice. No amount of learning is useful if it can’t be applied to stressful, real-life situations. A WFR course helps mimic the stress of emergencies in a safe and supportive environment. This allows students to learn the valuable process of managing their own stress to make important decisions. Participants will graduate feeling far better prepared to transfer their knowledge into real-life emergencies.


Gaining a basic understanding of medical concepts will also be a foundational component of each course. This means there is some science, anatomy, and physiology in the core teaching.  Thankfully, the curriculum does a great job of taking complicated medical concepts, simplifying them, and breaking them down into bite-sized chunks.  The curriculum Gut-Z Journey licenses are provided by Wilderness Medical Associates (WMA), one of the leading educators in the business.  WMA has a dedicated team of doctors, physician assistants, and other medical personnel reviewing the latest research and updating materials for students.


Is there a WFR exam?

Water injuries can occur in wilderness settings


To pass a WFR class, you must demonstrate a basic understanding of emergency medicine and the ability to turn this knowledge into hands-on assessment and actionable treatments. Thus, there is no single exam that defines your success. Rather, your completion of the course relies upon continued assessment throughout. These assessments include quizzes, exams, and practice skill sessions. The feedback process occurs throughout the course so that students can continuously hone their skills. By the end, all students are expected to perform full patient assessments, identify problems, and critically think through an action plan.  


Still curious? You can see a complete list of all skills taught and assessed throughout the course HERE.


Who should take a WFR?

Ski Patrollers need a minimum of a WFR


  • Disaster Relief Personnel and Volunteers
  • Outdoor Educators
  • Outdoor Guides
  • Avid outdoors people
  • Those camping or traveling overnight into the backcountry
  • Military
  • Researchers
  • Search and Rescue Personnel and Volunteers
  • Offshore sailing and Seafarers
  • Remote field work Personnel
  • Those traveling over abroad
  • Anyone with the desire to develop skills beyond the Wilderness First Aid level

How long does a WFR certification last?

Wilderness First Responder students


Certifications with Wilderness Medical Associates last 3 years! Some companies grant 2-year certifications with a 1 year grace period for recertifying. During the grace period, you are no longer considered an active WFR.  With WMA you will be an active certified WFR for your full 3 years but you MUST seek out a recertification course before the last day of the month your certification expires.


How much does a WFR cost?

Hypothermia is a cold challenge faced in extreme wilderness settings


Each course has a unique price based on the location, lodging, and food options, and instructor travel fees. Typically, Wilderness First Responder courses cost between $700 to $1,000. All forms of the WFR (hybrid 5-day or 8 days in person) provide over a week’s worth of focused training. This breaks down to $88-$125 per full day of instruction.


Moulage, or fake wounds, make excellent WFR practice


This course is hands down the best investment for people who live or play in remote areas, have field work or desire to work in the outdoor industries.  It’s worth every penny of the investment.  Don’t just take my word for it, check out these testimonials!

"Natalie is an inspiration. She is very knowledgeable, including extensive Search and Rescue experience, best instructor I've ever had, and has a delightful personality!"


"...thank you. From the bottom of my heart, thank you for showing me the kind of person I can be and empowering me in every way to help others in need. The WFR course alone has opened so many doors for me and I know that I will carry this for the rest of my life."


"I thought I had seen the best, but N.B. is right up there and earlier in her career. Top echelon of outdoor professionals. This is clearly in her blood!"


"It is because of the lessons that you taught me that I saved a life today. I can never thank you enough for passing down the knowledge that I did not think I would ever have to use. I may have responded but you are the true hero Natalie. Thank you."


"I felt insanely confident when evaluating her injuries and creating a communication/evacuation plan.. So happy to have had your amazing instruction and would take the class again in a heartbeat."

Kyle S

The class was challenging. Patient engagements often hard. And I am truly grateful for the opportunity to learn by doing; the drills are so valuable and essential. I'm a much better prepared WFR for it

Bill Voight

Natalie blew me away with her knowledge, passion, and excellent teaching skills. Throughout her WFR Recertification class, I felt challenged, supported, and empowered. A great teacher, making greater guides.


Your passion for wilderness education was evident ... and immediately attracted me to your offerings. Your instruction style was direct, corrective, repetitive, when necessary, and the entire time I could still feel the love you have for the curriculum and the desire to send us onward as stewards of your studio...I was grateful for every piece of instruction.

Aaron R

My satisfaction comes from the countless stories of how my students have helped someone in need and even saved lives because of this course!

Your instructor,
~ Natalie



Treating Hypothermia

I’m just snuggled up by my fireplace on a cold rainy day which is inspiring me to talk about the cold, specifically hypothermia.


Problems with the cold have been on my mind a lot lately. I did just return from working in Antarctica where it was quite cold. Since being back in California, it has been raining and snowing, a lot. We are being hit by the “atmospheric river,” and while these are relatively warm storms, it is still colder and damper than most people are used to – especially in sunny California. On top of that, I recently attended a lecture by the renowned cold physiology scientist, Dr. Giesbrecht aka Dr. Popsicle, on hypothermia and crevasse rescue[i].


All of this led me to write this article. Let’s talk about what’s going on physiologically when we get cold, discuss the decision process needed to determine when it is causing a problem, and the actions to take to prevent it from becoming something significant (AKA hypothermia).


So, first things first, cold will always be a problem when we are losing heat faster than we can replace it.


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Scoring a Wilderness Medicine Job

A Guide to Jobs in Wilderness Medicine


Gaining a wilderness medicine certification is an asset to anyone’s resume.  For many jobs a Wilderness First Aid (WFA) or Wilderness First Responder (WFR) certification is a requirement.  In other cases, a certification isn’t required but opens up additional doors of opportunity for future work.  Below is a reference of how your certification can help you in a wilderness medicine job. 

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Wilderness Medicine Case Study # 2: Rock Fall on Descent

This accident has been adapted from Accidents in North American Climbing 2021. The accident was real. The discussion of actions is a hypothetical exercise to review wilderness medicine practices and critical thinking in emergencies.

Throughout this case study, I’ll indicate the scene and what happen in italicsQuestions for the reader to consider before moving on are underlined. Everything else will be a discussion of wilderness medicine practices.

skip to the bottom of this post if you prefer to watch the video version of this case study discussion.

The Incident

In this incident, there are two people headed out to explore potential boulders to climb. It is March in the Pacific Northwest, so we can envision a lush, wooded area, with a fair bit of weather swings.  This was during the pandemic, and thus they were trying to be socially responsible by avoiding crowded areas.  In their exploration they used creek beds and erosion pathways to hike off trail.  The incident took place on their descent which was returning the same way they had hiked earlier.

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draws on a route

Wilderness Medicine Case Study 1: Climber Fall


Leader Fall on rock


This accident has been adapted from Accidents in North American Climbing 2021.[i]  The accident was real. The discussion of actions is a hypothetical exercise to review wilderness medicine practices and critical thinking in emergencies.


Throughout this case study, I’ll indicate the scene and what happen in italics. Questions for the reader to consider before moving on are underlined. Everything else is discussion of wilderness medicine practices.

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How to choose between a hybrid WFR vs Traditional

Gut-Z Journey offers 2 different wilderness first responder course formats.  One is a traditional 7 or 8 day course.  The other is a hybrid WFR course, giving you 5 days of in person learning.   It can be hard to decide which is the right course for your needs.  Beyond the obvious difference in class time there are a variety of reasons to choose one course over the other.


Is a Hybrid Course right for you?  Let’s explore some of the pros and cons of both course formats.


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How to choose between a WFA & WFR


The WFA is a two day wilderness first aid course. At baseline this course teaches you everything you would expect out of a basic CPR and first aid class while also expanding in to other common medical, trauma and environmental based injuries.  All of this is accomplished with a wilderness based twist* to providing care.  This 2 day course format allows for a lot more hands on practice and discussion of how to apply the training than a typical one day CPR & First aid class.

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